ABSTRACT
The meaningfulness of psychotherapy outcome as measured in therapy research is a persistent and important issue. Following a period of emphasis on statistically significant findings for treated versus control groups, many researchers are renewing efforts to investigate the meaningfulness of individual change. Several statistical methods are available to evaluate the meaningfulness of client's changes occurring as a result of treatment. This article reviews the history of the clinical significance concept; describes the various methods for defining improvement, recovery, and clinically significant change; examines current criticisms of the methods; and describes the current use of the methods in practice.
Subject(s)
Outcome Assessment, Health Care , Psychotherapy , Endpoint Determination , Humans , Mental Disorders/therapy , Quality of Health Care , Reproducibility of ResultsABSTRACT
N. S. Jacobson and P. Truax's (1991) method for evaluating the clinical significance of client change has gained some prominence in psychotherapy outcome research. However, little has been done to investigate the validity of this methodology. This study addresses this limitation by comparing (a) the perceived level of change (as subjectively reported from 3 distinct perspectives) across outcome groupings based on Jacobson and Truax's reliable change index (RCI) and (b) subjective reports of therapeutic alliance and satisfaction across outcome groupings. The results of these comparisons indicate that the RCI is effective in identifying those who make reliable improvement in therapy but is less effective in differentiating between no-changers and deteriorators. In addition, the relationship between treatment outcome and satisfaction with service is questioned.
Subject(s)
Mental Disorders/therapy , Outcome and Process Assessment, Health Care , Psychotherapy , Adult , Community Mental Health Centers , Female , Humans , Male , Mental Disorders/psychology , Middle Aged , Multivariate Analysis , Patient Satisfaction , Reproducibility of ResultsABSTRACT
The DEPRESSION Awareness, Recognition and Treatment (D/ART) program under the sponsorship of the National Institutes of Health has made consistent efforts to help educate many communities around the nation about depression. One important aspect of this effort includes offering free screening for depression to the general public. Since new technology often promotes curiosity and interest, a computerized depression screening and awareness program was created to use at fairs and other local events. Individuals who participated completed a computerized version of the Center for Epidemiological Studies Depressed Mood Scale (CES-D) and then received a one page printout that described the common symptoms of depression, a score indicative of their level of depressed mood, a brief explanation of the score, and a telephone number where additional information could be obtained. This paper details the construction of the computerized version of the CES-D including an evaluation of psychometric properties and consumer satisfaction with the program.
Subject(s)
Awareness , Depressive Disorder/prevention & control , Diagnosis, Computer-Assisted , Mass Screening , Personality Inventory , Adult , Attitude to Computers , Consumer Behavior , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Female , Humans , Male , Middle Aged , Personality Inventory/statistics & numerical data , Psychometrics , Reproducibility of Results , SoftwareABSTRACT
The measurement of consumer satisfaction with behavioral healthcare services in increasing with market and regulatory requirements. Some organizations refer to the results of their measures as "outcomes." Some confusion and debate has consequently arisen as to the meaning of consumer satisfaction and its relationship to other types of outcomes. In this article, Lunnen and Ogles refer to existing research to clarify these meanings and relationships.
