Inpatient and Residential Treatment - correct answer Very Resource Intensive
-Average cost for 1 month of inpatient treatment in US is $30,000
-Average duration of residential treatment in US is 83 days with average cost of $956/day or an average
total cost of $79,348 - back in 2006, so likely much more today
Inpatient treatment reserved for medically severe cases and those at risk for suicide
Residential treatment limited to individuals with resources (insurance or income) to cover costs
Outpatient Treatment - correct answer Costs substantially lower for outpatient than
inpatient/residential treatment setting:
$4,000 for full course of cognitive-behavioral therapy at $200/hour
$1,689 for full course of CBT with Medicare/Medicaid reimbursement level
However, have to consider safety and efficacy
-If someone is at the risk of death or disability, then outpatient treatment may not be cost effective
(saving money would not offset cost of disability or death)
,How do we know if treatments work? - correct answer Have to compare effect of
treatment against control condition in controlled studies
-Within-subject Design
-Between-subject Design
Within-Subject Design - correct answer Within-subject design participant serves as
her own control (AB, ABA< or ABAB)
A. Establish patient's baseline symptom level
B. Begin Treatment - reassess symptom level
A. Discontinue or alter effective component of treatment - reassess symptom level
-If they are getting better, you will figure out which aspect is helping them to recover, if they continue to
improve, that is not the aspect helping them
B. Resume treatment - reassess symptom level
If treatment is impacting symptoms, then changes in symptoms should be observed with changing
presence/absence of active treatment
Agras et al. 1974 - correct answer Active treatment is using positive reinforcement
(TV time, socialization with others) to increase caloric intake
-Increase in caloric intake and weight
-After taking positive reinforcement away, caloric intake drops dramatically, but weight only decreases a
little bit
-After reading positive reinforcement, weight and caloric intake both go up
-This shows that in this case, positive reinforcement is affective
Limits of Within-Subject Design - correct answer -Limited generalizability - what
worked for one patient may not work for other
-Once patient is recovered, never have the opportunity to test whether a different treatment would
have been better or worse
-Not ethical to withhold treatment that you know works
, Between-Subjects Design - correct answer Between-subject design compare
outcome between people who receive intervention vs. people who do NOT receive intervention
-One group of people gets active treatment
-The other group does not and is the control group; different people are the controls
-In this design, IV is the treatment condition (group) patients belong to
DV: recovery
Randomized Controlled Trial (RCT) - correct answer -Randomly assigned: Active
treatment group gets treatment
-Measure outcome in both groups
Importance of Random Assignment - correct answer -Increases representativeness
of those in a condition to the population seeking treatment
-Reduces likelihood that differences before treatment (e.g. differences in symptom severity) influence
comparison of outcomes between conditions
Empirically Supported Interventions - correct answer -Interventions that produce
superior outcomes compared to control conditions (no treatment/waitlist or placebo or alternative
treatment)
-Also known as evidence-based treatments
Different Control Conditions = Different levels of Support - correct answer Between-
Subject Design
-Waitlist Control:
Compare people who receive intervention to people placed on a waiting list for treatment
Placebo Control:
Compare people who receive intervention to people who receive fake treatment
Alternative Treatment Control:
Compare people who receive intervention to people given a different kind of intervention
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