Presidential address: What we have learned from a decade of research aimed at improving psychotherapy outcome in routine care

The findings of a decade-long program of research aimed at tracking patient treatment response are summarized. Outcome measures were developed and applied on a weekly basis with patients undergoing therapy in routine practice. Treatment response was defined as reliable and clinically significant change, and longitudinal statistical models for identifying poor progress were applied. The author was able to estimate the amount of therapy necessary for recovery, study early dramatic improvers, and assess the consequences of providing practitioners with alarm signals when patients were off track for a positive outcome. Results indicate that integrating treatment response research into routine mental health care reliably improved positive outcomes and reduced negative outcomes. Future directions for this line of action research are suggested.