Identifying Reliable Change in Outcome Assessments for Behavioral Interventions

Behavioral interventions have demonstrated group-level benefits for a variety of behavioral presentations and conditions. The ability to capture and quantify reliable individual-level change during the course of behavioral interventions is essential for making rational clinical management decisions. Recently, the neurobehavioral evaluation tool (NET) was developed and revised for use within behavioral intervention outcome assessment. Traditional, practice-adjusted, and standardized regression-based reliable change indices (RCIs) were calculated for the NET domains to provide reliable change norms. In two samples (Ns = 498 and 125), traditional RCIs indicated that reliable symptom reductions and skill improvements needed to be +/− 0.7 to 1.3 SDs across domains. Standardized regression-based change norms indicated that slightly smaller magnitude changes are required to be considered reliable. NET-derived RCIs can be used to inform clinical management during behavioral interventions. Regression-based RCIs may be particularly useful for guiding clinical management for individuals with very high symptoms/very low skills at baseline.