SOME COMMENTS ON ASSESSING CLINICAL-SIGNIFICANCE

The strategies for extending clinical significance (CS) methodology, s uggested by Tingey et al., have considerable merit. They also serve to highlight the difficulties encountered with CS methodology in general . Problems encountered with the original methodology may be compounded , not solved, by such extensions. For example, problems around lack of agreement about the appropriateness of certain measures, and the ques tionable psychometric properties of measures, are likely to be exacerb ated, not lessened, when attempting to measure social impact. Similarl y, the proposal that multiple normative groups be identified to provid e the impact factor does not resolve the original difficulty of identi fying and discriminating more obviously diverse groups, such as functi onal and dysfunctional. Other problems with the proposed extensions, s uch as using criterion ''c'' (Jacobson and Truax, 1991) with non-norma l distributions, are discussed. Some recommendations regarding these p roblems are made.