THE EVALUATION OF A “TARGET PROBLEM” APPROACH TO OUTCOME MEASUREMENT*

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Abstract

ABSTRACT

This study examined the agreement among three sources (patients, therapists, and independent judges) in their evaluation of psychotherapeutic improvement for 25 outpatients in group psychotherapy. Sources used a “target problem” approach, which involved constructing an ideographic problem list for each patient before entering therapy. After eight and twelve months of therapy they rated improvement on each of the individualized problems. Sources did not generally agree either on the content of patients' problems or on patients' improvement, even when assessment of agreement was limited to specific problem areas. Furthermore, mean target problem improvement ratings were highly correlated with simple global ratings made by each source, suggesting that the elaborate problem identification procedure was unnecessary. These disappointing findings, typical for psychotherapy outcome research, suggest psychometric weaknesses in ideographic assessment approaches which recently have been gaining popularity.

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