Clinical Outcome, Consumer Satisfaction, and Ad Hoc Ratings of Improvement in Children's Mental Health

Mental health clinics and managed care organizations assess treatment effectiveness with consumer satisfaction measures and ad hoc measures of improvement obtained from a single informant; some of these measures are as simple as asking clients whether they improved during treatment. In the present correlational study of 199 treated adolescents, we used a multitrait-multimethod analysis to examine psychometrically measured pathology change (pre- and postassessment of symptoms and functioning), consumer satisfaction, and perceived improvement reported by multiple informants. Confirmatory factor-analytic results indicate that (a) outcome variance due to multiple informants cannot be ignored, (b) consumer satisfaction is unrelated to pathology change, and (c) parent-reported perceived improvement ratings are more akin to satisfaction than to pathology change.