ASSESSING THE FIELD EFFECTIVENESS OF ACCEPTANCE AND COMMITMENT THERAPY - AN EXAMPLE OF THE MANIPULATED TRAINING RESEARCH METHOD

Health care reform and managed care have produced a growing emphasis o n field effectiveness research. The present paper proposes a simple me thodological model for conducting such research that can assimilate al l of the setting features of effectiveness questions while not requiri ng that researchers abandon experimental controls in favor of survey m ethods. This ''manipulated training method'' is then applied to an ana lysis of the field effectiveness of Acceptance and Commitment Therapy (ACT). Seventeen master's-level therapists and one psychologist (those not receiving training = 10; receiving training = 8) participated in a 1-year project. The training package consisted of a didactic worksho p, an intensive clinical training, and monthly supervision groups. Pri or to training and following training the clients of all clinicians in the project were assessed. Among other findings, clients of ACT-train ed therapists reported significantly better coping than the clients of untrained therapists and were more likely to have completed treatment in the 5 months following initiation of treatment. A structural equat ion model indicated that ACT training accounted for differential copin g outcomes. There was also evidence that training improved clients' se lf-ratings of psychological acceptance. At 5 months following the init ial session, clients of ACT-trained therapists were more likely than c lients of untrained therapists to have concluded therapy, and were mor e likely to agree with their clinician regarding the ongoing status of therapy. Implications for research on clinical effectiveness and tech nology transfer of behavior therapy are discussed.