Calculate global reliable change (e.g., require reliable change on two out of three measures) 3. Relational effect: Measure social desirability “Hello-goodbye” artifact emphasize distress at Researcher, not therapist, interviews (interpersonal beginning, positive client dynamics functioning at end Encourage negative comments between client Listen for spontaneous remarks and therapist) expressing desire to please or evaluation apprehension Global or vague positive descriptions versus supporting or convincing detail Presence of both positive and negative descriptions 4. Expectancy Client to convince Ask client to evaluate changes as expected artifacts (cultural self and others that versus surprising or personal change has occurred Examine client descriptions for when it has not consistency with cultural stereotypes “scripts”) versus plausible detail Look for spontaneous client attempts to convince self and therapist that change has occurred 5. Self-generated Temporary initial state Evaluate duration of problems (interview return to baseline of distress or or ratings) dysfunction Ask client to evaluate likelihood that Reverts to normal change might have occurred without baseline through client’s therapy own natural corrective Use multiple pretests; look for change or self-help processes before therapy starts Not caused by therapy; Look for client narratives of self-help would have happened efforts begun before therapy anyway 6. Extra-therapy Improvements in Ask client: qualitative interview events (positive relationships or work Look for in-session narratives about life events) Changes in health status positive extra-therapy events or changes unrelated to therapy Look for extra-therapy events associated (e.g., successful surgery, with weekly change negative biopsy) 7. Unidirectional Psychopharmacological Keep track of medications and herbal psychobiological medications/herbal remedies including changes and dose causes remedies adjustments Hormonal stabilization Look for in-session narratives about in recovery from stroke medical intervention or childbirth
Calculate global reliable change (e.g., require reliable change on two out of three measures) 3. Relational artifact (interpersonal dynamics between client and therapist) “Hello-goodbye” effect: emphasize distress at beginning, positive functioning at end Measure social desirability Researcher, not therapist, interviews client Encourage negative comments Listen for spontaneous remarks expressing desire to please or evaluation apprehension Global or vague positive descriptions versus supporting or convincing detail Presence of both positive and negative descriptions 4. Expectancy artifacts (cultural or personal “scripts”) Client to convince self and others that change has occurred when it has not Ask client to evaluate changes as expected versus surprising Examine client descriptions for consistency with cultural stereotypes versus plausible detail Look for spontaneous client attempts to convince self and therapist that change has occurred 5. Self-generated return to baseline Temporary initial state of distress or dysfunction Reverts to normal baseline through client’s own natural corrective or self-help processes Not caused by therapy; would have happened anyway Evaluate duration of problems (interview or ratings) Ask client to evaluate likelihood that change might have occurred without therapy Use multiple pretests; look for change before therapy starts Look for client narratives of self-help efforts begun before therapy 6. Extra-therapy events (positive life events) Improvements in relationships or work Changes in health status unrelated to therapy (e.g., successful surgery, negative biopsy) Ask client: qualitative interview Look for in-session narratives about positive extra-therapy events or changes Look for extra-therapy events associated with weekly change 7. Unidirectional psychobiological causes Psychopharmacological medications/herbal remedies Hormonal stabilization in recovery from stroke or childbirth Keep track of medications and herbal remedies including changes and dose adjustments Look for in-session narratives about medical intervention
Elliott_2014_HSCED_Overview_2nd_Ed_author_final.docx