On the Identification of Clinically Significant Client Changes: Reinterpretation of Jacobson's Cut Scores

摘要: “Cut points” or “cut scores” play a central role in Jacobson's popular method of identifying clinically significant changes psychotherapy. When pre- and posttherapy scores client are on different sides one these cut scores, the change is considered significant, provided that it also “reliable” (i.e., not due to measurement errors). This article critically examines meanings implications scores. Contrary beliefs, they generallynot test for which probability “belonging” Functional population equal Dysfunctional population. distribution above population, persons scoring can, fact, have much greater probabilities belonging than Goals can be attained only with Bayesian methods. modifications proposed, although their use limited by availability relevant base rates. methods (a) provide information about an individual belongs each given his (her) score, (b) expected yield total misdiagnosis rates many times lower those method. Users cautioned against interpreting ratios likelihoods as if were posterior probabilities.