Jay L. Lebow

Research assessing consumer satisfaction with mental health treatment: a review of findings.

This article reviews the findings of studies examining consumer satisfaction with mental health treatment. Typically, published studies find the vast majority of patients satisfied with treatment. Despite the numerous methodological problems in this research, it remains highly probable that the majority of consumers are satisfied with the services received. More specific findings in this literature remain less well demonstrated; there generally are few studies relevant to each specific question and the methodology of these studies often has been weak. However, trends point to weak relationships between patient demographic variables and satisfaction; significant relationships between patient diagnosis, treatment history, and psychological status and satisfaction; strong relationships between length of treatment and manner of termination and satisfaction; a strong relationship between satisfaction and patient global report of outcome; and a weak relationship between satisfaction and therapist rating of outcome. Satisfaction also appears to be multidimensional, although a large general factor is evident in most studies. A number of additional findings are catalogued; and research lying outside the formal domain of satisfaction research, but relevant to this body of research, is reviewed.

Consumer Assessments of the Quality of Medical Care

Studies using consumer evaluations of the quality of medical care are reviewed. Important methodological issues in studies using this approach are discussed and future paths for research are presented.

Research Assessing Couple and Family Therapy

CONTENTS INTRODUCTION .. . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . DEFINING THE DOMAIN OF COUPLE AND FAMILY THERAPy . THE EFFICACY OF COUPLE AND FAMILY THERAPY .. . . . . . . . . . . . . . . . . . .... . . . . . . . . . EFFICACY OF SPECIFIC TYPES OF COUPLE AND FAMILY THERAPy ......... . . . . . .. . . . . . . Behavioral Couple and Family Therapy .

Client Satisfaction With Mental Health Treatment: Methodological Considerations in Assessment

This article critically assesses the evaluation of consumer satisfaction in mental health treatment settings. Methodological problems addressed include uniformity myths, inclu sion of items not measuring satisfaction, ambiguity in response alternatives, lack of precision in the use of terminology, failure to distinguish dissatisfaction and lack of satisfaction, failure to sufficiently probe, poor psychometric practice, the absence of accepted measures, failure to identify norms for satisfaction, lack of control over proce dure, sampling bias, biasing responses, the lack of variability in responses, and primitive design , analyses, and reporting. Consumer satisfaction emerges as an important indicator of the quality of care, but one that must be interpreted with caution.

Similarities and differences between mental health and health care evaluation studies assessing consumer satisfaction.

This paper compares the literatures assessing consumer satisfaction with health care and mental health treatment. Similarities and differences in the quantity, origins, quality, methodology, results, and utilization of findings are examined. The similarities identified far outweigh the differences. The trend toward carefully constructed high quality studies in the health care field is seen as suggesting a promising direction for future research.

Integrative family therapy for disputes involving child custody and visitation

This article describes integrative multilevel family therapy for disputes involving child custody and visitation, a multiple-level systems-based treatment specifically targeted at those engaged in intractable conflicts over child custody and visitation. Parents and children engaged in these conflicts are at risk for a variety of difficulties. Key aspects of the approach include the articulation of clear therapy contracts, the utilization of multiple therapy session formats, the maintenance of a systemic perspective, intervention on multiple system levels, the tailoring of intervention strategy based in an assessment of the locus of difficulty in each case, planning for intervention over time, and working at the interface of the legal system in order to impact on these problems.

Pragmatic decisions in the evaluation of consumer satisfaction with mental health treatment.

This article examines pragmatic choices which must be made in conducting consumer satisfaction assessment of mental health treatment. It is argued that choices involving sample, format, and procedure for examining satisfaction may influence the results of such research, and must be considered when creating or evaluating these efforts. These choices are examined in detail.

Evaluation of an Outpatient Pediatric Practice Through the Use of Consumer Questionnaires

Two questionnaires were given to parents accompanying children to an outpatient pediatric center. The first was given to all Ss directly after a care-receiving visit; the second was given one week after the visit only to Ss accompanying Ps receiving throat cultures. Care was judged extremely favorably in both instances. Quality of care measures intercorrelated very highly. No strong relationship was found between length of illness or illness versus absence and rated quality of care received.

You cannot choose what is not on the menu--obstacles to and reasons for the inclusion of relational processes in the DSM-V: comment on the special section.

Relational diagnosis has crucial importance in clinical treatment, but its development and inclusion in systems of classification such as the Diagnostic and Statistical Manual has been constrained by a number of factors. First, there is little consensus about what relational assessment and/or diagnosis entails. A second obstacle is the innate complexity of relational assessment and diagnosis, which results in a lack of definitive, well-accepted, evidence-based operational definitions of difficulties. Third, empirical testing of relational issues has lagged well behind the development of elegant theory. A fourth significant block to including relational disorders in the DSM is the discomfort engendered in some quarters about labeling social difficulties as disorders. Finally, the political process that is part of the evolution of diagnostic systems poses difficulties in the acceptance of new disorders or dimensions. This comment on the articles in the special section on relational disorders of the Journal of Family Psychology addresses how each of these articles contributes to overcoming these constraints.

Assessing Consumer Satisfaction in Mental Health Treatment Settings: A Guide for the Administrator.

This paper offers a guide for administrators of mental health facilities who seek to obtain consumer evaluation data. A number of specific choices in these studies are considered. These include the selection of: the purpose intended for the research, the inclusion of personnel, client groups, and governing boards in the generation of the research, the client sample, the instrument for assessing satisfaction, the method of data collection, the method of presentation of the survey to the consumers, and the timing of the assessment. Issues surrounding consent are also addressed, and a number of additional pragmatic suggestions are offered.