[The Symptom Checklist-90-R (SCL-90-R) for presenting statistically and clinically significant psychotherapy outcome].
After a long period of discussions on the efficacy of psychotherapy, there is still a lack of conventions for measuring change after psychological treatment. This paper first describes the concept of statistical and clinical significance of change. Using the SCL-90-R as a commonly administered instrument we then propose conventions and cut-off points for its global severity score (GSI) and change after therapy. A German standard population and several psychotherapy samples were aggregated to determine cut-off points and confidence intervals (reliable change indices) for statistically and clinically significant changes. Tingey et al. (1996) proposed the use of multiple clinical groups (inpatients and outpatients) aiming at a more realistic determination of "stepwise" changes. We examined this procedure with our data. Results show that it is not applicable in the German samples collected so far. Initial SCL-90-R scores in these groups did not differentiate sufficiently between inpatients and outpatients. Therefore, according to Jacobson and Truax (1991), moving from a "functional" to a "dysfunctional" population is still the criterion for a clinically significant change.
Schauenburg
H
H
Klinik für Psychosomatik und Psychotherapie, Universität Göttingen.
Strack
M
M
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics; D011602:Psychophysiologic Disorders / Q000523:psychology / Q000628:therapy*; D011613:Psychotherapy; D015203:Reproducibility of Results; D013001:Somatoform Disorders / Q000523:psychology / Q000628:therapy*