Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance

Jacobson, Neil S.; Follette, William C.; Revenstorf, Dirk

doi:10.1016/s0005-7894(84)80002-7

Cited by 1,196 publications

(991 citation statements)

References 24 publications

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“…This test regards the amount of change in scores for the total sample.However, by using t tests, it is not possible to determine a significant change at the level of an individual, which is important in clinical practice. Therefore, we calculated clinically significant change for each child on CBCL and PedsQL scale scores,as defined by Jacobson et al [14,16]. They set a twofold criterion for clinically significant change: (1) the magnitude of the change has to be statistically reliable, and (2) by the end of therapy, an individual should score in the range of normal functioning [15].…”

Section: ■ Statistical Analysesmentioning

confidence: 99%

Psychopathology in children: Improvement of quality of life without psychiatric symptom reduction?

Bastiaansen

Koot

Ferdinand

2005

Europ.Child & Adolescent Psych

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■ Abstract Objective The aim of this study was to assess the association between change in psychopathology and Quality of Life (QoL) across time in children with high levels of psychopathology. Methods A referred sample of 126 seven-to 19-year-olds was studied across a 1-year follow-up period. Information concerning QoL and psychopathology was obtained from parents. Results Overall, 38.1 % of children showed neither psychiatric symptom reduction nor QoL improvement, 33.3 % of children showed both a clinically significant psychiatric symptom reduction and QoL improvement, and 28.6 % of children showed either psychiatric symptom reduction or QoL improvement. In 11

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Section: ■ Statistical Analysesmentioning

confidence: 99%

Psychopathology in children: Improvement of quality of life without psychiatric symptom reduction?

Bastiaansen

Koot

Ferdinand

2005

Europ.Child & Adolescent Psych

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“…In a previous study, a clinically significant reduction in pain severity measured with the reliability change index (11) was found in 42% of the sample and was maintained for 6 months (10). One recent meta-analysis of CBT in patients with FMS, however, questioned the efficacy of CBT (12).…”

Section: Introductionmentioning

confidence: 97%

Responder criteria for operant and cognitive–behavioral treatment of fibromyalgia syndrome

Thieme¹,

Turk²,

Flor³

2007

Arthritis & Rheumatism

102

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Objective. To predict the effects of cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT) in fibromyalgia syndrome (FMS).Methods. A total of 125 patients who fulfilled the American College of Rheumatology FMS criteria were randomly assigned to CBT (n ‫؍‬ 42), OBT (n ‫؍‬ 43), or attention placebo (AP; n ‫؍‬ 40). The pretreatment to 12-month followup reliability change index was used to determine clinically meaningful changes in pain intensity and physical impairment. Multinominal logistic regression analyses were used to determine the predictors of improvement in pain intensity and physical impairment for the entire sample. Analyses of variance were computed to compare the characteristics of responders and nonresponders in each of the 3 interventions. Results. At the 12-month followup, 53.5%, 45.2%, and 5% of patients in the OBT, CBT, and AP groups, respectively, reported clinically meaningful improvements in pain intensity. Similarly, 58.1%, 38.1%, and 7.5% of patients treated with OBT, CBT, and AP, respectively, reported clinically significant improvements in physical impairment. Prior to treatment, the OBT physical impairment responders displayed significantly more pain behaviors, physical impairment, physician visits, solicitous spouse behaviors, and level of catastrophizing compared with nonresponders. The CBT physical impairment responders, compared with nonresponders, reported higher levels of affective distress, lower coping, less solicitous spouse behavior, and lower pain behaviors. Conclusion. The results of this study suggest that pretreatment patient characteristics are important predictors of treatment response and may serve as a basis for matching treatments to patient characteristics. Prospective outcome studies are needed to confirm whether the tailoring of treatment actually leads to better outcomes for patients with FMS.

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“…Using Reliable Change as an evaluation criterion was first suggested over 20 years ago [42] and the technique was described in detail by Jacobson and Truax in 1991 [43]. Since then it has been increasingly used in fields such as psychotherapy, but is much less common in medical outcomes research [19].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Multi-disciplinary Back Pain Rehabilitation Programme—Individual and Group Perspectives

et al. 2008

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Objective: To evaluate the impact of a multi-disciplinary back pain rehabilitation programme using a combination of individual and group change data. Methods: 261 consecutive patients attending assessment for the programme completed the SF-36 questionnaire. Questionnaires were repeated at programme completion and at 6-month follow-up. Reliable Change Index was used to define 'clinical significance' to assess individual change. Results: Half of those considered suitable for the programme subsequently completed it. In group terms, noncompleters scored lower than completers on all SF-36 scales. Statistically significant improvements were evident for those completing the programme (all scales at p< 0.000), with improvement maintained at follow-up. In individual terms, 'clinical significance' was exceeded most frequently in Physical Functioning and Role Physical scales. Whilst some participants lost previous improvements between completion and follow-up, others improved over this time period. The majority of those completing the programme showed improvement in at least one scale. Conclusions: Adding assessment of individual change to traditional group change measures provides greater insight into the impact a rehabilitation programme has upon participants' quality of life. Whilst the programme is clearly effective for those who complete it, work is required to limit post programme deterioration and improve uptake.3

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Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance

Cited by 1,196 publications

References 24 publications

Psychopathology in children: Improvement of quality of life without psychiatric symptom reduction?

Psychopathology in children: Improvement of quality of life without psychiatric symptom reduction?

Responder criteria for operant and cognitive–behavioral treatment of fibromyalgia syndrome

Evaluation of a Multi-disciplinary Back Pain Rehabilitation Programme—Individual and Group Perspectives

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