Measuring Change Throughout the Duration of Therapy

The most common way to assess the outcome of therapy is to gather information relating to well-being, functionality, and problems that brought someone to therapy, and to do this both at the beginning of therapy and again at the conclusion of therapy. This allows a therapist, and the person attending therapy, to see the progress they have made and determine what areas may still need to be addressed in the future. Unfortunately, this outcome measure is rarely accurate, because a large number of people who receive cognitive therapy or talk therapies drop out prior to therapy conclusion.

Therefore, Slawomir Czachowski of the College of Medicine at the Nicolaus Copernicus University in Poland recently led a study utilizing a revised outcome tool. Czachowski altered the Psychological Outcome Profiles (PSYCHLOPS) tool to include questions pertaining to problems that could arise during therapy, not just those that were present when therapy began. Further, Czachowski repeatedly administered the revised PSYCHLOPS throughout the therapy process to gauge progress along the way.

Using a sample of 238 clients, Czachowski administered pre-therapy, during therapy, and post-therapy surveys. A total of 135 people completed all three assessments. The results revealed that those who experienced valid change increased from 56% to 81%. This suggests that the revised PSYCHLOPS method captured more accurate data than the traditional delivery method, or more change occurred because PSYCHLOPS was repeatedly administered.

Czachowski also discovered that 60% of the completers reported new problems during therapy. However, these problems were not more severe than any that they presented with and the level of change that occurred with respect to these new problems was equal to that that occurred for the prior existing problems.  In fact, completers were more likely to have new problems arise during therapy, or at least admit them, than those who did not complete therapy.

Another interesting finding was that during therapy PSYCHLOPS allowed Czachowski to recognize that non-completers had the lowest PSYCHLOPS scores before and during. This could help therapists identify and take steps to help those most at risk for early drop out. In sum, these results support intermittent PSYCHLOPS to measure therapeutic outcome. “A large proportion of outcome data is lost when outcome measures depend upon completed end of therapy questionnaires,” said Czachowski. “The use of a during-therapy measure increases data capture.”

Reference:
Czachowski, S., Seed, P., Schofield, P., Ashworth, M. (2011). Measuring psychological change during cognitive behaviour therapy in primary care: A Polish study using ‘PSYCHLOPS’ (Psychological Outcome Profiles). PLoS ONE 6(12): e27378. doi:10.1371/journal.pone.0027378

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  • Nan

    Nan

    October 19th, 2013 at 6:05 AM

    While I do find this very interesting and I know that data compilation has to help both clients and therapists alike I do have concern that some of these tools would be a little too subjective and that the results could then say what you wanted them to say instead of being based on hard data. Does anyone else have these same concerns or is that me just being kind of old and crotchety?

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