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Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance
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“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
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How we should measure "change": Or should we?
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“Further, Jacobson et al. (1984) propose the value of 1.96 as the cut-off point to describe clinically relevant change.”
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“Jacobson, Follette, and Revenstorf (1984) proposed the use of a reliable change index where RCI = X2 − X1/SEM and RCI = reliable change index X1 = pretest score X2 = posttest score SEM = standard error of measurement.”
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Evaluation of paraffin bath treatment in patients with systemic sclerosis
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Prediction of depression in systemic lupus erythematosus patients using SF-36 Mental Health scores.
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“Forty-four percent (57/131) of patient outcomes examined met recommended criteria for “recovery” (Jacobsen et al., 1984) and significantly more showed clinically significant change.”
BackgroundThe dose response relationship in psychotherapy: Implications for social policy
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Measuring the real impact of accredited offending behaviour programmes
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Differential effects of two forms of psychoanalytic therapy: Results of the Heidelberg-Berlin study
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“In accordance with the proposals by Jacobson, Follette, and Revenstorf ( 1984 , 1986 ) and Jacobson and Truax ( 1991 ), a reliable change index (RCI) was determined for each scale, calculated from standard deviation and reliability of the instrument.”
MethodKropmans, T., Dijkstra, P. U., van Veen, A. V., Stegenga, B., & de Bont, L. D. (1999) · Journal of dentistry research · doi:10.1177/00220345990780081001 · Cited by 71
Hypothesis validity of clinical research.
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Coping strategies for working women: Aerobic exercise and relaxation interventions
Long, B., & Haney, C. J. (1988) · Behavior Therapy · doi:10.1016/s0005-7894(88)80057-1 · Cited by 71
Placebos and common factors in two decades of psychotherapy research.
Horváth, P. (1988) · Psychological bulletin · doi:10.1037/0033-2909.104.2.214 · Cited by 71
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“At the final visit, the therapist specified the reason for discharge: (1) patient achieved all treatment goals, (2) loss of insurance coverage, (3) referral to another practitioner, (4) patient did not appear for appointment, and (5) other.”
BackgroundConsultation-Liaison in Child Psychiatry: A Review of the Past 10 Years. Part I: Clinical Findings
Knapp, P., & HARRIS, E. S. (1998) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199801000-00012 · Cited by 67
Intraindividual Dynamic Network Analysis – Implications for Clinical Assessment
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The effects of behavioral activation therapy with inpatient geriatric psychiatry patients.
Snarski, M., Scogin, F., Dinapoli, E. A., Presnell, A., Mcalpine, J., & Marcinak, J. (2011) · The Behavior Therapist · doi:10.1016/j.beth.2010.05.001 · Cited by 70
Cassel Personality Disorder Study
Chiesa, M., & Fonagy, P. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.176.5.485 · Cited by 70
Stein, J., Luppa, M., Maier, W., Wagner, M., Wolfsgruber, S., Scherer, M., Köhler, M., Eisele, M., Weyerer, S. B., Werle, J., et al. (2012) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2012.01850.x · Cited by 66
“(9), belongs to the most frequently used methods and assesses the extent to which an individual s change in test performance refers to real changes in underlying cognitive abilities and not to chance trends.”
BackgroundLeijten, P. H. O., Raaijmakers, M. A. J., Meij, L. W., Matthys, W., Menting, A. T. A., Putten, M. H.-V., & de Castro, B. O. (2018) · Prevention Science · doi:10.1007/s11121-018-0864-y · Cited by 76
“Following clinical significance guidelines (Jacobson et al. 1984), there was a reduction of 14% in the intervention condition of children who scored above the 90th percentile of conduct problems (24% at pretest, 10% at posttest), relative to a reduction of 6% in the control condition (23% at…”
BackgroundRoberts, L., Neal, D., Kivlahan, D., Baer, J., & Marlatt, G. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.3.500 · Cited by 68
Reduced therapist contact in the cognitive behavioral treatment of panic disorder
Côté, G., Gauthier, J., Laberge, B., Cormier, H., & Plamondon, J. (1994) · Behavior Therapy · doi:10.1016/s0005-7894(05)80149-2 · Cited by 68
Spacing of exposure sessions in treatment of agoraphobia and simple phobia
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A component analysis of a brief psycho-educational couples' workshop: one-year follow-up results
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Measuring Treatment Change in Sex Offenders
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“The Jacobson, Follette, and Revenstorf (1984) method allocates each participant into one of four possible groups.”
MethodToward improved statistical reporting in the journal of consulting and clinical psychology.
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Principles of Defining Reliable Change Indices
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“These measures, which we, following Jacobson et al. (1984), refer to as Reliable Change Indices (RC), are the topic of this article.”
BackgroundBrief group psychoeducation for bulimia nervosa: assessing the clinical significance of change.
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Contrasts and Interactions Redux: Five Easy Pieces
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Multiple Criteria for Evaluating the Magnitude of Experimental Effects.
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Analyzing Therapeutic Change Using Modified Brinley Plots: History, Construction, and Interpretation
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“The Reliability of Change Index (RC) was employed which has been described by Jacobson et al. (1984) as: RC post-treatment pre-treament SE RC is being essentially expressed as an effect size, and any pre post change is significant (at p B/0.05) if RC is greater than 1.64 (i.e. the 5% significance…”
MethodInfluentialPsychopathology in children: Improvement of quality of life without psychiatric symptom reduction?
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“[14,16].”
Delinquency Prevention Through Training Parents in Family Management
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Worry: daily self-report in clinical and non-clinical populations
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Interpreting Statistical Significance and Meaningfulness in Adapted Physical Activity Research
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The Statistical versus Clinical Significance Debate
LeFort, S. M. (1993) · Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.1993.tb00754.x · Cited by 87
Clinical significance of improvement resulting from two behavioral marital therapy components
Jacobson, N. S., & Follette, W. C. (1985) · Behavior Therapy · doi:10.1016/s0005-7894(85)80013-7 · Cited by 50
Self-citationThe Efficacy of Psychological Treatments for Generalised Anxiety Disorder?
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Cognitive-Behavior Therapy for Low Self-Esteem: A Case Example
Mcmanus, F., Waite, P., & Shafran, R. (2009) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2008.12.007 · Cited by 63
Parabiaghi, A., Barbato, A., D'Avanzo, B., Erlicher, A., & Lora, A. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2005.01656.x · Cited by 63
“Reliable change (RCindex; for formula see Appendix) is assessed using a variation on the standard error (SEdiff ; for formula see Appendix) of measurement which considers two subsequent assessments (i.e. baseline and follow-up) [21–23].”
BackgroundTherapeutic outcome assessment in permanent temporomandibular joint disc displacement.
Kropmans, T., Dijkstra, P. U., Stegenga, B., & de Bont, L. D. (1999) · Journal of Oral Rehabilitation · doi:10.1046/j.1365-2842.1999.00417.x · Cited by 63
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Psychological Treatment of Generalised Anxiety Disorder
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The effectiveness of couple therapy in Germany: a replication study.
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THE SENSITIVITY TO CHANGE OF MEASURES FOR OBSESSIVE-COMPULSIVE DISORDER
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Therapeutic alliance: Early indicators, course, and outcome.
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Management of depression in older people with osteoarthritis: A systematic review
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“We have examined each individual article for clinical significance using the Jacobson, Follette, and Revenstorf (1984) criteria for judging published articles whether the intervention(s) was successful in ameliorating depression or not.”
BackgroundMethodSelf-mutilative behaviors in male veterans with posttraumatic stress disorder
Sacks, M. B., Flood, A. M., Dennis, M. F., Hertzberg, M. A., & Beckham, J. C. (2007) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2007.05.001 · Cited by 64
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The effectiveness of marital counseling in Germany : A contribution to health services research
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Changes in the SF-36 in 12 months in a clinical sample of disadvantaged older adults.
Wolinsky, F., Wan, G. J., & Tierney, W. M. (1998) · Medical Care · doi:10.1097/00005650-199811000-00008 · Cited by 61
Cognitive Changes Following Recovery from Depression in a Group Cognitive-Behaviour Therapy Program
Oei, T. P. S., & Sullivan, L. M. (1999) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.1999.00562.x · Cited by 53
“They chose to use normative methods [12,13,15] where post-treatment change in depression can be compared with the distribution of scores for clinically identified but non-distressed persons or for population norms.”
BackgroundMethodBeidel, D. C., Turner, S. M., & Cooley-Strickland, M. (1993) · Behaviour Research and Therapy · doi:10.1016/0005-7967(93)90033-q · Cited by 61
The Significance of Clinical Change and Clinical Change of Significance: Issues and Methods
Ottenbacher, K., Johnson, M., & Hojem, M. A. (1988) · American Journal of Occupational Therapy · doi:10.5014/ajot.42.3.156 · Cited by 60
“The Reliability Change Index (RCI) pro posed by Jacobson, Follette, and Revenstorf (1984) is a more general purpose measure that is useful with outcomes thal are "nondevelopmental" in nature.”
Marie Lincoln, T., Rief, W., Hahlweg, K., Frank, M., Witzleben, I. V., Schroeder, B., & Fiegenbaum, W. (2005) · Psychotherapy Research · doi:10.1080/10503300512331387834 · Cited by 58
“…in the 90 patients who had completed the SCL-IS at post- as well as F1 assessment, we calculated reliable change indexes (RCI) using the formula by Jacobson, Foll- ette, and Revenstorf (1984), with RCI (Mposttest MF1)=SE and SE SDposttest ffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi 1 rxx?…”
MethodInfluentialClaus, B. B., Stahlschmidt, L., Dunford, E., Major, J., Harbeck-Weber, C., Bhandari, R. P., Baerveldt, A., Neß, V., Grochowska, K., Hübner-Möhler, B., et al. (2022) · Pain · doi:10.1097/j.pain.0000000000002636 · Cited by 59
Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes.
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Erectile dysfunction: A review of diagnostic and treatment procedures
Mohr, D., & Larry, E. (1990) · Clinical Psychology Review · doi:10.1016/0272-7358(90)90110-v · Cited by 59
Adherence to guidelines for treatment of depression in in-patients
Schneider, F., Härter, M., Brand, S., Sitta, P., Menke, R., Hammer-Filipiak, U., Kudling, R., Heindl, A., Herold, K., Frommberger, U., et al. (2005) · British Journal of Psychiatry · doi:10.1192/bjp.187.5.462 · Cited by 58
Gabel, C. P., Michener, L. A., Melloh, M., & Burkett, B. (2010) · Journal of Hand Therapy · doi:10.1016/j.jht.2009.09.007 · Cited by 58
“Both criteria were required to categorize a subject as improved or deteriorated.(37) These changes in cut-off values ensured the MCID on the criteria standards.”
BackgroundMethodTHE MARGINALIZATION OF FAMILY THERAPY: A HISTORICAL AND CONTINUING PROBLEM
Shields, C., Wynne, L., McDaniel, S., & Gawinski, B. A. (1994) · Journal of Marital and Family Therapy · doi:10.1111/j.1752-0606.1994.tb01021.x · Cited by 57
Eye movement desensitization and reprocessing for panic disorder: A case series☆
Goldstein, A., & Feske, U. (1994) · Journal of Anxiety Disorders · doi:10.1016/0887-6185(94)00023-9 · Cited by 57
Weisz, J. R., Hawley, K. M., Pilkonis, P. A., Woody, S. R., & Follette, W. C. (2000) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.7.3.243 · Cited by 72
Self-citationWollersheim, J., & Wilson, G. L. (1991) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.22.6.496 · Cited by 56
Weber, M. L., Dean, J.-H. L., Hoffman, N. L., Broglio, S. P., McCrea, M., McAllister, T. W., Schmidt, J. D., Hoy, A., Hazzard, J. B., Kelly, L. A., et al. (2018) · The American Journal of Sports Medicine · doi:10.1177/0363546518765145 · Cited by 57
The Effectiveness of Group Parent–Child Interaction Therapy with Community Families
Nieter, L., Thornberry, T., & Brestan-Knight, E. (2013) · Journal of Child and Family Studies · doi:10.1007/s10826-012-9601-5 · Cited by 55
Harris, M. A., Freeman, K. A., & Beers, M. (2009) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsp009 · Cited by 49
Assessing the clinical significance of change scores following carpal tunnel surgery
Amirfeyz, R., Pentlow, A., Foote, J., & Leslie, I. J. (2007) · International Orthopaedics · doi:10.1007/s00264-007-0471-1 · Cited by 53
“Another distribution method statistic is the reliable change index (RCI) devised by Jacobsen et al. [ 12 ].”
MethodMethodologically Sound, Cost-Effective Research on the Outcome of Couple Therapy.
Christensen, A., Baucom, D. H., Vu, C. T.-A., & Stanton, S. E. (2005) · Journal of Family Psychology · doi:10.1037/0893-3200.19.1.6 · Cited by 53
Lacks, P. B., & Powlishta, K. K. (1989) · Behavior Therapy · doi:10.1016/s0005-7894(89)80122-4 · Cited by 53
Clinically significant change: practical indicators for evaluating psychotherapy outcome.
Tingey, R. C., Lambert, M. J., Burlingame, G., & Hansen, N. B. (1996) · Psychotherapy Research · doi:10.1080/10503309612331331668 · Cited by 55
“We see our work as a refinement and a response to criticisms of Jacobson et al. (1984a) original work, rather than an undermining of CS, and consider this Correspondence concerning this article should be addressed to Richard C. Tingey, V.A. Medical Center, Psychology Service (1 16B), 5901 East 7th…”
MethodCommon measures or common metrics? A plea to harmonize measurement results
de Beurs, E., Boehnke, J. R., & Fried, E. I. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2742 · Cited by 55
von Glischinski, M., Willutzki, U., Stangier, U., Hiller, W., Hoyer, J., Leibing, E., Leichsenring, F., & Hirschfeld, G. (2018) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2179 · Cited by 54
Regan, B., & Varanelli, L. (2013) · International Psychogeriatrics · doi:10.1017/s104161021300152x · Cited by 60
“Seven mild to moderate dementia using ICD-10 criteria (World Health Organization, 1992) (MMSE = 20–30) and a diagnosis of depression using ICD-10 criteria (World Health Organization, 1992) Depression: GDS. Cognition: MMSE Significant change was found in depression levels across preand postintervention (p = 0.007), but…”
MethodInfluentialMachado, P. P. P., & Fassnacht, D. B. (2014) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12048 · Cited by 53
Scholey, K., & Woods, B. (2003) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.368 · Cited by 54
A Legacy Neglected: Restating the Case for Single-case Research in Cognitive-Behaviour Therapy
Blampied, N. (1999) · Behaviour change · doi:10.1375/bech.16.2.89 · Cited by 54
Metadata
- 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)
- 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
- 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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