Doctor of Philosophy

dissertationEvaluating the effectiveness of psychotherapy services, such as through client ratings of mental health symptoms, is a vital component of maintaining quality of care. However, the performance of psychotherapy outcome measures is not fully understood. Specifically, there are gaps in knowledge regarding the convergent validity of two widely disseminated measures, the Counseling Center Assessment of Psychological Symptoms (CCAPS) and the Outcome Questionnaire (OQ). The purpose of this study is to test the comparability of the OQ and the CCAPS as psychotherapy outcome measures. The first step to address this research question is to test the convergent validity of OQ Total scores and CCAPS Distress Index scores. Further analyses examine the relationship between these two general distress scores and the subscales of both instruments, which informs the question of whether the two instruments are providing similar or unique information. Clients at one college counseling center completed both the CCAPS and the OQ at every counseling session. The primary method of analysis was multivariate multilevel modeling, in which occasions were nested within clients. More specifically, the Bayesian mixed effects models fit provides point estimates and highest posterior density (HPD) intervals from the simulated parameters. In examining the correlation of the client-level random effects for the OQ Total score and CCAPS Distress Index, the mode of the posterior distribution of the correlated random effects was r = 0.967, HPD[.962, .971], suggesting that the two measures are highly correlated. Unfortunately, when we included session number as part of the model, the multivariate multilevel model did not appear to converge appropriately. Analyses comparing various subscales on both instruments revealed high correlations frequently, though some smaller correlations did exist where they might be expected, thus demonstrating divergent validity. The CCAPS Distress Index and the OQ Total score provide very similar information. Further, the CCAPS subscales do provide some additive information beyond the general measure of distress. Thus, college counseling centers can consider other practical and psychometric factors in deciding which instrument to use, based on their center, clientele, and institution

MS

thesisStructured career counseling is generally beneficial for participants. However, there is not a clear understanding of what factors (e.g., intervention characteristics, client characteristics) contribute to the effectiveness of career counseling. Stage of Change is a specific client characteristic in the psychotherapy field suggested to moderate outcome. The purposes of this study were to examine the effectiveness of a career-related college course in advancing a student's development, as measured by stage of change and by career maturity, and to determine if the effectiveness of a career-related college course- as measured by career maturity-was moderated by the stage of change of the student. The sample consisted of 132 undergraduate students enrolled in the career course or a comparison course over five semesters. The students in the career class demonstrated significantly higher posttest scores on the Committed Action variable than the comparison group, but the differences on the other measures (Stage Assignment, Readiness to Change, and Career Maturity Inventory) were nonsignificant. Also, none of the three measures of Stage of Change acted as a moderator on outcome. These findings suggest that the career course had a beneficial effect on students' ratio of action and maintenance behaviors to contemplation behaviors. More research should consider how the Stage of Change theory applies to career development, including testing instruments and evaluating outcomes of interventions