Models of psychotherapy outcome: Are they applicable in training clinics

To explore whether psychotherapy models are applicable in the training clinic setting, the dose-effect model of psychotherapy outcome was tested in the outpatient clinic of an American Psychological Association-approved doctoral training program in clinical psychology. Outcome data, using the Outcome Questionnaire 45.2, were gathered immediately prior to each psychotherapy session during the course of treatment (mean total number of sessions: 14.81). Sixty-one clients, treated by 21 trainee clinicians, participated. Although a similar pattern emerged, response to treatment was not as rapid as the dose-effect model would predict. Ideas for future research are proposed. The dose-effect model of psychotherapy out-come (Howard, Kopta, Krause, & Orlinsky, 1986) emerged from meta-analytic findings spanning 30 years and has spawned renewed interest and research into psychotherapy re-search. However, those analyses did not exam-ine possible site differences (e.g., whether the site was a training clinic) in the dose-effect response. Nevertheless, the relationship between train-ing and treatment outcome has been examined in the literature for decades, and numerous stud-ies have suggested that training is not related to outcome (e.g., Elkin, Parloff, Hadley, & Autry, 1985; Strupp & Hadley, 1979). The few indica-tions that training may correlate with outcome were weak findings and difficult to explain (e.g.