The Annals of Applied Statistics

Analysis of rolling group therapy data using conditionally autoregressive priors

Susan M. Paddock, Sarah B. Hunter, Katherine E. Watkins, and Daniel F. McCaffrey

Full-text: Open access

Abstract

Group therapy is a central treatment modality for behavioral health disorders such as alcohol and other drug use (AOD) and depression. Group therapy is often delivered under a rolling (or open) admissions policy, where new clients are continuously enrolled into a group as space permits. Rolling admissions policies result in a complex correlation structure among client outcomes. Despite the ubiquity of rolling admissions in practice, little guidance on the analysis of such data is available. We discuss the limitations of previously proposed approaches in the context of a study that delivered group cognitive behavioral therapy for depression to clients in residential substance abuse treatment. We improve upon previous rolling group analytic approaches by fully modeling the interrelatedness of client depressive symptom scores using a hierarchical Bayesian model that assumes a conditionally autoregressive prior for session-level random effects. We demonstrate improved performance using our method for estimating the variance of model parameters and the enhanced ability to learn about the complex correlation structure among participants in rolling therapy groups. Our approach broadly applies to any group therapy setting where groups have changing client composition. It will lead to more efficient analyses of client-level data and improve the group therapy research community’s ability to understand how the dynamics of rolling groups lead to client outcomes.

Article information

Source
Ann. Appl. Stat., Volume 5, Number 2A (2011), 605-627.

Dates
First available in Project Euclid: 13 July 2011

Permanent link to this document
https://projecteuclid.org/euclid.aoas/1310562197

Digital Object Identifier
doi:10.1214/10-AOAS434

Mathematical Reviews number (MathSciNet)
MR2840167

Zentralblatt MATH identifier
1223.62163

Keywords
Bayesian modeling hierarchical modeling mental health multilevel modeling substance abuse treatment

Citation

Paddock, Susan M.; Hunter, Sarah B.; Watkins, Katherine E.; McCaffrey, Daniel F. Analysis of rolling group therapy data using conditionally autoregressive priors. Ann. Appl. Stat. 5 (2011), no. 2A, 605--627. doi:10.1214/10-AOAS434. https://projecteuclid.org/euclid.aoas/1310562197


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