Client Evaluations of Therapeutic Processes and Outcomes in a University Mental Health Center

Abstract

Evaluations of therapeutic processes and outcomes by clients, therapists, and independent third parties are all important dimensions in an overall system of accountability for a college mental health facility. This study focused on client evaluation. All clients (N = 287) who used mental health services in a large midwestern university during a two-week period completed an evaluative questionnaire. In contrast to previous satisfaction studies that focused on overall satisfaction, this study examined specific therapist and client tasks and their relationship to outcomes. The findings indicate that different types of client evaluation items yield somewhat different results. Those specific evaluation items have varying relationships with overall measures of client satisfaction and problem improvement. The study also pointed to the importance of looking at sex differences in client evaluations of therapy and at differences among therapists in their relative success in working with clients with differing problems.

“The Diagnosis of Testicular Torsion,” Bruce E. Haynes, Howard A. Bessen, and Vital E. Haynes. Prompt diagnosis of testicular torsion remains difficult. Since warning symptoms occur in one third of patients and salvage rates correspond to the interval between symptom onset and operation, higher salvage rates should be achievable. Separating torsion from epididymitis is complicated by overlapping ages of peak incidence, shared symptoms, and the need for rapid distinction of the two. Doppler studies (88% accuracy) and nuclear scans (95% accuracy) help confirm the diagnosis, but correct technique is essential, and their use should not delay prompt operation. The diagnosis of epididymitis should be made cautiously in persons younger than the age of 35 years. (Journal of the American Medical Association 1983;249:2522–2527.)

“Hepatitis and Jaundice Associated with Measles in Young Adults: An Analysis of 65 Cases,” Dov Gavish, Yosef Kleinman, Abraham Morag, Tova Chajek-Shaul. We analyzed the clinical course of 65 adult patients hospitalized because of measles during the years 1975 and 1981–1982. Liver involvement was found in 80% (52/65) of the patients, five patients had clinical jaundice. The disturbances of liver function tests reached their peak values between days 5 and 10 of the disease. In this study of measles in adulthood we have three observations of unusual interest: (1) hepatitis occurs commonly in the more severely ill patients and it may manifest clinically as jaundice; (2) long-term follow-up (up to seven years) shows a clear tendency to complete resolution of the liver damage; (3) there is a clear correlation between the severity of hepatic involvement and the occurrence of secondary bacterial infections. (Archives of Internal Medicine 1983;143:674–677)