Assessing Outcomes: Practical Methods and Evidence

University counseling center clients' (N = 52) perceptions of precounseling functioning were highly correlated with their actual well-being scores at intake. The magnitude of change based on perceptions of precounseling functioning to current well-being was approximately double of what is found from the difference of actual precounseling well-being to current well-being scores. Retrospective methods for assessing precounseling functioning are best suited for comparison among clients or counseling processes. Keywords: retrospective data, counseling outcomes, multicultural competency ********** The number of college students seeking help at university counseling centers is on the rise (Gallagher, 2005). With increased demand for services, it is important for counseling centers to keep pace with staffing needs in order to deliver adequate services, a key concern in campuses across the United States (see Owen & Rodolfa, 2009). Many counseling center directors use formal and informal satisfaction and outcome assessments to ensure that current services are adequately addressing their clients' needs. These assessments can also support the mission of counseling centers by highlighting areas of strength (e.g., providing multiculturally competent treatment) as well as identifying areas of need (e.g., long wait times because of lack of staff). The utility of formal treatment evaluations has slowly, but steadily, moved into center stage over the past 2 decades. For instance, client-based feedback systems, wherein counselors receive reports of their clients' psychological well-being/distress before every session, have been empirically supported as a meaningful way to enhance treatment (M. J. Lambert & Shimokawa, 2011; Reese, Toland, Slone, & Norsworthy, 2010). This approach to understanding clients' welfare and trajectories of change (or lack thereof) is in many ways a gold standard of assessing counseling outcomes. In particular, clients' precounseling functioning and their early change (e.g., changes in distress from precounseling to third or fourth session) are robust predictors of counseling outcomes (e.g., Anker, Owen, Duncan, & Sparks, 2010; Barber, 2009). However, quite often, counseling centers (as well as researchers) would like to have more information about the psychological services provided at their counseling center, information that would be too burdensome to collect every session or even periodically. Moreover, nearly 40% to 60% of clients drop out of counseling (Sharf, Primavera, & Diener, 2010; Wierzbicki & Pekarik, 1993); therefore, it is important to understand these clients' experiences. To address the broader evaluation needs, some counseling centers use anonymous surveys to try to understand the effectiveness of various facets of their services, such as multicultural competencies. These evaluations can provide an opportunity to gather more information as well as reach those clients who may no longer be attending services. Although the anonymity of such surveys is likely a useful way to promote honest feedback and protect clients' confidentiality, it introduces another issue: How can such surveys capture clients' precounseling functioning without actually assessing their functioning before counseling services? The answer to this question can be found partly in naturalistic studies (i.e., pre-post evaluations of counseling services without manipulation of treatment), in particular, retrospective naturalistic research designs. These designs gained substantial attention through Seligman's (1995) analysis of the Consumer Reports (CR) retrospective analysis of approximately 3,000 clients who reported about their counseling experience. In some areas of counseling research, retrospective designs are very prevalent. For instance, all known studies examining clients' perceptions of their counselors' multicultural counseling competencies have relied on retrospective designs (e. …