The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Clinical significance: A statistical approach to defining meaningful change in psychotherapy research.
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In the citing paper
“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 & Truax, 1991
In the citing paper
“The brief version of the World Health Organization Disability Assessment Schedule (WHODAS-II) 47,48 is a 12-item self-report measure that has evidence of reliability and validity for assessing various aspects of psychosocial and physical disability.”
From Acceptance-based Behavior Therapy for Depression With Psychosis (2015) · cites this paper as [48]
In the citing paper
“we examined if the changes in distress tolerance were clinically significant (as indexed by the reliable change index (RCI; Jacobson and Truax, 1991)).”
From Initial RCT of a distress tolerance treatment for individuals with substance use disorders (2012) · cites this paper as Jacobson and Truax, 1991
In the citing paper
“Formative indicators of working memory, inhibitory control, and set shifting were derived, and these participant-level component scores were subjected to reliable change analyses (Jacobson & Truax, 1991) that explicitly account for measurement error to objectively define impairment (Kofler et al., 2016; Sarver et al., 2015).”
From Executive Functioning Heterogeneity in Pediatric ADHD (2019) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“Clinical significance at post-intervention was operationalized by the recommended reliable change index and cut-off points (Jacobson and Truax 1991; Vollestad et la. 2011)”
From CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety (2014) · cites this paper as Jacobson and Truax 1991
In the citing paper
“The reliable change index (RCI) (Jacobson & Truax, 1991) was used as a means of calculating clinical significance of the changes on the TFI.”
From Internet-based cognitive behavioural therapy for tinnitus in Spanish: a global feasibility trial. (2022) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“Patient safety was measured via adverse event monitoring on three indices (1) crisis/home treatment team involvement during the intervention (present/absent and number of treatment days); (2) inpatient hospitalization days during the intervention (present/absent and number of inpatient days); and (3) a reliable deterioration on the CORE-OM (see below) as defined by Jacobson and Truax (1991).”
From Acceptance and Commitment Therapy for perinatal mood and anxiety disorders: A feasibility and proof of concept study. (2020) · cites this paper as Jacobson and Truax (1991)
In the citing paper
“Using Jacobson criteria for defining recovery, 80% of the MCT group were recovered at post-treatment and 12 month follow-up as measured by the Penn State Worry Questionnaire, compared with 10% of patients who had received relaxation.”
From Metacognitive Theory and Therapy for Worry and Generalized Anxiety Disorder: Review and Status (2010) · cites this paper as Jacobson & Truax (1991)
In the citing paper
“Jacobson & Truax (1991) criteria for defining reliable improvement and recovery demonstrated that 87% of patients were recovered at post treatment as assessed by trait-anxiety and 75% remained recovered at 6 and 12 month follow-up.”
From Metacognitive Theory and Therapy for Worry and Generalized Anxiety Disorder: Review and Status (2010) · cites this paper as Jacobson & Truax (1991)
In the citing paper
“Reliable change indices 18 provided fi ner grained detail with a minimum of 15 (44%) inperson participants achieving reliable improvement on at least one measure (CPAQ)”
From A service evaluation to examine the effectiveness of chronic pain management programmes delivered using video conferencing technology compared to in-person (2023) · cites this paper as [18]
In the citing paper
“Caseness data were unavailable for the CompACT-8; therefore, Jacobson and Truax’s “criterion a” was used to tentatively estimate thresholds (Jacobson & Truax, 1991).”
From “I don’t want to take buprenorphine for the rest of my life”: Acceptance and Commitment Therapy for a Client Struggling to Reduce Low-Dose Buprenorphine (a Hermeneutic Single-Case Efficacy Design) (2023) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“The RCI is considered a reliable indicator to test the efficacy of a particular therapy or program and can show whether an individual improves or deteriorates in comparison to pretreatment.”
From THE EFFICACY OF A COMPASSION, ACCEPTANCE AND MINDFULNESS-BASED PILOT INTERVENTION FOR ADOLESCENTS’ TEST ANXIETY: A CASE STUDY USING THE ACADEMIC PROGRAM (2023) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“To determine whether the detected change is in fact reliable, the RCI also considers normative data and the measurement error of the scale (Jacobson & Truax, 1991).”
From THE EFFICACY OF A COMPASSION, ACCEPTANCE AND MINDFULNESS-BASED PILOT INTERVENTION FOR ADOLESCENTS’ TEST ANXIETY: A CASE STUDY USING THE ACADEMIC PROGRAM (2023) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“It was based on the Jacobson and Truax model for clinical significance [27].”
From Virtual reality exposure therapy for fear of spiders: an open trial and feasibility study of a new treatment for arachnophobia (2024) · cites this paper as [27]
In the citing paper
“Reliability of change was calculated based on the reliable change index (RCI) according to Jacobson and Truax (24).”
From Acceptance and commitment therapy in a psychiatric day hospital—A longitudinal naturalistic effectiveness trial (2023) · cites this paper as [24]
In the citing paper
“The SDC and LOA provide indices determining whether the change in scores in a scale can be considered true change or not (Shimoi, 2011) and play similar roles to the reliable change index (Jacobson & Truax, 1991).”
From Reliability and validity of the Japanese version of the experiential avoidance in caregiving questionnaire (EACQ) (2023) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“The patients' psychological inflexibility clinically reduced; that is, most moved from the dysfunctional to the functional group according to the AAQ-II scores (Jacobson & Truax, 1991).”
From Acceptance and commitment therapy for chronic pain: a quasiexperimental study (2023) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“RCIs lower than -1.96 indicate reliable symptom improvement [33].”
In the citing paper
“When the calculated RC score is >1.96, it is unlikely that the change that occurred during the treatment does not reflect real change (46).”
From Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events (2022) · cites this paper as [46]
In the citing paper
“Clinically significant change was defined as the posttreatment score falling below two standard deviations from the mean pretreatment score, i.e.M pre -2 × SD pre (Jacobson & Truax, 1991), in this study 21 points on the PSWQ-C.”
From Intolerance of Uncertainty–Focused Treatment for Adolescents With Excessive Worry: A Pilot Feasibility Study (2020) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“Each RCI calculation (see Table 1) indicated that a reliable change had indeed occurred at the data collection points in August, September, and December for all four measures, with only one exception: Toby’s scores on the PHLMS awareness subscale did not change reliably from June to August.”
From Piloting a New Model for Treating Music Performance Anxiety: Training a Singing Teacher to Use Acceptance and Commitment Coaching With a Student (2020) · cites this paper as Jacobson and Truax, 1991
In the citing paper
“The observed shift in mean depression scores from the moderate level to the mild level represents not only a significant reduction in depressive symptoms from pre- to post-intervention, but also a clinically significant change according to Jacobson and Truax [37] whereby post-treatment scores fall within two standard deviations of the normal population mean score [39].”
From A pilot evaluation of a smartphone application for workplace depression (2020) · cites this paper as Jacobson and Truax [37]
In the citing paper
“This framework is stricter than the most used method advocated by Jacobson and Truax (1991) and does not rely on the conceptual problems of p-values.”
From A Multiple-Baseline Evaluation of Acceptance and Commitment Therapy Focused on Repetitive Negative Thinking for Comorbid Generalized Anxiety Disorder and Depression (2020) · cites this paper as Jacobson and Truax, 1991
In the citing paper
“We did not assess reliable change (Jacobson & Truax, 1991), because, due to our inclusive entry criteria, this would have necessitated post-intervention scores at or above ceiling level for several participants.”
From A pilot case series of a brief acceptance and commitment therapy (ACT)-based guided self-help intervention for improving quality of life and mood in muscle disorders (2017) · cites this paper as Jacobson & Truax, 1991
In the citing paper
“Statistically reliable improvements in score were used to define minimal clinicallyimportant change, in the same way they are used in the national Improving Access to Psychological Therapies programme. 31”
From Cognitive behaviour therapy for long-term frequent attenders in primary care: A feasibility case series and treatment development study (2016) · cites this paper as [31]
In the citing paper
“Figure 1. The equation for calculating Reliable Change Index”
From Acceptance and Commitment Therapy for depression following psychosis: An examination of clinically significant change (2015) · cites this paper as Jacobson, N. S. & Truax, P. (1991)
In the citing paper
“is associated with a large burden of disease and generates considerable economic costs to society. 3-5”
From Early intervention in panic: Pragmatic randomised controlled trial (2010) · cites this paper as [5]
In the citing paper
“is associated with a large burden of disease and generates considerable economic costs to society. 3-5”
From Early intervention in panic: Pragmatic randomised controlled trial (2010) · cites this paper as [5]
In the citing paper
“As cautioned by Jacobson and Truax 21 cutoff scores can be arbitrary and may not capture all improvements (e.g., from one end of a range to another).”
From The Effectiveness of an Acceptance and Commitment Therapy Self-help Intervention for Chronic Pain. (2010) · cites this paper as [21]
In the citing paper
“In order to provide consistency in discussing clinically significant change, and as recommended by Jacobson and Truax 21 , overall improvement (shift toward mean of general population) was reported.”
From The Effectiveness of an Acceptance and Commitment Therapy Self-help Intervention for Chronic Pain. (2010) · cites this paper as [21]
In the citing paper
“Evidence of such “reliable change” is one of the 2 criteria for clinically significant change suggested by Jacobson and colleagues.24,25”
In the citing paper
“In a post-hoc analysis of EESC data sets based on the Jacobson and Truax method (Jacobson and Truax 1991), ≥99% of participants did not show emotional control impairments and method-defined, reliable change in emotional expression during LDX treatment (Katic et al. 2012).”
From Treatment Outcomes with Lisdexamfetamine Dimesylate in Children Who Have Attention-Deficit/Hyperactivity Disorder with Emotional Control Impairments (2013) · cites this paper as Jacobson and Truax 1991
In the citing paper
“Deterioration was measured using the criteria for clinically significant deterioration by Jacobson and Truax (1991) in 11 studies, while 7 studies used another definition (such as moving to another symptom category or scoring a number of points lower on a depression scale).”
From Negative effects of psychotherapies for adult depression: A meta-analysis of deterioration rates (2018) · cites this paper as Jacobson and Truax (1991)
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“The majority have examined chronic pain [28–31], with the remainder focusing on GAD [14], veterans with depression [32], and those living in long-term care facilities [33].”
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“This was done using the formula of Jacobson and Truax (1991).”
MethodYoung, K. S., LeBeau, R. T., Niles, A. N., Hsu, K. J., Burklund, L. J., Mesri, B., Saxbe, D., Lieberman, M. D., & Craske, M. G. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.08.016 · Cited by 30
“The cutoff for reliable change was calculated as the difference between the pre-treatment and post-treatment scores across the whole sample, divided by the standard error of the difference between the two scores (Jacobson and Truax, 1991).”
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“96 indicate reliable symptom improvement [33].”
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“QIDS depressive symptom scores are used to determine depression response in accordance to the recommendations of Jacobson and Truax (54).”
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“RCIs were thus calculated for each participant by dividing the difference of the scores before and after the intervention by the standard error of measurement (Jacobson & Truax, 1991); RCI values greater than ± 1.96 indicate reliable improvement or reliable deterioration.”
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“Clinically significant change was examined in accord with the two-step approach recommended by Jacobson et al. (1984) and Jacobson and Truax (1991).”
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“Clinical significance will be determined using Jacobson & Truax method (Jacobson and Truax, 1991).”
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A randomized controlled trial of attention modification for social anxiety disorder
Carleton, R. N., Teale Sapach, M. J. N., Oriet, C., Duranceau, S., Lix, L. M., Thibodeau, M. A., Horswill, S. C., Ubbens, J. R., & Asmundson, G. J. G. (2015) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2015.03.011 · Cited by 24
Stanley, I. H., Hom, M. A., & Joiner, T. E. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.01.008 · Cited by 24
What the future holds: Machine learning to predict success in psychotherapy
Taubitz, F.-S., Büdenbender, B., & Alpers, G. W. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104116 · Cited by 25
Eustis, E. H., Williston, S. K., Morgan, L. P., Graham, J. R., Hayes-Skelton, S. A., & Roemer, L. (2017) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2016.03.011 · Cited by 24
Thew, G. R., Powell, C. L., Kwok, A. P., Lissillour Chan, M. H., Wild, J., Warnock-Parkes, E., Leung, P. W., & Clark, D. M. (2019) · JMIR Formative Research · doi:10.2196/13446 · Cited by 24
Graham, C. D., O'Hara, D. J., & Kemp, S. (2018) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2174 · Cited by 24
Sensitivity analysis in multiple imputation in effectiveness studies of psychotherapy
Crameri, A., von Wyl, A., Koemeda, M., Schulthess, P., & Tschuschke, V. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01042 · Cited by 24
Théberge-Lapointe, N., Marchand, A., Langlois, F., Gosselin, P., & Watts, S. (2015) · European Review of Applied Psychology · doi:10.1016/j.erap.2014.10.001 · Cited by 24
Rudd, B. N., Last, B. S., Gregor, C., Jackson, K., Berkowitz, S., Zinny, A., Kratz, H. E., Cliggitt, L., Adams, D. R., Walsh, L. M., et al. (2019) · American Journal of Community Psychology · doi:10.1002/ajcp.12370 · Cited by 24
Ebenfeld, L., Kleine Stegemann, S., Lehr, D., Ebert, D. D., Jazaieri, H., van Ballegooijen, W., Funk, B., Riper, H., & Berking, M. (2014) · Trials · doi:10.1186/1745-6215-15-427 · Cited by 20
“We will also conduct clinical significance change analyses as described by Jacobson and Truax [72].”
BackgroundMethodPinto, R. A., Kienhuis, M., Slevison, M., Chester, A., Sloss, A., & Yap, K. (2017) · Clinical Psychologist · doi:10.1111/cp.12057 · Cited by 23
Malins, S., Kai, J., Atha, C., Avery, A., Guo, B., James, M., Patel, S., Sampson, C., Stubley, M., & Morriss, R. (2016) · British Journal of General Practice · doi:10.3399/bjgp16x686569 · Cited by 23
Hjeltnes, A., Moltu, C., Schanche, E., Jansen, Y., & Binder, P.-E. (2018) · Psychotherapy Research · doi:10.1080/10503307.2016.1169330 · Cited by 23
Lavelle, J., Storan, D., Eswara Murthy, V., De Dominicis, N., Mulcahy, H. E., & McHugh, L. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11102757 · Cited by 23
“However, it could be argued that a change of this magnitude such that participants’ scores fall into the range of healthy peers may be unreasonable given the persistence and impact of lifelong illness in the form of IBD [80].”
BackgroundNewby, J. M., Haskelberg, H., Hobbs, M. J., Mahoney, A. E. J., Mason, E., & Andrews, G. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.087 · Cited by 23
Koszycki, D., Guérin, E., DiMillo, J., & Bradwejn, J. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2502 · Cited by 24
Schuster, R., Fichtenbauer, I., Sparr, V. M., Berger, T., & Laireiter, A.-R. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-018412 · Cited by 23
Flujas-Contreras, J. M., García-Palacios, A., & Gómez, I. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18062958 · Cited by 23
Klan, T., Gaul, C., Liesering-Latta, E., Both, B., Held, I., Hennemann, S., & Witthöft, M. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.852616 · Cited by 22
“For the psychometric questionnaires (e.g., HDI), the Reliable Change Index (RCI) (47) was calculated with a CI of 95% for observed values.”
MethodMindfulness-Based Cognitive Therapy Enhances Emotional Resiliency in Children with Divorced Parents
Esmaeilian, N., Dehghani, M., Dehghani, Z., & Lee, J. (2018) · Mindfulness · doi:10.1007/s12671-017-0840-9 · Cited by 21
Dalrymple, K. L., Morgan, T. A., Lipschitz, J. M., Martinez, J. H., Tepe, E., & Zimmerman, M. (2014) · Behavior Modification · doi:10.1177/0145445513518422 · Cited by 22
“The percentage of patients meeting criteria for clinically reliable change was calculated, based on procedures by Jacobson & Truax (1991).”
MethodAttachment style among outpatients with substance use disorders in psychological treatment
Gidhagen, Y., Holmqvist, R., & Philips, B. (2018) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12172 · Cited by 21
Mason, L., Grey, N., & Veale, D. (2016) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465815000065 · Cited by 22
Majore-Dusele, I., Karkou, V., & Millere, I. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.587923 · Cited by 22
Zhao, C., Zhao, Z., Levin, M. E., Lai, L., Shi, C., Hu, J., Chen, W., & Ren, Z. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104440 · Cited by 22
Kemmeren, L. L., van Schaik, A., Draisma, S., Kleiboer, A., Riper, H., & Smit, J. H. (2023) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10363-y · Cited by 22
Radically open dialectical behaviour therapy for refractory depression: the RefraMED RCT
Lynch, T. R., Hempel, R. J., Whalley, B., Byford, S., Chamba, R., Clarke, P., Clarke, S., Kingdon, D., O’Mahen, H., Remington, B., et al. (2018) · Efficacy and Mechanism Evaluation · doi:10.3310/eme05070 · Cited by 22
A self-guided internet-delivered intervention for adults with ADHD: a feasibility study
Nordby, E. S., Kenter, R. M. F., Lundervold, A. J., & Nordgreen, T. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100416 · Cited by 22
Bornas, X., Tortella-Feliu, M., & Llabrés, J. (2006) · Psychotherapy Research · doi:10.1080/10503300500091058 · Cited by 22
Bliokas, V. V., Cartmill, T. K., & Nagy, B. J. (2007) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e31803685dc · Cited by 22
Schwartzman, J. M., Roth, M. C., Paterson, A. V., Jacobs, A. X., & Williams, Z. J. (2024) · Autism · doi:10.1177/13623613231213543 · Cited by 24
“To further examine individual-level change in depressive symptoms over the course of the intervention, we calculated the Reliable Change Index (RCI; Jacobson & Truax, 1991) for each individual at T2, T3, and T4.”
MethodEconomides, M., Bolton, H., Male, R., & Cavanagh, K. (2022) · JMIR Formative Research · doi:10.2196/34032 · Cited by 19
“The reliable change index was computed based on methods provided by Jacobson and Truax [56], using Cronbach α as a measure of reliability and an α level of .05 (Multimedia Appendix 3).”
Rasing, S. P. A., Stikkelbroek, Y. A. J., den Hollander, W., Riper, H., Deković, M., Nauta, M. H., Creemers, D. H. M., Immink, M. C. P., Spuij, M., & Bodden, D. H. M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18063102 · Cited by 21
Dibaj, I., Øveraas Halvorsen, J., Edward Ottesen Kennair, L., & Inge Stenmark, H. (2017) · Torture Journal · doi:10.7146/torture.v27i1.26534 · Cited by 21
Claudat, K., Reilly, E. E., Convertino, A. D., Trim, J., Cusack, A., & Kaye, W. H. (2022) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-022-01500-9 · Cited by 21
“RCI of Depression symptoms were not examined due to the two different measures administered.”
MethodInfluential
Metadata
- Authors
- Jacobson, N. S., & Truax, P.
- ORCID
- Jacobson, Neil S.
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 1991
- Volume
- 59
- Issue
- 1
- Pages
- 12-19
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W4235813114
- Cited by
- 7,770
- References
- 0
- Citations by year
- 2026: 323 · 2025: 310 · 2024: 326 · 2023: 363 · 2022: 411 · 2021: 472 · 2020: 484 · 2019: 457 · 2018: 452 · 2017: 395 · 2016: 385 · 2015: 399 · 2014: 373 · 2013: 350 · 2012: 304
- FWCI
- 20.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- meaningful change, clinical significance, psychotherapy outcome assessment, statistical significance, effect size
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