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Brief Reports   |    
Patient-Clinician Agreement on Treatment Type and Helpfulness: Results From a WTC Rescue and Recovery Worker Cohort
John Leikauf, M.D.; Clyde B. Schechter, M.A., M.D.; Kathryn Marrone, L.C.S.W.R.; Fatih Ozbay, M.D.; Alison Rapoport, M.D.; Vanshdeep Sharma, M.D.; Craig L. Katz, M.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.201200402
View Author and Article Information

Dr. Leikauf, Dr. Ozbay, Dr. Sharma, and Dr. Katz are affiliated with the Department of Psychiatry, and Ms. Marrone is with the Department of Social Work, all at the Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl., Box 1230, New York, NY 10029 (e-mail: john.leikauf@mssm.edu). Dr. Schechter is with the Departments of Family and Social Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, New York. Dr. Rapoport is with the Department of Internal Medicine, Cambridge Health Alliance, Cambridge, Massachusetts. A poster version of this report was presented at the Institute on Psychiatric Services, New York City, October 4–7, 2012.

Copyright © 2013 by the American Psychiatric Association

Abstract

Objective  This study assessed patient and clinician agreement about treatment type and its association with treatment helpfulness among World Trade Center rescue and recovery workers.

Methods  A total of 187 outpatients and 280 clinicians completed a survey, which gathered information on patient characteristics, treatment types, and treatment helpfulness. Kappa statistics and sensitivity and specificity analyses were used, and the association between patient-clinician agreement and reported treatment benefit was determined.

Results  Patient-clinician agreement was highest for group therapy, medication management, eye movement desensitization and reprocessing, and couples therapy. Agreement about medication management, individual psychotherapy, and workers’ compensation evaluation was associated with higher reported treatment benefits.

Conclusions  Findings support the hypothesis that agreement regarding treatment type is associated with higher reported benefit and extend findings of previous studies to a linguistically diverse, naturalistic sample exposed to a disaster trauma. Results also highlight the need for better understanding of eclectic therapies offered in real-world clinical practice.

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Anchor for Jump
Table 1Patient-clinician agreement regarding treatment type among 187 World Trade Center rescue workers and their clinicians
Table Footer Note

a Eye movement desensitization and reprocessing

Table Footer Note

b Mann-Whitney U test, p=.05 for internal benefit

Table Footer Note

c Mann-Whitney U test, p=.05 for external benefit

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