Matching therapists to patients: research

• Better patient outcomes are associated with better matches of therapists to patients.

• PCORI funded a study, Matching Patients with Therapists to Improve Mental Health Care, which tested a system called TOP Match. TOP Match pairs patients and therapists based on how well the therapist has treated patients in the past with similar concerns. Patient surveys were used to rate therapists' strengths in treating specific concerns and issues. The study randomly assigned patients using the TOP Match approach with a clinic's usual approach. 

• After four months, TOP Match resulted in better patient outcomes:

  • greater reduction in general mental health symptoms, impaired functioning, and specific symptoms of concern;

  • more consistent outcomes of treatment;

  • lessened feelings of distress

 

Good matches: putting research into practice

• The TOP Match study was well-designed but small and limited to one geography. The patient population was 89% White, 6% Black, 3% Latino, and 2% were another race. The tool used to rate therapists focused on one measure. Patients were only followed for 4 months. Is it possible to generalize from this study? 

• PCORI is now funding an implementation project of the TOP Match system in 62 mental health clinics in more than 30 states. The project will have two phases:

• Phase 1 will take place in 9 clinics in Pennsylvania and a coordinator is working with patients to select a therapist that is well-matched to their top concerns (as rated by past patients). In addition,

  • staff is being trained to use TOP Match to assign therapists;

  • TOP Match is being added to the electronic health record;

  • each site has a "champion" to promote TOP Match among therapists and clinic staff

  • other support is provided as needed

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Phase 2 will expand further to additional sites in more states. Phase 1 will involve at least 140 therapists and 10,000 patients. Phase 2 will reach 700 more therapists and 50,000 more patients. The project is expected to end by December 2027 and will be evaluated on several outcomes, including patients' "general impairment severity."