Measuring therapeutic success

[From Bill Powers (960408.0740 MST)]

Brian D'Agostino (960408.0530 EST) --

     I suspect that many therapies would fail to show any measurable
     results, and that subjective impressions of improvement can be
     attributed to the placebo effect.

Considering that the lists are self-administered, it would seem that
failure to show improvement could indicate primarily the difference
between what the therapists want the patients to get from therapy and
what the patients want from it. Consider a (made-up) list like this:

cooperative with therapist
gets along with peers well
good worker
respects authority
meets norms for social behavior
prefers social gatherings to reading books

I know that the actual lists would not look like this, but the point is
that for a given person, a positive assessment on the above list might
represent a failure of therapy for a given person, but might be viewed
as a success by a therapist oriented to the needs of society or business
rather than the needs of the individual. A patient who scored low might
actually feel a lot better, yet this feeling would be judged as a
"placebo effect" (it's all in your mind).

It seems to me that the idea of an objective measure of the benefits of
therapy might be hard to devise. The very idea implies that all people
are alike. I suppose that one could put together an instrument that
takes the patient's own goals as the criterion and scores in terms of
how close the patient came to meeting them -- but of course we know that
goals change in therapy. Not a trivial problem!

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Best,

Bill P.

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