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 1,294Psychotherapy Techniques and ApplicationsMeta-analysis and systematic reviewsPsychology Research and Bibliometrics

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

Jacobson, Neil S., Follette, William C., Revenstorf, Dirk·1984·Behavior Therapy

DOI 10.1016/s0005-7894(84)80002-7

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A change of 6.39 points on the Y-BOCS was considered reliable.
“A change of 6.39 on the Y-BOCS was considered reliable.”
From A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder (2010) · cites this paper as Jacobson, Follette, & Revenstorf, 1984

SOCIAL VALIDITY: THE CASE FOR SUBJECTIVE MEASUREMENT or HOW APPLIED BEHAVIOR ANALYSIS IS FINDING ITS HEART <sup>1</sup>
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Kazdin, A. E. (1977) · Behavior Modification · doi:10.1177/014544557714001 · Cited by 1,117 · see citing works

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“To determine whether or not the magnitude of change was statistically reliable, we proposed a reliable change index (RCI; Jacobson, Follette, & Revenstorf, 1984 ). There were mathematical problems in our original formula for the RCI pointed out by Christensen and Mendoza (1986) . In response to their suggestions, the…”
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“In psychotherapy research, one of the most widely used methods for clarifying the clinical meaningfulness of change is clinical significance (Jacobson et al., 1984; Jacobson & Truax, 1991).”
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“PGIC scale* % (n) % (n) 1) No change or worse 6.1 (10) 2.0 (2) 2) Almost the same 2.4 (4) 2.0 (2) 3) A little better 7.3 (12) 5.0 (5) 4) Somewhat better 2.4 (4) 8.0 ( 8 ) 5) Moderately better 24.9 (41) 20.0 (20) 6) Better 39.4 (65) 37.0 (37) 7) A great deal better 17.6 (29) 26.0 (26)”
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“The primary index used is effect size, that is, the absolute magnitude of change or the degree to which the treatment group improves relative to control group subjects ( Jacobson, Follette, & Revenstorf, 1984; Rosnow & Rosenthal, 1988).”
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“Kazdin & Wilson, 1978;Jacobson et al, 1984),but there has been little consensus on the criteria for evaluating clinical significance.”
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“Jacobson and colleagues (Jacobson, Follette, & Revenstorf, 1984; Jacobson & Revenstorf, 1988; Jacobson et al., 1999; Jacobson & Truax, 1991) have repeatedly contended that consumers and clinicians “expect to be as normal as their functional counterparts by the time therapy has ended” (Jacobson & Revenstorf, 1988, p. 1…”
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“…need to be considered, including (a) the importance of change, (b) the proportion of treated individuals who change, (c) the breadth of change, (d) the efficiency and cost of treatments, and (e) consumer evaluation of treatment (Kazdin and Wilson 1978; Hugdal and Ost 1981; Jacobson et al. 1984).”
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The Outcome Questionnaire (OQ‐45) in a Dutch population: A cross‐cultural validation
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Variability in outcome and clinical significance of behavioral marital therapy: A reanalysis of outcome data.
Jacobson, N. S., & al, E. (1984) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.52.4.497 · Cited by 195 · see citing works
Self-citation
One-session therapist-directed exposure vs. self-exposure in the treatment of spider phobia
Öst, L.-G., Salkovskis, P. M., & Hellström, K. (1991) · Behavior Therapy · doi:10.1016/s0005-7894(05)80374-0 · Cited by 220 · see citing works
The Relationship Between Visual Analysis and Five Statistical Analyses in a Simple AB Single-Case Research Design
Brossart, D. F., Parker, R. I., Olson, E. A., & Mahadevan, L. (2006) · Behavior Modification · doi:10.1177/0145445503261167 · Cited by 217 · see citing works
“Jacobson, Follette, and Revenstorf (1984) advocate moving still further, from practical significance to clinical significance, which they define as client improvement from a dysfunctional to functional range of activity.”
Background
Differential treatment responses of TMD patients as a function of psychological characteristics
Rudy, T. E., Turk, D. C., Kubinski, J. A., & Zaki, H. S. (1995) · Pain · doi:10.1016/0304-3959(94)00151-4 · Cited by 215 · see citing works
“This statistical methodology goes beyond the traditional group oriented analyses and provides an indication of the proportion of patients who made statistically reliable and clinically significant improvements (Jacobson et al. 1984; Turk et al. 1992).”
Method
A problem-solving formulation of depression: A literature review and proposal of a pluralistic model☆
Nezu, A. (1987) · Clinical Psychology Review · doi:10.1016/0272-7358(87)90030-4 · Cited by 213 · see citing works
Outcomes of Parent-Child Interaction Therapy: A Comparison of Treatment Completers and Study Dropouts One to Three Years Later
Boggs, S. R., Eyberg, S. M., Edwards, D. L., Rayfield, A., Jacobs, J., Bagner, D., & Hood, K. K. (2005) · Child & Family Behavior Therapy · doi:10.1300/j019v26n04_01 · Cited by 210 · see citing works
“To determine whether the magnitude of change was reliable, a reliable change index (RCI; Jacobson, Follette, & Revenstorf, 1984 ) was used to ensure that the degree of change exceeded the margin of measurement error.”
Method
Mindfulness-Based Cognitive Therapy for Neuroticism (Stress Vulnerability): A Pilot Randomized Study.
Armstrong, L., & Rimes, K. A. (2016) · Behavior Therapy · doi:10.1016/j.beth.2015.12.005 · Cited by 207 · see citing works
Empirically supported religious and spiritual therapies.
Hook, J., Worthington, E., Davis, D. E., Jennings, D. J., Gartner, A. L., & Hook, J. P. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20626 · Cited by 208 · see citing works
Age effects in parent training outcome.
Dishion, T., & Patterson, G. (1992) · Behavior Therapy · doi:10.1016/s0005-7894(05)80231-x · Cited by 208 · see citing works
The efficacy of group psychotherapy for depression: A meta-analysis and review of the empirical research.
McDermut, W., Miller, I. W., & Brown, R. A. (2001) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.8.1.98 · Cited by 206 · see citing works
A perspective on the history of process and outcome research in counseling psychology.
Hill, C. E., & Corbett, M. M. (1993) · Journal of Counseling Psychology · doi:10.1037/0022-0167.40.1.3 · Cited by 181 · see citing works
Reliable and clinically significant change in the clinician-administered PTSD scale for DSM-5 and PTSD checklist for DSM-5 among male veterans
Marx, B. P., Lee, D. J., Norman, S. B., Bovin, M. J., Sloan, D. M., Weathers, F. W., Keane, T. M., & Schnurr, P. P. (2022) · Psychological Assessment · doi:10.1037/pas0001098 · Cited by 199 · see citing works
Effect-Size Measures and Meta-Analytic Thinking in Counseling Psychology Research
Henson, R. K. (2006) · The Counseling Psychologist · doi:10.1177/0011000005283558 · Cited by 200 · see citing works
Relationship Between Therapeutic Climate and Treatment Outcome in Group-Based Sexual Offender Treatment Programs
Beech, A., & Hamilton-Giachritsis, C. (2005) · Sexual abuse. A Journal of Research and Treatment · doi:10.1177/107906320501700204 · Cited by 197
“The Reliability of Change Index (RC) has been described by Jacobson et al. (1984) as:”
MethodInfluential

Authors: Jacobson, N. S., Follette, W. C., & Revenstorf, D.
Affiliations: University of Washington (US)
University of Tübingen (DE)
Corresponding author: Jacobson, Neil S.
ORCID: Jacobson, Neil S.
Venue: Behavior Therapy
Publisher: Elsevier BV
Published: 1984-09
Volume: 15
Issue: 4
Pages: 336-352
ISSN: 0005-7894 (ISSN-L)
DOI: 10.1016/s0005-7894(84)80002-7
OpenAlex: W2086791094
Cited by: 1,294
References: 0
Citations by year: 2026: 15 · 2025: 20 · 2024: 29 · 2023: 26 · 2022: 33 · 2021: 46 · 2020: 34 · 2019: 40 · 2018: 39 · 2017: 39 · 2016: 42 · 2015: 52 · 2014: 45 · 2013: 51 · 2012: 48
FWCI: 19.53
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behavior Therapy (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
Social Sciences › Psychology › Experimental and Cognitive Psychology › Psychology Research and Bibliometrics
Keywords: psychotherapy outcome research, clinical significance, statistical significance, treatment response classification, statistical reliability, treatment outcome assessment

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

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