Making and Sustaining Change from Psychotherapy: A Mixed Methods Study

April 16, 2018 / By: David Roseborough, PhD
Dr. David Roseborough with his 682 Mixed Methods Research group at Clinical Presentation Day in 2017
Research Team at 2017 Clinical Presentation Day

Graduates of our MSW program no doubt remember completing an original piece of research by way of your own clinical research paper (GRSW 682). These projects, serving as an internship in research, have consistently sought to have both clinical relevance and to link to practice in a meaningful way.

With this in mind, last year I proposed the idea to my applied research seminar of completing a group project, where we would pair up with a local mental health clinic (in this case, Hamm Memorial Psychiatric Clinic, now over sixty years old) to look at both some quantitative and qualitative data they had, as a form of secondary data analysis. The clinic embraced the idea, and when I offered this option to my seminar, seven graduate students did as well. (People had the option to take part in this or to continue with their own individual project. We had takers in both camps).

We accessed quantitative data (in the form of Outcome Questionnaire, or OQ 45.2 scores), to measure the extent to which clients improved over time: from beginning psychotherapy, upon ending it, and then two years later. We saw strong evidence that, using an empirical measure, participants made and maintained statistically and clinically significant gains. In fact, OQ scores tended to continue to improve even after psychotherapy ended. (This phenomenon has been referred to by some scholars as an incubation effect).

We were also able to review transcripts from 14 former participants in psychotherapy who agreed to return to the clinic and to talk about how their experience in therapy had been. In these, former clients were asked by two staff clinicians about how these adults had both (1) made change and (2) maintained the changes they made. While this may seem like an obvious question, scientists like Michael Kazdin (2009) of Yale have noted how infrequently clients have been asked directly about “what helps” from their perspective. These former clients had a lot to say.

We all really enjoyed partnering with a “real life clinic” and completing this project together. Students were able to code the interviews both individually and then as a group. We benefitted from interview questions originally created by a group of staff clinicians and from Dr. Laurel Bidwell, who consulted with us on what a mixed method design could look like for a project like ours.

We were able to present our findings not only at the 2017 Clinical Paper Day as a group, but we presented at the clinic to the staff, and to a standing committee on Hamm’s Board of Directors. The clinic has gone on to use parts of our report as part of their orientation for new interns. We were pleased to have a summary of this project accepted for a poster presentation at a national research conference: the Society for Social Work Research (SSWR). I enjoyed representing our group and presented this this past January in Washington, D.C. Finally, we’ve also recently submitted a pared down version of this paper in the form of a journal article, which we hope to publish. In the meantime, if you’d like to read the paper in its entirety, it is available electronically on Sophia, St. Catherine University’s electronic repository, at: (It can be searched by simply entering the title: "Making and sustaining change from psychotherapy: a mixed methods study).