This study examined sources of therapist effects in a sample of 25 therapists who saw 1,141 clients at a university counseling center. Clients completed the Outcome Questionnaire-45 (OQ-45) at each session. Therapists' facilitative interpersonal skills (FIS) were assessed with a performance task that measures therapists' interpersonal skills by rating therapist responses to video simulations of challenging client-therapist interactions. Therapists completed the Social Skills Inventory (SSI) and therapist demographic data (e.g., age, theoretical orientation) were available. To test for the presence of therapist effects and to examine the source(s) of these effects, data were analyzed with multilevel modeling. Of demographic predictor variables, only age accounted for therapist effects. The analysis with age, FIS, and SSI as predictors indicated that only FIS accounted for variance in outcomes suggesting that a portion of the variance in outcome between therapists is due to their ability to handle interpersonally challenging encounters with clients.
This survey investigated psychologists' use of outcome measures in clinical practice. Of the respondents, 37% indicated that they used some form of outcome assessment in practice. A wide variety of measures were used that were rated by the client or clinician. Clinicians who assess outcome in practice are more likely to be younger, have a cognitive-behavioral orientation, conduct more hours of therapy per week, provide services for children and adolescents, and work in institutional settings. Clinicians who do not use outcome measures endorse practical (e.g., cost, time) and philosophical (e.g., relevance) barriers to their use. Both users and nonusers of outcome measures were interested in similar types of information, including client progress since entering treatment, current strengths and weaknesses, and determining if there is a need to alter treatment. Implications for practicing clinicians are discussed. DEREK R. HATFIELD received his MS in clinical psychology from Ohio University, where he is currently a doctoral student. His primary areas of research are outcome assessment and clinical judgment and decision making. BENJAMIN M. OGLES received his PhD in clinical psychology from Brigham Young University. He is a professor in the Department of Psychology at Ohio University. His research is focused on the assessment of outcome for mental health services. WE THANK Michael J. Lambert for his suggestions concerning this survey and the preparation of this article.
This study reports the development of an instrument to assess the motives of marathon runners. The Motivations of Marathoners Scales (MOMS) contains 56 items distributed across nine scales. Content areas covered included health orientation, weight concern, self-esteem, life meaning, psychological coping, affiliation, recognition, competition, and personal goal achievement. Adequate internal consistency (Cronbach's alpha range .80 to .93), retest reliability (intraclass Rs range .71 to .90), and factorial validity of the scales were demonstrated. Assessment of the relationship between individual MOMS scales and other variables of conceptual relevance documents early evidence for the convergent and discriminant validity of the instrument. Future uses of the MOMS are discussed in light of theoretical, empirical, and practical considerations.
Improving the effects of psychotherapy has been accomplished through a variety of methods. One infrequently used method involves profiling patient outcomes within therapist in order to find the empirically supported psychotherapist. This study examined data collected on 1841 clients seen by 91 therapists over a 2.5‐year period in a University Counseling Center. Clients were given the Outcome Questionnaire‐45 (OQ‐45) on a weekly basis. After analysing data to see if general therapist traits (i.e. theoretical orientation, type of training) accounted for differences in clients' rate of improvement, data were then analysed again using Hierarchical Linear Modeling (HLM), to compare individual therapists to see if there were significant differences in the overall outcome and speed of client improvement. There was a significant amount of variation among therapists' clients' rates of improvement. The therapists whose clients showed the fastest rate of improvement had an average rate of change 10 times greater than the mean for the sample. The therapists whose clients showed the slowest rate of improvement actually showed an average increase in symptoms among their clients. Use of this information for improving quality of patient outcomes is discussed. Copyright © 2003 John Wiley & Sons, Ltd.
Injury prohibiting continued athletic participation has been hypothesized to have a predictable emotional impact on athletes (Rotella & Heyman, 1986). However, the psychological impact of injury has not been well documented. This study examined the psychological reactions to injury among 343 male collegiate athletes participating in 10 sports. All athletes were assessed using measures of depression, anxiety, and self-esteem during preseason physical examinations. Injured athletes along with matched controls were later assessed within one week of experiencing an athletic injury and 2 months later. A 4 x 3 (Injury Status x Time of Testing) repeated measures multivariate analysis of variance (DM MANOVA) revealed that injured athletes exhibited greater depression and anxiety and lower self-esteem than controls immediately following physical injury and at follow-up 2 months later. These findings supported the general observation that physically injured athletes experience a period of emotional distress that in some cases may be severe enough to warrant clinical intervention.
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