Naturalistic Changes in Subjective Distress Outside of Therapy

Objectives: To establish the effectiveness or efficacy of psychological interventions, it is important to understand the nature of changes that occur in the absence of therapy. Design: In this study, clinically distressed college students from 2 universities (n = 228) completed the Outcome Questionnaire (OQ)-45.2 on a weekly basis throughout a single semester. Results: Although 56.6% of the sample made no change or deteriorated, 43.4% made a reliable improvement. Change status was predicted by previous therapy experience and length of study participation. Multilevel growth modeling also indicated that participants' OQ-45.2 scores decreased over time (following a cubic trend) and the amount of decrease was associated with Time 1 OQ-45.2 scores. Conclusions: Limitations of the study and further implications for treatment outcome research are discussed. (C) 2012 Wiley Periodicals, Inc. J. Clin. Psychol. 68:421-431, 2012.