I believe the paper is highly cited because it shows how to blend research and clinical practice in a way that can enhance practice at little expense to the practioner.

  Does it describe a new discovery or a new methodology that's useful to others? 

  What were some of the circumstances that led you to do this research?  

I have a long-standing interest in patient deterioration and its causes, publishing my first review of this area in 1977. With the advent of managed care and the increasing pressure for accountability and also for efficient yet effective interventions, the tracking of patient response to treatment and ensuring quality of care were natural areas for me to research. This endeavor was also made possible at this time because of the availability of computer technology and new statistical methods. At the request of a managed care company I developed a reliable and valid outcome measure that could be used for tracking client treatment response. Fortunately, I hold an academic position at a very generous university that has supported my work. 

  Could you summarize the significance of your paper in layman's terms?  

The paper is the first in a series of studies that shows how clients who have psychological problems but who are not benefiting from the treatment that is offered can be identified before they leave treatment. Furthermore, if this information is provided to the client's therapist before the client terminates, they have a much better chance of having a positive outcome. In effect, this research offers a practical, inexpensive method for therapists to provide better psychotherapy to their clients.

Michael J. Lambert, Ph.D.
Professor of Psychology
Brigham Young University
Provo, UT, USA