A Multiperspective, Multivariable Evaluation of Reliable Change

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N. S. Jacobson and P. Truax's (1991) method for evaluating the clinical significance of client change has gained some prominence in psychotherapy outcome research. However, little has been done to investigate the validity of this methodology. This study addresses this limitation by comparing (a) the perceived level of change (as subjectively reported from 3 distinct perspectives) across outcome groupings based on Jacobson and Truax's reliable change index (RCI) and (b) subjective reports of therapeutic alliance and satisfaction across outcome groupings. The results of these comparisons indicate that the RCI is effective in identifying those who make reliable improvement in therapy but is less effective in differentiating between no-changers and deteriorators. In addition, the relationship between treatment outcome and satisfaction with service is questioned.

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