Michael, B., Kellett, S. and Delgadillo, J. orcid.org/0000-0001-5349-230X (2023) Is clinical decision-making in stepped-care psychological services influenced by heuristics and biases? Behavioural and Cognitive Psychotherapy, 51 (4). pp. 362-373. ISSN 1352-4658
Abstract
Background:
The manner in which heuristics and biases influence clinical decision-making has not been fully investigated and the methods previously used have been rudimentary.
Aims:
Two studies were conducted to design and test a trial-based methodology to assess the influence of heuristics and biases; specifically, with a focus on how practitioners make decisions about suitability for therapy, treatment fidelity and treatment continuation in psychological services.
Method:
Study 1 (N=12) used a qualitative design to develop two clinical vignette-based tasks that had the aim of triggering heuristics and biases during clinical decision making. Study 2 (N=133) then used a randomized crossover experimental design and involved psychological wellbeing practitioners (PWPs) working in the Improving Access to Psychological Therapies (IAPT) programme in England. Vignettes evoked heuristics (anchoring and halo effects) and biased responses away from normative decisions. Participants completed validated measures of decision-making style. The two decision-making tasks from the vignettes yielded a clinical decision score (CDS; higher scores being more consistent with normative/unbiased decisions).
Results:
Experimental manipulations used to evoke heuristics did not significantly bias CDS. Decision-making style was not consistently associated with CDS. Clinical decisions were generally normative, although with some variability.
Conclusions:
Clinical decision-making can be ‘noisy’ (i.e. variable across practitioners and occasions), but there was little evidence that this variability was systematically influenced by anchoring and halo effects in a stepped-care context.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s), 2023. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies. This is an author-produced version of a paper subsequently published in Behavioural and Cognitive Psychotherapy. Article available under the terms of the CC-BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Cognitive biases; Decision making; Improving Access to Psychological Therapies (IAPT) programme; Interpretation biases; Judgement bias; Psychological Wellbeing Practitioner |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Science (Sheffield) > Department of Psychology (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 17 Mar 2023 12:52 |
Last Modified: | 03 Oct 2024 14:56 |
Status: | Published |
Publisher: | Cambridge University Press |
Refereed: | Yes |
Identification Number: | 10.1017/S1352465823000115 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:197346 |
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