Beyond symptom reduction: Development and validation of the Complementary Measure of Psychotherapy Outcome (COMPO).

Abstract

Most measures of psychotherapy outcome focus on symptomatic change. However, clients often report other changes through therapy, such as increased self-acceptance. This study reports on the development and validation of the Complementary Measure of Psychotherapy Outcome (COMPO) that assesses different areas of psychological functioning deemed important by clients and therapists. Items were written based on a literature review of client-reported change and feedback from experienced therapists. Exploratory factor analysis was conducted on the initial 42-item COMPO administered to 264 psychotherapy clients. Iterative item reduction resulted in the final 12-item, four-factor solution, with factors named self-acceptance, selfknowledge, relationship quality, and consideration of others. This factor structure, along with a bifactor model that contains a general factor and the four domain-specific factors, was replicated on a sample of 571 adults in the community. The 12-item COMPO exhibits convergent validity with measures of self-esteem, insight, social support, and empathy; demonstrates 2-week test-retest reliability; and predicts life satisfaction. The 12-item COMPO was further administered to 28 clients in short-term psychodynamic therapy for depression. Except for consideration of others, COMPO subscales and total scale scores improved from pre-to posttherapy. Posttherapy COMPO scores were also higher among clients who experienced clinically significant change compared to those who did not. The COMPO was negatively associated with depressive symptoms and impairments in functioning across the three samples. The brevity of the COMPO makes it a convenient tool to supplement symptom-based measures for a more comprehensive assessment of outcome in psychotherapy. Public Significance StatementThe goal of psychotherapy does not only include the reduction of psychological symptoms, yet most outcome measures focus on symptom change. A new measure is developed to assess nonsymptomatic changes that patients and therapists care about in therapies across theoretical orientations.

Therapist emotion and emotional change with clients: Effects on perceived empathy and session quality.

“…Although Rogers’s definition of empathy implicates the therapist to move toward the client’s inner experience (Rogers, 1995), recent writings emphasize emotional coregulation where both the therapist and the client mutually influence each other (Fosha, 2001; Hilpert et al, 2020; Li & Kivlighan, 2020). For the client, learning to empathize with others (Chui et al, 2021; MacFarlane et al, 2017; Yalom, 2002), in this case to the therapist’s emotional experience, may be an important part of the psychotherapy process and also interpersonal learning and growth. A recent study also showed that mutual influence between therapist and client is associated with positive client outcome (Li, 2021).…”

Italian validation of the Clinical Outcomes in Routine Evaluation 10 (CORE-10): a short measure for routine outcome monitoring in clinical practice

“…Psychological Functioning. The Complementary Measure of Psychotherapy Outcome (COMPO-12; Chui et al, 2021) is a self-report questionnaire consisting of 12 items that evaluates the psychological functioning deemed important by clients and therapists. A multi-step strategy was adopted for the translation of the COMPO-12 starting from the original English version developed by Chui (2021).…”

Psychotherapy skills and methods: Introduction to the special issue.

“…Posttreatment outcomes are typically assessed through clients completing standardized, psychometrically sound self-report measures before beginning psychotherapy and then again at its completion (and sometimes at intervals within treatment). Examples of such distal measures include the Beck Depression Inventory (Beck et al, 1961) and the Complementary Measure of Psychotherapy Outcome (Chui et al, 2021). In the vast majority of published randomized clinical trials comparing the relative efficacy of two or more treatment packages, the difference in distress between the start and the end of treatment constitutes the primary index of success.…”