This study compared the differences in treatment length, cost, cost effectiveness, dropout, and recidivism between a biomedical, talk therapy, and a collaborative mental health model for outpatient psychotherapy insurance claims. A biomedical model was the most cost effective with fewer sessions, but had a significantly higher dropout rate. Collaborative care had the least dropout, but also had higher costs and recidivism rates. Within collaborative care, differences between modality type, diagnosis, and provider type combinations were also examined. Within collaborative models, mixed modes of therapy had the lowest dropout, but at significantly higher costs and recidivism rates. Family therapy had the lowest recidivism and cost, with the highest dropout rate. In terms of specific problems, eating disorders had significantly more sessions and were significantly less cost-effective than any other diagnoses, followed by mood disorders. Relational disorders had the fewest sessions, best cost-effectiveness, and lowest recidivism rates. Finally, the MD/MFT provider type combination had the lowest dropout and recidivism rates, with the lowest cost, and a significantly better cost effectiveness than the MD/psychologist combination. The MD/psychologist combination had a significantly higher recidivism rate, and the MD/MSW combination had the highest dropout. No significant differences were found for any RN/talk therapy combination. Implications of the findings are discussed, along with limitations and future directions for research.



College and Department

Family, Home, and Social Sciences; Marriage and Family Therapy



Date Submitted


Document Type





collaborative care, integrated care, cost effectiveness, family therapy, medical family therapy, health care, bio-psychosocial