RMME/STAT Joint Colloquium
Causal Inference Under Interference in Dynamic Therapy Group Studies
Dr. Susan Paddock
NORC University of Chicago
Friday, April 16th, at 12:00PM ET
Group therapy is a common treatment modality for behavioral health conditions. Patients often enter and exit groups on an ongoing basis, leading to dynamic therapy groups. Examining the effect of high versus low session attendance on patient outcomes is of interest. However, there are several challenges to identifying causal effects in this setting, including the lack of randomization, interference among patients, and the interrelatedness of patient participation. Dynamic therapy groups motivate a unique causal inference scenario, as the treatment statuses are completely defined by the patient attendance record for the therapy session, which is also the structure inducing interference. We adopt the Rubin Causal Model framework to define the causal effect of high versus low session attendance of group therapy at both the individual patient and peer levels. We propose a strategy to identify individual, peer, and total effects of high attendance versus low attendance on patient outcomes by the prognostic score stratification. We examine performance of our approach via simulation, apply it to data from a group cognitive behavioral therapy trial for reducing depressive symptoms among patients in a substance use disorders treatment setting, and discuss the strengths and limitations of this approach.