Enhancing mental health and well being outcomes for psychotherapy and counselling through idiographic analysis: A four quadrant approach

Jenna Jacob, John P. Rae, Beatrice Allegranti, Charlie Duncan, Mick Cooper

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© 2023, British Association for Counselling and Psychotherapy. The attached document (embargoed until 25/04/2024) is an author produced version of a paper published in Counselling and Psychotherapy Research uploaded in accordance with the publisher’s self-archiving policy. The final published version (version of record) is available online at the link. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.
AbstractMental health and well‐being outcomes in psychotherapy and counselling have largely been studied through the use of standardised nomothetic measurement. A key limitation is that nomothetic measurement and current statistical analyses do not necessarily capture the outcomes of the complicated and individual psychotherapy processes. There is an increased interest in the use of idiographic patient‐reported outcome measures (I‐PROMs), which are uniquely useful because they may explore areas of importance that are unexplored by nomothetic outcome measures. We argue that to optimise the value of I‐PROMs, it is necessary to consider their contribution alongside standardised nomothetic measures. However, there are important considerations with respect to whether or not I‐PROMs from different clients, or indeed from the same client, can be meaningfully explored at a team/service level, and alongside standardised nomothetic outcomes. We provide worked examples on real client data to show that delineating four quadrants of analysis is important to explore the breadth of information: (a) individual progress on single items, (b) individual progress by aggregated scores, (c) team/service‐level progress by goal item/theme and (d) team/service‐level progress by aggregated scores.
Original languageEnglish
JournalCounselling and Psychotherapy Research
Early online date25 Apr 2023
Publication statusPublished - 25 Apr 2023


  • Psychiatry and Mental health
  • Applied Psychology
  • Clinical Psychology

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