ASSESSING CLINICAL-SIGNIFICANCE - PROPOSED EXTENSIONS TO METHOD

Jacobson, Follette, and Revenstorf's (1984) proposal for assessing cli nical significance provides a needed convention for psychotherapy outc ome research. Several limitations that exist in this method (Jacobson & Revenstorf, 1988) are addressed in this paper and extensions are pro posed. Specifically, limitations regarding the operationalization of t he underlying social validation methodology in the derivation of norma tive samples and the resultant standards they set are discussed. Exten sions and guidelines are proposed for specifying normative samples, de termining the distinctness of these samples, and expanding procedures to accommodate multiple samples. This paper initially assumes a psycho metric perspective and presents extensions, based on the Symptom Check list 90-R. Then it shifts to a clinician perspective and applies relia ble change estimates and cutoff scores to actual outcome data by analy zing the progress of four patients during and after therapy. The overa ll merit and utility of extensions to clinical significance are then d iscussed.