Counselors in the Managed Care Era: The Efficacy of the Data-Based Problem Solver Model
Eaves, Susan PhD, Emens, Rebecca PhD, Sheperis, Carl J. PhD, Journal of Professional Counseling, Practice, Theory, & Research
It has become increasingly important in the managed care era for counselors to be accountable for the services they provide. This study utilized the Data-Based Problem Solver Model as a guide for counselor preparation and subsequently employed the model in the treatment of 55 participants in a counseling training laboratory. We used a MANOVA Repeated Measures design to analyze the data obtained from the Brief Symptom Inventory, measuring participant symptomology prior to and upon completion of treatment. Results indicate significant improvements in overall client functioning, supporting the efficacy of the DBPS Model.
Increasing attention to the efficacy of mental health treatment has forced practi- tioners to examine interventions and outcomes within the therapy setting. The scientist- practitioner model has been advocated as a guide to increase such effectiveness. The Data-Based Problem-Solver (DBPS), a data-driven model used to increase treatment effectiveness, is a subsidiary of the scientist-practitioner (SP) model. Both the DBPS and SP models have been criticized as lacking empirica 1 evidence supporting their success (Crane 8c Hafen, 2002). The purpose of this research was to investigate the efficacy of the DBPS in treating individuals participating in voluntary counseling sessions, thus providing further evidence in support of the DBPS model as an effective model for reducing symptomology, measuring outcomes, and preparing counselors- in-training for practice in the managed care era. The model was incorporated over the course of five therapy sessions with 55 participants. Pre- and post-measures from the Symptom Inventory were analyzed to obtain therapeutic outcomes for each participant.
Review Of Related Literature
Since the 1970s the healthcare industry, under the rubric of managed care, has been cutting costs. Managed care organizations have eliminated all but what they deem to be medically necessary treatment by establishing a predetermined number of treatment sessions based on the diagnosis (Hayes, R. L. & Dagley, 1996; Kent & Hersen, 2000; Sanchez & Turner, 2003). In order to practice and be competitive during the managed care era, counselors must be able to provide proof that interventions used are research based, empirically sound (Crane & Mc Arthur, 2002; Kent & Her sen, 2000), and result in desired outcomes (Hayes, S. C, Barlow, & Nelson-Gray, 1999; Kent & Hersen, 2000). With evidence-based treatment becoming a focus of practice and training, attention has been directed to the scientistpractitioner model as a way to bring closer the subjective experiences of therapy and the objective evidence of science, thus leading to more effective treatment, and thereby saving money (Corrie & Callanan, 2001).
Hayes, S. C. et al. (1999) reported that a critical component of training counselors to function in the managed care era involves teaching them to function as scientist-practitioners. According to Stoner and Green (1992) the scientist-practitioner model was developed for use in clinical psychology in 1949. The American Association of Counseling and Development acknowledged the scientistpractitioner model as the "model for preparing individuals to function in counseling" (Howard, 1985; p. 39). The impetus for developing the SP model was to combine both clinical and research training, leading to an integration of research and therapy, thus making both more meaningful and efficacious (Crane & McArthur, 2002). Through this model, counselors act as consultants who monitor symptoms and evaluate tretment outcomes (Austad, 2000). Counselor educators espousing the scientist-practitioner model encourage counselors-in-training to approach all cases as formal research projects and to use empirical evidence in everyday practice (Cherry et al, 2000; Hayes, S. C. et al., 1999; Lampropoulos &C Spengler, 2002; Wakefield & Kirk, 1996.)
As part of the SP model, three roles have been delegated to the practicing counselor: (a) producers of new data, (b) consumers of research, and (c) evaluators of effective therapy. …