TPC-Journal-V4-Issue4

The Professional Counselor \Volume 4, Issue 4 393 one item from the Social Adjustment Scale-Self Report (SAS-SR; Weissman & Bothwell, 1976), the Subjective Social Support (SSS) subscale of the Duke Social Support Index (DSSI; Blazer, Hybels, & Hughes, 1990), the Treatment Expectancy Scale (TES; Sotsky et al., 1991), and numerous demographic questions including gender, race, age, relationship status, reasons for entering counseling, income, educational attainment and health insurance status. Clients who consented to participate completed all forms and returned them to the front desk before beginning their initial counseling session. Participants completed the OQ prior to each subsequent counseling session. The method of asking participants to complete OQs prior to each session offers at least two advantages for outcome researchers (Ogles, Lambert, & Fields, 2002): (a) It reduces confusion over when to administer outcome measures, and (b) it reduces potential data loss from unexpected dropout because the last available measure serves as the posttest (Ogles et al., 2002). In the current study, 54 clients consented to participate and completed an initial OQ, at least one additional OQ (posttest) and the other study measures. The clients reported coming to counseling to address various personal and career-related issues such as relationship difficulties, anxiety, depression, job loss and career transition. The majority estimated that their presenting concern had lasted on and off for the last few years (38.8%). The ages of the participating clients ranged from 19–79 years old ( M = 38.76, SD = 12.41) and most (61.2%) were female. The majority of the sample described themselves as Caucasian (91.8%) and married/partnered (30.6%). Others reported being unmarried (24.5%), divorced/widowed/separated (22.4%) or dating (22.4%). The majority of the sample reported being employed (65.3%), with 16.3% indicating no job and 18.4% leaving the response blank. One participant was a university student. Measures Outcome Questionnaire-45.2. The OQ is a standardized, 45-item self-report instrument that is commonly used as a general “index of mental health” (Lambert et al., 2003, p. 10). The items utilize 5-point Likert scale responses ranging from 0 (never) to 4 (almost always) to determine the severity of various symptoms and psychosocial stressors, resulting in a score ranging from 0–180. Concurrent validity has been established between the OQ Total Score and various other measures of symptomology (e.g., Behavior and Symptom Identification Scale [BASIS-32] Depression and Anxiety subscale; Doerfler, Addis, & Moran, 2002). Construct validity is demonstrated by the OQ’s sensitivity to client change and ability to discriminate between clinical and non-clinical populations (Lambert et al., 2003). The manual (Lambert et al., 2003) reports high internal consistency ( a = .93) and 10-week test-retest reliability (.66–.86). Objective SES. Objective SES was operationalized using three indicators: education level, income and health insurance. For education level, participants indicated their educational attainment, with answer choices ranging from 1 (some high school) to 8 (Ph.D. or equivalent). Income level was assessed by asking participants to indicate their yearly household income, with a continuum of choices ranging from 1 (under $10,000) to 8 (over $100,000) in $10,000–$20,000 increments. Health insurance was dichotomously assessed by asking participants to indicate whether they were receiving health insurance benefits—either through an employer, Medicaid or other source—or were uninsured (see Table 1 for descriptive statistics regarding the SES variables). Subjective SES. Subjective SES was operationalized using two indicators: perceived financial security and perceived SES. Perceived financial security was measured using one item from the SAS-SR (Weissman & Bothwell, 1976). Participants were asked if they had had enough money for their financial needs in the past 2 weeks. The item was rated on a 5-point scale ranging from 1 (I had great financial difficulty) to 5 (I had enough money for needs). Regarding perceived SES, participants were asked to choose “the economic class that best describes you” on a three-point scale corresponding to either 1 (lower), 2 (middle) or 3 (upper economic class). With each subjective variable, we did not analyze differences between financially independent versus dependent clients since only one participant was a university student.