Ethnic differences on the Outcome Questionnaire

Development and validation of 21-item outcome inventory (OI-21)

Background

Outcome measurement is important for monitoring patients' progress. The study aimed to develop an outcome inventory (OI) for clinical use in routine practice in psychiatric services and to examine the psychometric properties of the newly developed OI.

Methods

48 items measuring anxiety, depression, interpersonal difficulties, and somatization were collected. Factor analysis was used to reduce the number of items. The final OI consisting of 21 items was then examined for psychometric properties among 1302 participants, 880 were nonclinical and 422 clinical patients. Tests included confirmatory factor analysis, internal consistency, test-retest reliability, convergent and discriminant validity, and diagnostic ability for major depression. Responsiveness was compared between baseline and 3-month follow-up.

Results

Confirmatory factor analysis revealed the OI-21 demonstrated the designated four components. Cronbach's alpha was good to excellent for all subjects with good test-retest reliability, concurrent validity, convergent and discriminant validity. It demonstrated area under the ROC curve of 0.89 indicating good diagnostic performance. Sensitivity to change after 3 months was observed in both types of treatment. However, interpersonal difficulties were sensitive to change in those receiving additional psychotherapy.

Conclusion

OI-21 demonstrated its validity, reliability, and sensitivity to change. It constitutes a promising tool for outcome assessment in nonclinical populations and among psychiatric patients.

Client Perspectives of Multicultural Counseling Competence

Multicultural competence is a burgeoning area of research in counseling psychology. However, there has been little focus on understanding multicultural competence from the perspective of clients. This study used qualitative interviews and grounded theory to develop a model of clients’ perspectives of multicultural counseling. The resulting model suggested that clients’ experiences of multicultural counseling were contingent on their self-identified needs and on how well they felt the counselor met these needs. Moreover, clients appeared to actively manage and moderate the extent to which culture was broached in counseling based on a host of conditions including counseling relationship, salience of identity, counselor behavior, and expectations of counseling, to name a few. Implications for future research and practice are discussed.

Counseling utilization by ethnic minority college students

Although multicultural awareness in counseling has risen substantially in the last decade, little research has examined counseling utilization and outcomes for ethnic minorities on university campuses. A sample of 1,166 African American, Asian American, Caucasian, and Latino help-seeking university students from over 40 universities nationwide filled out the Outcome Questionnaire 45 (OQ45) at the first and last therapy sessions. Caucasian students attended significantly more sessions than all other groups. Greatest distress was found at intake in Asian American students, followed by Latino, African American, and Caucasian students. All groups appeared to benefit from therapy, as noted by a decrease in symptomatology, but none of the groups met the criteria for clinically significant change for the OQ45. Implications for therapists working with minority clients are discussed.