Client Outcomes in Graduate Trainee-Provided Psychotherapies: A Mixed Model and Exploratory Analysis

Abstract

Purpose: This study used a linear mixed model and descriptive analysis of quantitative, archival data to evaluate improvement among clients receiving graduate trainee-delivered individual psychotherapy ( N = 421), and for those in dialectical behavior therapy ( n = 52). Method: The OQ 45.2 was administered to clients on a session-by-session basis. This analysis gave attention to an overall course of recovery and to meaningful interaction effects: to those variables serving as potential moderators. We gave attention to both attrition and deterioration, based on Lambert’s earlier observation of this elevated risk among trainees. Results: Analysis showed evidence of client improvement (change over time), broadly. Distinct trajectories emerged early in treatment for participants who went on to improve versus those who deteriorated. Discussion: Clinical and training implications are discussed, including the importance of giving attention to these unique and potentially distinct trajectories early in a clinical relationship.