Clinical and Scientific Considerations in Progress Monitoring: When Is a Measure Too Long?

| June 20, 2013

“How brief is too brief in progress monitoring in therapy?”


Barry L. Duncan

Robert J. Reese


A common psychometric question regarding outcome measurement tools is “how brief is too brief”? Some suggest that in order for an outcome-tracking tool to be reliable and valid, a measure must be of sufficient length. Although there is no agreed upon standard within the scientific community to what is considered sufficient validity, the authors of this paper do not refute this suggestion that increased length increases reliability and validity – but the question is, is it clinically significant in practice? The idea of reliability and validity is a research characteristic and it is yet to be empirically decided whether slightly higher reliability and validity has any meaningful clinical difference. And even if it does, does it offset the burden of low-compliance rates that accompany longer measures? Furthermore, longer measures are not feasible for every day use as few front line psychotherapists have the time or resources for the administration and interpretation of lengthy measures. Therefore, the current, long-winded measures intended for outcome tracking along the journey of recovery are instead used in a pretest/post-test manner. Feasibility is critical in order to preserve the integrity of the data these measures are designed for. A brief, feasible measure is necessary for the fast-pace environment of today's therapists. My Outcomes® has integrated two short scales into a user friendly, web-based interface where analysis of client improvement, and indications of at risk cases are clear, simple and secure.

The authors conclude the paper, not by suggesting that a 4-item measure is just as reliable and valid as a 30-item measure, they say more investigation is needed to determine how brief is too brief – but by answering the question how long it too long? It's simple, when clinicians won't use it.


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Category: Outcomes Software

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