A review of the adult psychotherapy outcome literature reveals decades of empirical studies that support the efficacy of group treatment for mental health concerns (Burlingame, Fuhriman, & Mosier, 2003; Horne & Rosenthal, 1997). Although research demonstrates positive results for the utilization of group therapy, between 33-50% of clients drop out before treatment is completed (Baekeland & Lundwall, 1975; Wierzbicki & Pekarik, 1993). Methods for improving psychotherapy retention have been addressed through the application of a client feedback model (i.e., monitoring treatment outcome routinely). Although using client feedback has been found to be beneficial for improving retention and even enhancing client outcome in both individual (Lambert et al., 2001a; Lambert et al., 2002; Miller, Duncan, Brown, Sorrell, & Chalk, 2006; Reese, Norsworthy, & Rowlands, 2009; Whipple et al., 2003) and couples psychotherapy (Anker, Duncan, & Sparks, 2009; Reese, Toland, Slone, & Norsworthy, 2010), evidence of client feedback efficacy in a group format is limited but worthy of investigation given the positive individual and couples therapy findings. In the current study, I evaluated the effects of client feedback in group psychotherapy using a randomized clinical trial design. Participants (N = 85) attended psychotherapy groups that were randomly assigned to a client feedback (Feedback) or treatment as usual (TAU) condition. Clients in the Feedback condition were predicted to experience a statistically significantly higher pre-post gain on the ORS compared to group clients in the TAU when controlling for their initial functioning. The effect size (ES) for Feedback between treatment conditions was found to be d = 0.35 on the Outcome Rating Scale when initial treatment functioning was controlled, which is a medium ES (Cohen, 1988). Additionally, statistically significantly more clients in the Feedback condition experienced reliable and clinically significant change, attended statistically significantly more sessions, and dropped out at a lower rate than clients in the TAU condition. Results of this study were similar to those generated by other studies that evaluated the efficacy of client feedback with individuals (Reese et al., 2009) and couples (Anker et al., 2009; Reese et al., 2010). Study limitations and implications for future work are provided.

The fields of quality assurance in higher education and e-learning, or technology-enhanced learning, are current and topical, yet seldom overlap (Reid, 2003). Higher education institutions are experiencing pressure to become more client focused and compete on the global stage, especially with respect to technology-enhanced learning. We are on the brink of a genuine pedagogical revolution (Moon, 2003) and calls for quality promotion, accountability, self-evaluation, value for money and client satisfaction cannot go unheeded. Three knowledge domains provide the context for this study: quality assurance, higher education and web-supported learning. Their intersection locates the research problem that was investigated, namely the quality assurance of web-supported learning in higher education. The research design is an instrumental case study, focusing on web-supported learning as a supportive medium in a flexible, blended learning model at the University of Pretoria, South Africa. The research methods include the literature survey, case analysis meetings, a student survey, lecturer interviews, expert consultation and task teaming. The conceptual framework for this study (Figure 2.5) is based on the confluence of the existing theories: quality assurance theory, instructional systems design and systems theory. The updated conceptual framework (Figure 7.1) and the synthesized findings (Table 7.1) reflect the holistic nature of the process-based quality management system for web-supported learning that characterises this study. The value of this study to the academic community is in the findings, which include a taxonomy of critical success factors for web-supported learning, the identification of factors which promote student and lecturer satisfaction (or frustration) with web-supported learning experiences, and lessons learnt by applying standard quality assurance theory to the instructional design process. The self-evaluation exercise in an academic support unit provides a precedent and contributes criteria that will be useful to the Higher Education Quality Committee in South Africa, as well as to other higher education institutions. / Thesis (PhD (Computer Integrated Education))--University of Pretoria, 2006. / Curriculum Studies / unrestricted

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Patient-focused research systems have been developed to monitor and inform therapists of patients' treatment progress in psychotherapy as a method to enhance patient outcome. The current study examined the effects of providing treatment progress information and problem-solving tools to both patients and therapists during the course of psychotherapy. Three hundred seventy patients at a hospital-based outpatient psychotherapy clinic were randomly assigned to one of two treatment groups: treatment-as-usual, or an experimental condition based on the use of patient/therapist feedback and clinical decision-support tools. Patients in the feedback condition were significantly more improved at termination than the patients in the treatment as usual condition. These findings are consistent with past research on these approaches although the effect size was smaller in this study. Treatment effects were not a consequence of different amounts of psychotherapy received by experimental and control clients. Not all therapists were aided by the feedback intervention.