Measuring Clinically Meaningful Change Following Mental Health Treatment
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Assessment of clinically meaningful change is useful for treatment planning, monitoring progress, and evaluating treatment response. Outcome studies often assess statistically significant change, which may not be clinically meaningful. Study objectives are to: (1) evaluate responsiveness of the BASIS-24© using three methods for determining clinically meaningful change: reliable change index (RCI), effect size (ES), and standard error of measurement (SEM); and (2) determine which method provides an estimate of clinically meaningful change most concordant with other change measures. BASIS-24© assessments were obtained at two time points for 1,397 inpatients and 850 outpatients. The proportion showing clinically meaningful change using each method was compared to the proportion showing change in global mental health, retrospectively reported change, and clinician-assessed change. BASIS-24© demonstrated responsiveness at both aggregate and individual levels. Regarding clinically meaningful improvement and decline, SEM was most concordant with all three outcome measures; regarding no change, RCI was most concordant with all three measures.
Keywordsclinically meaningful change outcome assessment
The authors thank Colleen McHorney, Ph.D., for suggesting use of the SEM to assess clinically meaningful change, and Joel Reisman for his helpful comments on an earlier version of this manuscript.
This research was supported by grant R01 MH58240 from the National Institute of Mental Health and by the Veterans Affairs Health Services Research & Development program.
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