Brian T. Yates

Toward the incorporation of costs, cost-effectiveness analysis, and cost-benefit analysis into clinical research.

Most research in clinical psychology and related disciplines does not measure, report, or analyze costs, cost-effectiveness, or cost-benefit analysis. Reasons for this are discussed. It may be thought, for example, that costs are trivial to measure. Data are presented to show that the values of resources consumed in treatment (i.e., costs) actually can be quite complex to assess accurately and completely. Research findings are assembled to show that costs, as experienced by clients, may be beneficial to assess in that they can be significantly related to the outcomes of treatment. Empirical findings also show that costs also can be useful to measure because costs and outcomes can be related inversely rather than directly (i.e., clients may benefit most from treatments that cost less than several viable alternatives). Finally, perceived impediments to assessing costs and to cost-effectiveness and cost-benefit analysis in psychology are considered. Dialogue is encouraged on the scientific study of relationships between (a) monetary and other costs, (b) treatment techniques and treatment delivery systems, and (c) psychological and economic outcomes.

Analyzing costs, procedures, processes, and outcomes in human services

The Scientist-Manager-Practitioner and Cost - Procedure - Process - Outcome Analysis Cost Assessment Measuring the Value of Resources Used Monitoring Procedures, Processes, and Procedure - Process Relationships Evaluating Outcomes Effectiveness and Benefits Describing and Improving Cost - Procedure - Process - Outcome Relationships

Cost-Effectiveness and Cost-Utility of Cognitive Therapy, Rational Emotive Behavioral Therapy, and Fluoxetine (Prozac) in Treating Depression: A Randomized Clinical Trial

Cost-effectiveness and cost-utility of cognitive therapy (CT), rational emotive behavioral therapy (REBT), and fluoxetine (Prozac) for major depressive disorder (MDD) were compared in a randomized clinical trial with a Romanian sample of 170 clients. Each intervention was offered for 14 weeks, plus three booster sessions. Beck Depression Inventory (BDI) scores were obtained prior to intervention, 7 and 14 weeks following the start of intervention, and 6 months following completion of intervention. CT, REBT, and fluoxetine did not differ significantly in changes in the BDI, depression-free days (DFDs), or Quality-Adjusted Life Years (QALYs). Average BDI scores decreased from 31.1 before treatment to 9.7 six months following completion of treatment. Due to lower costs, both psychotherapies were more cost-effective, and had better cost-utility, than pharmacotherapy: median

Assessing the costs, benefits, cost-effectiveness, and cost-benefit of psychological assessment: we should, we can, and here's how.

26.44/DFD gained/month for CT and

Brief relationship therapy for alcoholism: a randomized clinical trial examining clinical efficacy and cost-effectiveness:

23.77/DFD gained/month for REBT versus

Cost-inclusive evaluation: A banquet of approaches for including costs, benefits, and cost-effectiveness and cost-benefit analyses in your next evaluation

34.93/DFD gained/month for pharmacotherapy, median

Costs of clubhouses: an international perspective.

/QALYs=

Behavioral Child-Management Cost-Effectiveness: A Comparison of Individual In-Office, Individual In-Home, and Group Delivery Systems

1,638,

Predicting obesity reduction in behavioral and nonbehavioral therapy from client characteristics: The self-evaluation measure

1,734, and

Cost effectiveness of three child mental health assessment methods: Computer-Assisted Assessment is effective and inexpensive

2,287 for CT, REBT, and fluoxetine (Prozac), respectively.