The Therapy Progress Scale: Is it Measuring Change?

Measurement-based care (MBC) is an evidence-based practice supported by the American Psychological Association (APA) since 2006 (APA Presidential Task Force on Evidence-Based Practice in Psychology, 2006). MBC is an approach to health care encompassing several procedures and systems. Within the scope of psychological services, MBC includes the administration of patient-reported outcome measures (PROMs), the interpretation of those PROMs scores over the course of therapy, and the modification of treatment in response to observed treatment progress (or lack thereof). Engagement in MBC has been shown to improve treatment retention and outcomes in a variety of naturalistic and experimental research designs (e.g., Anker et al., 2009; de Jong et al., 2021; Lambert et al., 2018; Miller & Wampold, in press; Reese et al., 2013). 

Most measures employed in MBC focus on symptom-based assessment. As a complementary approach, measures assessing clients’ well-being and life functioning have also become an integral component of the routine assessment batteries administered by several MBC systems (e.g., Jankowski et al., 2022; Kopta et al., 2015; Miller et al., 2003; Sanders et al., 2018). The Therapy Progress Scale (TPS) was developed to satisfy the need for a brief, yet broad measure capturing treatment progress across several life functioning domains. Moreover, the TPS emphasizes the assessment of clients’ perceived progress and change. This feature makes it uniquely relevant to routine psychotherapy assessment, providing clinically useful information to therapists.

The present study examined the psychometric properties of Therapeutic Progress Scale (TPS). The sample included 36,420 clients (sex: 29% male, 66% female, 5% missing; race/ethnicity: 55.5% White, 31.5% Racial/Ethnic Minority [REM], and 13% missing) from a practice-research group of private practitioners. The TPS is a four-item measure that assesses patients’ perceptions of treatment progress over the course of the previous two weeks across four life functioning domains. The TPS demonstrated strong validity and reliability and was consistently so across client sex and race/ethnicity. There were moderate negative correlations with symptom-based measures (i.e., PHQ-9, GAD-7). Thus, on average, as clients reported decreases in clinical symptom severity, they also reported increases in life functioning on the TPS. Moreover, the amount of change on the TPS from pre- to post-treatment was characterized by large-sized effect (Cohen’s d = 0.82, 0.92) for those who attended at least 2 and 3 sessions, respectively.