Client descriptions of outcomes compared with quantitative data: A mixed‐methods investigation of a quantitative outcome measure

Abstract

Aim In this mixed‐methods study, we examined client descriptions of counselling outcomes and how they corresponded with a quantitative measure of change (i.e., Outcome Questionnaire‐45; OQ‐45). Method Using purposeful sampling at a university counselling training centre, we compared 17 clients who had reliably improved, deteriorated or did not change to qualitative outcomes based on post‐counselling interviews using the Change Interview protocol. Results Qualitative outcomes included two Central change categories, the first of which included interpersonal, cognitive and behavioural, affective, and attitude changes. The second Central category of outcomes comprised four areas of change that varied by degree of change expressed (i.e., Problem Resolution, Confidence, Happiness and Changes Affirmed by Others). Congruence was not present between OQ‐45 and Central 1 changes but was present for three of the four Central 2 changes (Problem Resolution, Happiness and Changes Affirmed by Others), all correlating above .60. Conclusion OQ‐45 change scores showed congruence with three qualitative outcomes: degree of expressed improvement in Happiness, Problem resolution and changes noticed by significant others. However, the lack of congruence for Central 1 changes (i.e., Interpersonal, Cognitive and Behavioural, Affective, and Attitude Change) suggests a diverse range of outcomes important to clients that go undetected using the OQ‐45. We strongly encourage further mixed design research to better understand how best to appraise clinical improvement.

Community‐based counselling for benzodiazepine withdrawal: A mixed‐methods study of client outcomes

“…In addition, two client‐reported outcome ratings were also administered. Leibert et al (2020) have argued that mixed‐methods outcome research uses a variety of quantitative measures, given the challenges in capturing change during counselling. Moreover, single group designs using paired data help control for individual differences in outcomes.…”

Clients’ influence on psychotherapists and the treatment they provide.

“…Gathering client feedback and inputs to "take the temperature" of the treatment and the therapeutic relationship may be commonsensical these days (Duncan et al, 2011;Heinonen & Nissen-Lie, 2020;Leibert et al, 2020). However, Alfred Adler introduced one of the earliest clinical tools for collecting and using client inputs to determine the direction of treatment.…”