Bauer Stephanie, Lambert Michael J, Nielsen Steven Lars
Center for Psychotherapy Research, Stuttgart, Germany.
J Pers Assess. 2004 Feb;82(1):60-70. doi: 10.1207/s15327752jpa8201_11.
Clinically significant change refers to meaningful change in individual patient functioning during psychotherapy. Following the operational definition of clinically significant change offered by Jacobson, Follette, and Revenstorf (1984), several alternatives have been proposed because they were thought to be either more accurate or more sensitive to detecting meaningful change. In this study, we compared five methods using a sample of 386 outpatients who underwent treatment in routine clinical practice. Differences were found between methods, suggesting that the statistical method used to calculate clinical significance has an effect on estimates of meaningful change. The Jacobson method (Jacobson & Truax, 1991) provided a moderate estimate of treatment effects and was recommended for use in outcome studies and research on clinically significant change, but future research is needed to validate this statistical method.
临床显著变化是指在心理治疗过程中个体患者功能的有意义变化。继雅各布森、福利特和雷文斯托夫（1984年）提出的临床显著变化的操作性定义之后，又提出了几种替代方法，因为它们被认为在检测有意义变化方面要么更准确，要么更敏感。在本研究中，我们使用386名在常规临床实践中接受治疗的门诊患者样本比较了五种方法。各方法之间存在差异，这表明用于计算临床显著性的统计方法对有意义变化的估计有影响。雅各布森方法（雅各布森和特鲁克斯，1991年）对治疗效果提供了适度估计，并被推荐用于结果研究和临床显著变化的研究，但需要未来的研究来验证这种统计方法。
