Measuring Spiritual Outcomes in Psychotherapy

The Theistic Spirituality Outcome Scale (TSOS) has potential as a useful outcome measure.


Recently, a group of us completed a study of clients who saw Christian counselors. We assessed their current well-being using two measures: The Schwartz Outcome Scale (SOS) and the Theistic Outcome Scale (TSOS). (See references below.)


The TSOS was designed by Richards (2005) as a measure of well-being for people associated with a theistic religion like Christianity, Judaism or Islam. We used the 17-item version, which uses a 5-point response format from 1 = never to 5 = almost always to rate each item (e.g., “I felt spiritually alive.”).


Reliability

We only calculated coefficient alpha, which was strong at .95.

Validity

The TSOS was significantly correlated with ratings of satisfaction with Christian counseling (.65) and likelihood of returning to Christian counseling (.62).

It was significantly correlated with the SOS measure of general well-being (.84).

Other significant correlations were:

TIPI (a Big 5 measure; Gosling et al., 2003)

Extraversion .34

Agreeableness .50

Neuroticism .51

Conscientiousness .39

Snyder's Hope Scale .72 (Snyder et al., 2010)

Attachment to God Inventory (Beck & McDonald, 2004)

  Avoidant  -.55

  Anxious   -.40

Religious Practices Index  .41 (See Sutton et al., 2016)

Intratextual Fundamentalism Scale .56 (See Williamson et al., 2010)

Counselors, read more about reliability and validity of test scores in APPLIED STATISTICS: CONCEPTS FOR COUNSELORS

Resource Link:  A – Z Test Index

References

Beck, R., & McDonald, A. (2004). Attachment to God: The Attachment to God Inventory, tests of working model correspondence, and an exploration of faith group differences. Journal of Psychology and Theology, 32, 92-103. doi:10.1037/t46035-000

Gosling, S. D., Rentfrow, P. J., & Swann, Jr., W. B. (2003). A very brief measure of the big-five personality domains. Journal of Research in Personality, 37, 504-528. doi:10.1016/s0092-6566(03)00046-1

Richards, P. S., Smith, T. B., Schowalter, M., Richard, M., Berrett, M. E., & Hardman, R. K. (2005). Development and validation of the Theistic Spiritual Outcome Survey. Psychotherapy Research, 15, 457-469. doi:10.1080/10503300500091405

Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., Yoshinoba, L., Gibb, J., Langelle, C., & Harney, P. (1991). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60, 570-585. doi:10.1037/0022-3514.60.4.570

Sutton, G. W., Arnzen, C. A., & Kelly, H. L. (2016). Christian counseling and psychotherapy: Components of clinician spirituality that predict type of Christian intervention. Journal of Psychology and Christianity, 35, 204-214.

Sutton, G. W., Kelly, H., Worthington, E. L. Jr., Griffin, B. J., & Dinwiddie, C. (in press) Satisfaction with Christian Psychotherapy and Well-being: Contributions of Hope, Personality, and Spirituality. Spirituality in Clinical Practice.

Williamson, W. P., Hood, R. W. Jr., Ahmad, A., Sadiq, M., Hill, P. C. (2010). The Intratextual Fundamentalism Scale: Cross-cultural application, validity evidence, and relationship with religious orientation and the big 5 factor markers. Mental Health, Religion & Culture, 13, 721-747. doi:10.1080/13674670802643047

Read more about validity of surveys and tests in CREATING SURVEYS

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What makes a test valid?

 

What makes a test valid? is a tricky question. 

The short, and rather obnoxious response is, “nothing.” 

Like reliability, validity is a property of test scores

 rather than tests but more accurately, an interpretation
of the scores.

But it is important to take the question seriously when test-takers and users are wondering how much confidence to place in a test score. As with many aspects of science, the answers can be simply stated but there is a complicated backstory.

Validity Traditions

For many, the traditional views of test score validity will be sufficient. Tests measure constructs. Scientific constructs are ideas that have features that can be measured like reading comprehension, dominance, short-term memory, and verbal intelligence.

Construct validity is not a single entity but rather the current state of knowledge about how a test instrument’s scores have functioned in many settings and in relation to criteria. Construct validity primarily includes findings from studies of content validity, convergent validity and discriminant validity.

Content validity is based on judgment analysis from experts who mostly agree that test items measure the construct (e.g., marital satisfaction).

The other types of validity are based on the concept of correlations with a criterion. Researchers ask participants to take a specific test X along with other tests Y and Z. Test X is the test of interest such as a new math achievement test. Test Y represents other similar tests such as other math tests. When test X and test Y yield similar scores we have evidence of convergent validity.

When test X and test Z yield dissimilar results such as a relationship between our test X math achievement and test Z vocabulary, we have evidence of discriminant validity—a math test ought not to measure vocabulary aside from the minimal vocabulary used in the instructions and word problems. The relationship between the tests is based on a statistic called the validity coefficient, which will vary anytime you have a group of people taking two tests—even the very same people will get different scores on two different testing dates.

Criterion validity compares test scores to some criterion. The relationship between depression test scores measuring depression today is called concurrent validity. The relationship between test scores today and some future measurable performance is predictive validity—for example, a pre-employment test may be correlated with supervisor ratings after six months on the job.

Aside from content validity, most traditional studies are looking at the strength of the relationship between one set of test scores and another.

Factor analysis is a complex correlational procedure that examines the underlying relationship among test items and how they relate to other test items. For example, a set of vocabulary items may be correlated with answers to questions about general knowledge and be considered a “verbal factor” when the two sets of items may be grouped as representing an underlying verbal factor. These abstract underlying factors are sometimes called latent variables or latent traits.

Read more about validity of surveys and tests in CREATING SURVEYS- Chapter 18.

Counselors, read more about validity of test scores in APPLIED STATISTICS: CONCEPTS FOR COUNSELORS- Chapter 20.

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RELIABILITY 

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