Systematic Treatment Selection for General Outpatient Populations

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CEs

DIAGNOSIS: Mixed Anxiety Conditions
TREATMENT: Systematic Treatment Selection for General Outpatient Populations

2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Strength of Research Support

Empirical Review Status

2015 Criteria
(Tolin et al. Recommendation)

Very Strong

Strong

Weak

Insufficient Evidence

Treatment pending re-evaluation

1998 Criteria
(Chambless et al. EST)

Strong

Modest

Controversial

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Brief Summary

Basic premise: STS is an evidence based treatment that uses empirical principles to compile an integrated treatment plan to identify procedures that optimize clinical change, based on clients’ personal qualities and problem characteristics. Therapists can use STS principles within or across theories to tailor treatment for their client’s needs.
Essence of therapy: STS is a “prescriptive psychotherapy” which guides therapists as they choose procedures and treatment modalities from a wide variety of approaches by following evidence driven principles of change. STS therapy integrates both cognitive behavioral and psychodynamic therapies with regard to clients’ coping styles.
Length: STS therapy is conducted within a framework of 8 to 24 sessions. The length varies with clients’ levels of functional impairment, readiness for change, and therapists’ flexibility to select and use effective interventions that fit the patient. The effects are generally retained over 6 and 12 month follow ups.

Treatment Resources

Editors:Larry E. Beutler, PhD; Satoko Kimpara, PhD; Kimberley Miller, MS; Dennis Heller, MS

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals Training Resources Measures, Handouts and Worksheets Self-help Books Smartphone Apps Video Demonstrations Video Descriptions Clinical Trials Meta-Analyses and Systematic Reviews Other Treatment Resources

Treatment Manuals / Outlines

Treatment Manuals

Books Available for Purchase Through External Sites

Prescriptive Psychotherapy (Beutler & Harwood, 2000)
Guidelines for the Systematic Treatment of the Depressed Patient (Beutler, Clarkin, & Bongar, 2000)
Principles of Therapeutic Change that Work (Castonguay & Beutler, 2006)
Principles of Psychotherapy Change that Work: Applications, Vol II (Castonguay, Constantino, & Beutler, coming in 2019)

Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Smartphone Apps

STS Innerlife Smartphone Apps (Beutler & Heller, 2017)

Video Demonstrations

ICP 2016 Invited Symposium (46 minutes) (Beutler, 2016)
Selecting the Most Appropriate Treatment for Each Patient (Interview) (Beutler, 2016)
Larry Beutler & Robbie Playing Without a Bridle (Beutler, 2010, Nature of Our Relationships)

Videos Available for Purchase Through External Sites

Evidence-Based Treatment: Systematic Treatment Selection (Beutler, 2007, APA Systems of Psychotherapy Video Series)

Clinical Trials

Predictors of differential response to cognitive, experiential, and self-directed psychotherapeutic procedures (Beutler et al., 1991)
Looking for differential effects: Cross-cultural predictors of differential psychotherapy efficacy (Beutler, Mohr, Graw, Engle, & MacDonald, 1991)
Differential patient X treatment maintenance of treatment effects among cognitive, experiential, and self-directed psychotherapies (Beutler, Machado, Engle, & Mohr, 1991)
Interactions between psychotherapy process and patient attributes that predict alcohol treatment effectiveness: A preliminary report (Karno, Beutler, & Harwood, 2002)
A comparison of the Dodo, EST, and ATI indicators among co-morbid stimulant dependent, depressed patients (Beutler et al., 2003)
Common and specific effects of couples treatment for alcoholism: A test of the generic model of psychotherapy (Harwood, Beutler, Castillo, & Karno, 2006)
Common, specific and treatment fit variables in psychotherapy outcome (Beutler, Forrestor, Gallagher-Thompson, Thompson, & Tomlins, 2012)
Evidence-based supervision: Tracking outcome and teaching principles of change in clinical supervision to bring science to integrative practice (Holt et al., 2015)
Are all cognitive therapies alike? A comparison of cognitive and non-cognitive therapy process and implications for the application of empirically supported treatments (ESTs) (Malik, Beutler, Alimohamed, Gallagher-Thompson, & Thompson, 2003)

Meta-analyses and Systematic Reviews

Coping Style (2nd ed.; Beutler, Harwood, Kimpara, Verdirame, & Blau, 2011)
Resistance/Reactance Level (2^nd ed.; Beutler, Harwood, Michelson, Song & Holman, 2011)
Coping Styles (3^rd ed.; Beutler, Edwards, Kimpara, & Miller, in press)
Reactance/Resistance (3^rd ed.; Edwards, Beutler, & Someah, in press)

Other Treatment Resources

Common, specific, and cross-cutting psychotherapy interventions (Beutler, Forrester, Holt, & Stein, 2013)
Systematic Treatment Selection (STS) and Prescriptive Therapy (Beutler, Harwood, Bertoni, & Thomann, 2002)
Integrative and Eclectic Therapies in Practice (Beutler, Consoli, & Williams, 1995)
Making assessment relevant to treatment planning: The STS clinician rating form (Fisher, Beutler, & Williams, 1999)

DIAGNOSIS: Mixed Anxiety Conditions TREATMENT: Systematic Treatment Selection for General Outpatient Populations

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators. Modest: Support from one well-designed study or several adequately designed studies. Controversial: Conflicting results, or claims regarding mechanisms are unsupported.