Evan Lima


Psychological services have become increasingly important and accepted. The increase in the utilization of services has led to third party payers (e.g., insurance companies) paying more in reimbursement to providers of psychological services and therefore tightening parameters regarding how many sessions will be reimbursed. With the pressure from third party payers, a standardized means of monitoring client’s progress in treatment has become necessary. The goal of the current study was to determine whether (1) the trajectories of Outcome Questionnaire 45 (OQ-45) and Outcome Rating Scale (ORS) scores are the same over time, and if the Session Rating Scale (SRS) predicts subsequent scores for both the (2) OQ-45 and (3) ORS. Data was collected from adults seeking psychological services provided by doctoral students at the Loma Linda University Behavioral Health Institute. We conducted a series of multilevel models for longitudinal data for our first hypothesis and simple regression analyses for our second and third hypotheses. Due to the non-significant relationship between OQ-45 and ORS scores, our first hypothesis, which stated that scores on the OQ-45 and the ORS change at the same rate over time, was not supported, p > .05. We conducted a simple linear regression for our second and third hypotheses, which state that the SRS would predict the score of the subsequent sessions OQ-45 and ORS, respectively. Results indicated that scores on the SRS did not explain a significant amount of the variance in OQ-45 scores, p > .05. However, results indicated that scores on the SRS explained a significant amount of the variance of the subsequent sessions ORS scores (R2 = .065). Specifically, as SRS scores increase by one point, ORS scores increase by .403 points, 95% CI [.045, .762], p < .05.

LLU Discipline

Clinical Psychology




School of Behavioral Health

First Advisor

Vermeersch, David A.

Second Advisor

Arechiga, Adam L.

Third Advisor

Neece, Cameron

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Psychotherapy; Professional-Patient Relations; Patient Satisfaction; Brief Psychiatric Rating Scale; Psychometrics; Factor Analysis - Statistical

Subject - Local

Outcome Questionnaire 45; Outcome Rating Scale; Session Rating Scale; Linear Regression; Patient Progress



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives