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Within-condition t tests are also useful for determining whether a speci c condition actually showed signi cant change for any given dependent measure. This statistical procedure is especially important for follow-up assessments in order to ascertain whether a condition is generating increased, maintained, or decreased improvement relative to posttherapy levels. Special consideration should be given to participants with missing data. Investigators can usefully analyze the results separately on (a) only clients without any missing data and (b) all clients wherein missing data are replaced either by regression-determined values or by using the client s last available assessment score (end point analysis). Of course, the greater the amount of missing data, the less con dent one can be about one s conclusions, especially if analyses with and without clients having missing data yield different results. (For a detailed discussion of approaches to handling missing data, the reader is referred to the chapter by Graham, Cumsille, & Elek-Fisk in this volume.) Finally, power analyses should be conducted in order to verify a low probability of Type II error (see Cohen, 1988). Insuf cient power resulting from small sample sizes may help to explain the absence of a difference between any two conditions. (For a detailed discussion of power analyses, the reader is referred to the chapter by Wilcox in this volume.) As we have described in this section, several considerations factor into the statistical analysis of data in psychotherapy outcome research. An emerging recent concern, however, has been that investigators demonstrate the practical signi cance of their interventions in addition to showing statistical signi cance. In the next section, we present considerations associated with demonstrating that a given intervention leads to clinically signi cant change.

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that clinicians try to incorporate research findings into their practices whereas researchers tend less often to incorporate the concerns of clinicians into their research (Addis, 2002; Beutler et al., 1995). Several professional journals have been developed to specifically bridge the gap between research and practice (e.g., Clinical Psychology: Science and Practice; In Session: Psychotherapy in Practice). Talley, Strupp, and Butler (1994) proposed that research be made more relevant to clinicians by providing a therapeutic context for research results and interpretation, and that research funding be made more sensitive to the needs of clinicians. Stricker and Trierweiler (1995) and Clement (1996) suggested that clinicians bring the same rigorous scientific thinking and attitude to their practice as researchers bring to their experiments. Fensterheim and Raw (1996) suggested that clinical research and practice are such distinct areas that they should deintegrate clinical research from clinical practice so that workers from each area can meet as peers, each accepting that the other has different modes of thinking, of researching, and respecting that difference (p. 170).

40 breast cancer survivors receiving adjuvant therapy 25 survivors with prostate cancer (n = 12) or leukemia /carcinoma (n = 13) 20 survivors with various cancers 55 breast cancer survivors receiving adjuvant therapy

various factor analyses of personality test and rating scale data that recurrently identi ed four to six factors to which individual differences in personality could be attributed (see Digman, 1990) Selecting self-report items related to their preferred ve-factor formulation, Costa and McCrae developed a questionnaire that yields scores along ve trait dimensions, which they called domain scales : neuroticism, extraversion, openness, agreeableness, and conscientiousness Their effort resulted in the 1985 publication of the NEO Personality Inventory, currently available in revised form as the NEO PI-R (Costa & McCrae, 1992) Like the 16-PF, the NEO PI-R was intended as a measure of normal personality characteristics but has proved useful in evaluating personality problems in disturbed persons (see Piedmont, 1998).

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Human beings communicated with speech, which developed and evolved over thousands of years This was our principal form of communication However, it was not exactly communication at a distance Speech distance might be measured in feet or meters At the same time there was visual communication with body language and facial expressions This form of communication had even more limited distance Then there was semaphore, which was very specialized and required considerable training Semaphore was slow but could achieve some miles of distance using the manual version Semaphore consisted of two ags, one in each hand A ag could assume any one of six positions 45 degrees apart The two ags then could have six times six, or 36 unique positions This accommodated the 25-letter alphabet and 10 numbers The letters i and j became one letter for the 26-letter alphabet.

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