EFFECTIVENESS OF PSYCHOTHERAPEUTIC CARE WITHIN PREVENTIVE PROGRAMS OF HEALTH INSURANCE COMPANIES

Objectives. This study aimed to (1) examine the magnitude of therapeutic change occurring among clients in mental health insurance pre-- vention programs and (2) to find predictors of this change. Sample and settings. N = 2059 clients (78% fe-- male) completed depression (PHQ-9), anxiety (GAD-7), and somatization (PHQ-15) question-- naires at the beginning and end of therapy, but no later than after the tenth session. The sample included therapies initiated in 2022 in the con-- text of one of the preventive programs of Czech health insurance companies. Psychotherapy was conducted by 228 therapists. Hypotheses. Positive changes in depression, anxiety, and somatization were expected after psychotherapy. An interaction between base-- line outcome severity and final outcome was expected. Statistical analyses. The magnitude of change and its predictors were estimated using a se-- ries of multilevel models in which the effect of therapist (random effect) and other intervening variables were controlled. Percent change was expressed by categorizing clients into recov-- ered, improved, no change, and deteriorated, using the concepts of statistically reliable and clinically significant change. Results. The effect size was d =-0.57 for de-- pression, d =-0.62 for anxiety, and d =-0.40 for somatization. For the clinical part of the sam-- ple, the effect size was d =-1.05 for depression, d =-1.26 for anxiety, and d =-0.86 for somatiza-- tion. Except for the baseline outcome severity, no substantive predictor of therapeutic change was found on either the client or therapist side. Limitations. The absence of a control group made it impossible to distinguish the effect of the therapeutic intervention from other sources of change. Only selected indicators of psycho-- pathology were monitored. Results cannot be generalized outside the context of short-term individual psychotherapy provided in private practice.