THE PERSISTENCE OF THERAPEUTIC CHANGE

Abstract

The principal purposes of this study were to investigate the persistence of therapeutic change during the posttherapy period and the client variables associated with the persistence of therapeutic change. Secondary attention was given to the analysis of change and associated variables during the actual treatment period. Thirty outpatient, psychotherapy clients were studied and their relative change of status at termination and six-month follow-up was assessed through percent gain and residual change score analysis. Emphasizing the probability of change, the vast majority of clients (97%), using the percent gain analysis, and a substantial minority (30%), using residual change analysis, gained significantly during the treatment period. These differing results were attributed to the "outlier" effect, in which 17% of the clients did not evidence regression toward the mean, and thus made residual change an overly conservative estimate of improvement. Additionally, the low correlation between the residual change scores and the Follow-Up Rating supported this position. A majority (73%) maintained or continued to gain during the posttherapy period, using the residual gain analysis, while a majority (77%) maintained or continued to gain during the posttherapy period, using the percent gain analysis. Socioeconomic status, age, total psychotherapy sessions, initial neuroticism, and initial extroversion were identified as predictors of positive change in status at termination and follow-up. Socioeconomic status, negative life events, marital change, total psychotherapy sessions, initial neuroticism, and age were identified as variables discriminating between positive change and negative change in status groups. A number of limitations for this study were incorporated in implications for future research. These suggestions were designed to assist future researchers and therapists in understanding the persistence of change following psychotherapy.