ABSTRACT

Quantified symptom measurement by self-report questionnaires is part of the ‘gold standard’ of assessing psychotherapeutic efficacy. In this paper, we report a qualitative case comparison to explore how June and Amy, two patient-participants in a gold standard psychotherapy study, experienced the process of quantitative data collection. The study resembles cognitive interviewing studies conducted in the development of measures, yet advances them by investigating patients’ experiences of questionnaire administration in actual psychotherapy. Both cases reported known issues in interpretation of pre-structured item- and response formats, communicative administrator-respondent dynamics, and response shifts. Beyond known scoring problems, the act of questionnaire administration changed their interpretation of experienced symptoms, which facilitated clinical change beyond therapeutic effects. For Amy, this change was associated with improvement, but for June, questionnaire administration facilitated deterioration in experienced symptoms. These findings emphasize that it is both epistemically and ethically vital to consider measurement effects in clinical practice. This study demonstrates the importance of taking a qualitative stance in psychotherapy research, as qualitative research can elaborate the contextual and idiosyncratic nature of questionnaire scores, and highlights that both researchers and clinicians have to be attentive to the meaning of scores as words in participants’ clinical stories.

摘要

通过自我报告问卷进行的量化症状测量是评估心理治疗效果的“黄金标准”的一部分。在本文中，我们报告了一个定性案例比较，以探讨金标准心理治疗研究中的两名患者参与者 June 和 Amy 如何经历定量数据收集的过程。该研究类似于在制定措施时进行的认知访谈研究，但通过调查患者在实际心理治疗中问卷管理的经历来推进它们。这两个案例都报告了在解释预先构建的项目和响应格式、沟通管理员-响应者动态和响应转变方面的已知问题。除了已知的评分问题，问卷管理的行为改变了他们对经历症状的解释，这促进了超越治疗效果的临床变化。对于艾米来说，这种变化与改善有关，但对于 6 月份，问卷管理促进了经历症状的恶化。这些发现强调，在临床实践中考虑测量效果在认知和伦理上都至关重要。这项研究证明了在心理治疗研究中采取定性立场的重要性，因为定性研究可以详细说明问卷分数的上下文和特殊性质，并强调研究人员和临床医生都必须注意分数在参与者临床中的含义。故事。问卷管理促进了经历症状的恶化。这些发现强调，在临床实践中考虑测量效果在认知和伦理上都至关重要。这项研究证明了在心理治疗研究中采取定性立场的重要性，因为定性研究可以详细说明问卷分数的上下文和特殊性质，并强调研究人员和临床医生都必须注意分数在参与者临床中的含义。故事。问卷管理促进了经历症状的恶化。这些发现强调，在临床实践中考虑测量效果在认知和伦理上都至关重要。这项研究证明了在心理治疗研究中采取定性立场的重要性，因为定性研究可以详细说明问卷分数的上下文和特殊性质，并强调研究人员和临床医生都必须注意分数在参与者临床中的含义。故事。