Therapist memory for treatment contents: Implications for patient outcomes

OBJECTIVE: This secondary analysis evaluates the impact of therapist memory on patient outcomes in the context of a randomized trial comparing cognitive therapy plus memory support (CT + Memory Support) to cognitive therapy as usual (CT-as-usual). METHOD: Participants were 172 adults (mean age [SD] = 37.46 [15.31]; 62.79% female; 59.88% Caucasian) with major depressive disorder. Patients were treated by 19 therapists (age mean [SD] = 28.4 [5.95] years; 78.95% female; 42.11% Caucasian), with each therapist treating an average of 9 patients. Therapists completed cumulative and past session recall assessments immediately following sessions during weeks 4, 8, and 12, and the final session. Patient depression symptom severity (Inventory for Depressive Symptomatology Self-Report) and functional impairment (World Health Organization Disability Assessment Schedule 2.0) were self-reported at pre-treatment, post-treatment, 6-month (6FU), and 12-month follow-ups (12FU). RESULTS: Multilevel modeling revealed that better therapist cumulative recall predicted lower depression severity from pre-to post-treatment (unstandardized b = -3.43, p < 0.001) and at 6FU (b = -2.72, p < 0.001). Therapist cumulative recall predicted improved patient functional impairment in CT-as-usual only (b = 3.11, p = 0.02). Therapist past session recall (b = -2.68, p = 0.01) predicted improved functional impairment across treatment conditions. All other comparisons were non-significant, but the majority were in the hypothesized direction. CONCLUSIONS: These results signal a relationship between therapist memory and patient outcomes. Future research is needed to verify these findings and investigate ways to optimize therapist memory for treatment.