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Updated: Aug 2, 2025

Functional Near-Infrared Spectroscopy Hyperscanning Study in Psychological Counseling
Published on: January 17, 2025
Sudden gains and deteriorations: Modeling the impact across outcomes with university counseling center clients
Joanna M Drinane1, Jesse Owen2, S Mark Kopta3
1Department of Educational Psychology, University of Utah, Salt Lake City, Utah, USA.
Objective:
This study examines the longitudinal impact of sudden gains/deteriorations across the outcomes associated with the phase model.
Method:
In a sample of 16,657 clients who completed the Behavioral Health Measure-20, we identified sudden gains/deteriorations and employed multilevel piecewise analyses to assess their impact on subsequent treatment phases.
Results:
We found that: (1) Following a sudden gain in the well-being outcome, the mean-level for the symptom outcome increased (meaning symptoms improved), and the rate of change decreased, (2) Following a sudden gain in the symptom outcome, the mean-level for the life functioning outcome increased, (3) Following a sudden deterioration in the well-being outcome, the mean-level and rate of change for the symptom outcome decreased, and (4) Following a sudden deterioration in the symptom outcome, the mean-level for the life functioning outcome decreased.
Conclusions:
These findings reveal that sudden gains/deteriorations function and occur at different rates across phases of change in psychotherapy.
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