a V.A. Medical Center , Drew University , Long Beach.
Psychother Res. 1996;6(2):109-23. doi: 10.1080/10503309612331331638.
Jacobson, Follette, and Revenstorf's (1984) proposal for assessing clinical significance provides a needed convention for psychotherapy outcome research. Several limitations that exists in this method (Jacobson & Revenstorf, 1988) are addressed in this paper and extensions are proposed. Specifically, limitations regarding the operationalization of the underlying social validation methodology in the derivation of normative samples and the resultant standards they set are discussed. Extensions and guidelines are proposed for specifying normative samples, determining the distinctness of these samples, and expanding procedures to accommodate multiple samples. This paper initially assumes a psychometric perspective and presents extensions, based on the Symptom Checklist 90-R. Then it shifts to a clinician perspective and applies reliable change estimates and cutoff scores to actual outcome data by analyzing the progress of four patients during and after therapy. The overall merit and utility of extensions to clinical significance are then discussed.
雅各布森、福莱特和雷文斯多夫（1984）提出的评估临床意义的建议为心理治疗结果研究提供了一个必要的惯例。本文讨论了该方法存在的几个局限性（雅各布森和雷文斯多夫，1988），并提出了扩展。具体来说，讨论了在从规范样本中得出和设定他们所设定的标准时，对基础社会验证方法的操作性的限制。本文提出了扩展和指导方针，用于指定规范样本，确定这些样本的独特性，并扩展程序以适应多个样本。本文最初从心理计量学的角度出发，提出了基于症状清单 90-R 的扩展。然后，它转换为临床医生的角度，并通过分析四个患者在治疗期间和之后的进展，应用可靠的变化估计和截止分数来分析实际的结果数据。最后讨论了临床意义扩展的整体优点和实用性。
