Article

Popular or unpopular? Therapists' use of structured interviews and their estimation of patient acceptance.

University of Basel.
Behavior therapy (Impact Factor: 2.85). 12/2011; 42(4):634-43. DOI: 10.1016/j.beth.2011.02.003
Source: PubMed

ABSTRACT An accurate diagnosis is an important precondition for effective psychotherapeutic treatment. The use of structured interviews provides the gold standard for reliable diagnosis. Suppiger et al. (2009) showed that structured interviews have a high acceptance among patients. On a scale from 0 (not at all satisfied) to 100 (totally satisfied) patients rated overall satisfaction with a structured interview at M=86.55. Nevertheless, therapists rarely seem to use structured interviews in clinical practice. The aim of this study was to assess how frequently therapists use structured interviews in daily practice. Secondly, we hypothesized that therapists underestimate patient acceptance of structured interviews. As a third goal, we explored further reasons why therapists choose not to use structured interviews. We conducted an online survey of 1,927 psychiatrists and psychotherapists in Switzerland and asked them how frequently they used structured interviews and how they estimated patient satisfaction with these interviews. Furthermore, we asked therapists why they chose to use or not use structured interviews. Therapists reported using structured interviews on average with about 15% of their patients. Furthermore, therapists estimated significantly lower patient acceptance than patients themselves indicated (M(therapist)=49.41, M(patient)=86.55). Our data suggest lack of familiarity with these instruments as well as an overestimation of the utility of open clinical interviews as further reasons for not using structured interviews.

Full-text

Available from: Jürgen Margraf, May 22, 2015
0 Followers
 · 
224 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Diagnosing childhood depression can pose a challenge, even for mental health specialists. Screening tools can aid clinicians within the initial step of the diagnostic process. For the first time, the Children׳s Depression Screener (ChilD-S) is validated in a mental health setting as a novel field of application beyond the previously examined pediatric setting. Based on a structured interview, DSM-IV-TR diagnoses of depression were made for 79 psychiatric patients aged 9-12, serving as the gold standard for validation. For assessing criterion validity, receiver operating characteristic (ROC) curves were calculated. Point prevalence of major depression and dysthymia was 28%. Diagnostic accuracy in terms of the area under the ROC curve was high (0.97). At the optimal cut-off point ≥12 according to the Youden׳s index, sensitivity was 0.91 and specificity was 0.81. The findings suggest that the ChilD-S is not only a valid screening instrument for childhood depression in pediatric care but also in mental health settings. As a brief tool it can easily be implemented into daily clinical practice of mental health professionals facilitating the diagnostic process, especially in case of comorbid depression.
    04/2014; 217(3). DOI:10.1016/j.psychres.2014.03.037
  • [Show abstract] [Hide abstract]
    ABSTRACT: Evidence-based assessment (EBA) is an essential component of evidence-based practice. Information obtained from EBA can be used to make decisions about what to target in treatment, to generate a case conceptualization, and to objectively monitor treatment progress. Numerous studies indicate that incorporating EBA into treatment can improve client outcomes. Unfortunately, relative to the amount of information available to clinicians about evidence-based treatments, little information exists to guide clinicians who are interested in incorporating EBA into their treatment practices. This special section seeks to address that gap by providing practical clinical guides and case examples for a variety of EBA strategies across a variety of settings.
    Cognitive and Behavioral Practice 09/2014; DOI:10.1016/j.cbpra.2014.08.001 · 1.33 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Diagnosis of comorbid depressive disorder is challenging, even in mental health care. Screening instruments could be economic tools in indicating depression. For the first time, the current study investigates the validity of the newly developed Depression Screener for Teenagers (DesTeen) and its abbreviated five-item form DesTeen-a in a mental health setting. A total of 88 patients aged 13-16years were recruited in institutions specialized in child and adolescent psychiatry, psychotherapy or psychosomatic medicine. DSM-IV-TR diagnoses of major depression or dysthymia based on a structured diagnostic interview served as the gold standard for validation. For assessing the criterion validity of the DesTeen and the DesTeen-a, areas under the receiver operating characteristic curve (AUC) were calculated. Specificity and sensitivity were computed for optimal cut-off scores according to the Youden Index. Point prevalence of depression was 27.3%. Diagnostic accuracy of the DesTeen was high (AUC=.94). Using a cut-off score of ≥18, sensitivity was .96 and specificity was .86. The DesTeen-a showed no loss in validity (AUC=.94). At a cut-off point of ≥6, sensitivity remained excellent (.96), while specificity was slightly lower (.80). The limited representativeness and the small sample size restrict the generalizability of the findings. The DesTeen and its abbreviated version are valid instruments to screen for adolescent depression in mental health care. Since structured interviews to diagnose comorbid mental disorders are rarely applied, the DesTeen and the DesTeen-a can support mental health specialists in making the diagnostic process more efficient, thus facilitating effective treatment planning.
    Comprehensive psychiatry 03/2014; DOI:10.1016/j.comppsych.2014.03.006 · 2.26 Impact Factor