Objectives: Some of the domains in which more experienced practitioners have been shown to outperform their less experienced colleagues relate to interpersonal skills, that can be measured by...Show moreObjectives: Some of the domains in which more experienced practitioners have been shown to outperform their less experienced colleagues relate to interpersonal skills, that can be measured by performance-based measure called Facilitative Interpersonal Skills (FIS). FIS has been identified as a strong predictor of treatment outcome, yet it is not known whether the FIS score is dependent on therapeutic experience. The present study tested the impact of clinical experience on FIS task performance by examining the influence of experience on FIS total score and the eight domains. Method: A total of 46 clinical psychology master’s students and 94 licensed cognitive-behavioural therapists participated in FIS assessment and provided information on their prior clinical experience. To test the hypotheses the multi-level growth model for repeated measures was employed. Results: Experienced therapists, on average, scored higher on FIS assessment than master’s students. The analyses of individual FIS domains revealed that the therapists performed significantly better on the 5 out of 8 FIS domains. Conclusions: Results were consistent with the hypothesis that the FIS assessment is dependent on one’s level of experience. The results imply that interpersonal skills can be modified through training or over the course of a therapeutic career. Conceptual and practical considerations of the findings are discussed.Show less
The Dutch mental healthcare system can be divided into three echelons: Primary general medical healthcare, Primary Mental Healthcare and Specialized Mental Healthcare. Based on this framework, the...Show moreThe Dutch mental healthcare system can be divided into three echelons: Primary general medical healthcare, Primary Mental Healthcare and Specialized Mental Healthcare. Based on this framework, the Dutch Healthcare Authority has composed different patient profiles for each of the three echelons. This total of patient profiles with associated echelons constitutes the NZA model. The General Practitioner (GP) serves as a "gatekeeper" to adequately refer patients to the appropriate echelon based on initial assessment. Although the model provides a clear overview of the criterion domains that are required per echelon, it is unknown how heavy each criterion domain weighs in the decision outcome, whether using less criterion domains would yield a similar outcome and if some criteria may be moderated by various protective factors. To fill this gap in knowledge, this study focuses on the question: To what extent are the criteria domains redundant and can the NZA-model be replaced by a more comprehensive model without sizeable loss of predictive ability? To answer the research questions, an observational study was conducted at 1008 patients with mental health problems from fifty GP practices in the western part of the Netherlands. This was done in the form of an analysis of data obtained from a screening instrument that was administered as part of regular general practitioner care for clients with a request for psychological help, namely the Decision Support System - Transparent Next (BOI-TN). The BOI-TN survey consists of various internationally known (sub) scales and items and a number of ad hoc questions as an extension of the existing measures. The results of this analysis showed that of all the criteria domains, eleven predictors were found to be significantly predictive of NZA-indicated echelon advice. Especially probable presence of at least one current DSM disorders, positive mental health, developmental disorder and risk of sudden worsening appear to be predictive for the NZA-indicated echelon advice. At a group level, these eleven predictors explain 79.2% of echelon advice. On an individual level, it can be seen that the agreement of the advice of the reduced model with the NZA model, corrected for chance, is 'substantial' to 'almost perfect'. On the basis of the present study, it could therefore be argued that the reduction in the number of variables at both group and individual level still leads to an accurate prediction of the NZA-indicated echelon advice. An important note here is that the reduced model shows that in order to arrive at a good prediction, it is not enough to look only at the presence of a DSM diagnosis. A multidimensional model, with all five criteria domains, is considered necessary to arrive at a reduced model that explains as much of the NZA indicated advice as possible. Several limitations are discussed.Show less
Background: Many individuals with eating disorders (EDs) do not receive appropriate treatment. It is therefore important to make treatment more accessible. This can be done through online...Show moreBackground: Many individuals with eating disorders (EDs) do not receive appropriate treatment. It is therefore important to make treatment more accessible. This can be done through online interventions. Online interventions can be enhanced by the use of guidance, e.g., by expert patients. However, little is known about why and when expert-patient support is effective. Objective: The aim of this study was to clarify why and under which conditions expert-patient support may be effective in reducing ED symptomatology. Specifically, self-efficacy was investigated as mediator and perceived similarity as moderator in the relation between offering expert-patient support and ED symptom reduction. Methods: Participants (n=355) were recruited via the websites of Featback, WEET and Proud2Bme and were aged 16 years or older and had self-reported ED symptoms. They were randomized to four conditions: (1) Featback, an online self-help program for eating disorders (2) Weekly expert-patient support via chat or email, (3) combination of Featback and expert-patient support, and (4) waiting list condition. Online assessments were completed at baseline, post-intervention (8 weeks after baseline), and at one-year follow-up. Outcome measures were ED symptoms, self-efficacy and perceived similarity. Results: Self-efficacy was not a mediator and perceived similarity not a moderator in the relation between expert-patient support and ED symptom reduction. However, perceived similarity, which was not correlated with actual similarity, was a predictor of ED symptom reduction: people who felt more similar to their expert patient experienced a greater reduction in ED symptoms. Conclusions: Findings of this study indicate that people who perceive a higher similarity between themselves and the expert patient have less ED symptoms after one year, suggesting that the treatment of EDs can be enhanced by effective employment of expert patients.Show less
