Stiles, William, Leach, Chris, Barkham, Michael, Lucock, Mike, Iveson, Steve, Shapiro, David A., Iveson, Michaela and Hardy, Gillian E. (2003) Early sudden gains in psychotherapy under routine clinic conditions: Practice-based evidence. Journal of consulting and clinical psychology, 71 (1). pp. 14-21. ISSN 0022-006X

Sudden gains---large, enduring reductions in symptom intensity from one session to the next--were identified by T. Z. Tang and R. J. DeRubeis (1999) on the basis of data from 2 manualized clinical trials of cognitive therapy for depression. The authors found similar sudden gains among clients with a variety of disorders treated with a variety of approaches in routine clinic settings. Clients (N=135 who met inclusion criteria) completed short forms of the Clinical Outcomes in Routine Evaluation (CORE-SF) preceding 7 to 74 individual sessions. Those who experienced sudden gains within their first 16 sessions (n=23) had significantly lower CORE-SF scores in their final 3 sessions than did the other clients.

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