The ability to monitor client change in psychotherapy over time is vital to quality assurance in psychotherapy as well as the continuing improvement of psychotherapy research. Currently there is not a free and comprehensive outcome measure for psychotherapy that meets current research and treatment goals. This study took further steps to validate a suite of measures to aid in treatment and research, theoretically based in the research domain criteria (RDoC) and the phase model of change frameworks. Items previously tested in a community sample were further tested in a clinical population in psychotherapy training clinics and a community clinical sample Data was analyzed using bi-factor confirmatory factor analysis and multidimensional item response theory. Additional exploratory analyses were conducted to explore differential item functioning in these samples.

The current study sought to examine client outcome data for clients seen for outpatient psychotherapy services by graduate-level student therapists in doctoral psychology training clinics in order to better understand the change process occurring in such settings and to examine whether services being offered are meaningful for clients. One hundred ninety-nine clients seen by graduate-level therapists at a training clinic setting were assessed on a session-by-session basis using the Outcome Questionnaire-45 in order to identify the percentage of clients who met criteria for clinically significant change, reliable improvement, no change, or deterioration in outcomes across the course of treatment. Approximately 28% of clients seen for treatment met criteria for clinically significant change at the termination of treatment and 23% reliably improved. Survival analysis indicated that the median time required to attain clinically significant change was six sessions. Current findings are compared to earlier investigations in both training and nontraining settings. The implications of these findings for education and training, client care and clinical services, and policy are discussed.

The ability to monitor client change in psychotherapy over time is vital to quality assurance in service delivery as well as the continuing improvement of psychotherapy research. Unfortunately, there is not currently a comprehensive, affordable, and easily utilized outcome measure for psychotherapy specifically normed and standardized for use in psychology training clinics. The current study took the first steps in creating such an outcome measure. Following development of an item bank, factor analysis and item-response theory analyses were applied to data gathered from a stratified sample of university (n = 101) and community (n = 261) participants. The factor structure did not support a phase model conceptualization, but did reveal a structure consistent with the theoretical framework of the research domain criteria (RDoC). Suggestions for next steps in the measure development process are provided and implications discussed.