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Reflections on Clinical Significance: What Do Our Best Treatments Accomplish and How Can We Best Find Out?


Address correspondence to Bruce F. Chorpita, Department of Psychology, University of Hawaii at Manoa, 2430 Campus Road, Honolulu, HI 96822. E-mail:


Recent developments in clinical psychology have involved important advances in the treatments available for childhood disorders. Sheldrick et al. evaluated selected treatments for childhood behavior problems, skillfully demonstrating the application of two statistical procedures for estimating clinical significance. Statistics to estimate clinical effects using traditional dependent measures is an certainly important step toward estimating the gains that such treatments can accomplish, and such estimation of clinical effects should arguably become a routine part of the treatment outcome literature. However, the consideration of a variety of additional indices as a complement to the statistical estimation of clinical significance may ultimately be necessary to determine the true utility of treatments. Many such indices were originally outlined by the APA Task Force on Psychological Intervention Guidelines and are reviewed here in the context of evaluating best treatments.