Extreme deviations from expected recovery curves and their associations with therapeutic alliance, social support, motivation, and life events in psychosomatic in-patient therapy

Abstract

Objectives: Within the clinical support tools (CST) of the OQ-Analyst, the "Assessment for Signal Cases" (ASC) evaluates the therapeutic alliance, social support, motivation, and life events. We investigated whether the ASC covers domains of importance in treatment weeks with extreme deviations from expected recovery curves (ERCs).

Methods: Psychosomatic in-patients were monitored weekly with the ASC and the "Outcome Questionnaire" (OQ-45). The ERCs of the OQ-45 empirical algorithm were used to define treatment weeks with extreme positive deviations (EPD), extreme negative deviations (END), or without extreme deviations (NO). Associations between the ASC scales and EPD as well as END were analyzed by multilevel models.

Results: While each ASC scale was positively associated with EPD, only the social support and life events scales were negatively related to END.

Conclusions: CSTs prioritizing social support and life events might be more effective in preventing treatment failure.

Keywords: clinical support tools; considerable change; monitoring; psychosomatics; psychotherapeutic process.