Many college counseling centers use outcome measures to track therapeutic change for their clientele. These questionnaires have traditionally looked primarily at a client's symptom distress (e.g. depression, anxiety, suicidality, etc.) and are used to detect changes in the client's life that are due to therapy. Unfortunately, there is no measure that has been exclusively created and validated for use with college students. The College Adjustment Scales (CAS) form a multidimensional psychological measure designed specifically for use in college and university settings. Even though the CAS was created as a screening tool, it contains items that provide insight into changes that are possibly taking place for college students in therapy that are not measured by current outcome questionnaires. The purpose of this study was to determine which items and scales on the CAS were sensitive to therapeutic change for college students, thus assessing the validity of the test as an outcome measure and providing data for the development of future college counseling specific outcome questionnaires. This study used hierarchical linear modeling (HLM) to generate slopes that represent change over time for treatment and control groups. These slopes were compared to each other in order to determine whether each item and scale was sensitive to therapeutic change. The control sample consisted of 127 student participants that were not in therapy. The treatment sample was archival and consisted of 409 student clients. Seven of the nine scales were found to be sensitive to therapeutic change. However, 45 of the 108 individual items did not meet the set criteria. Because of these findings, the creators of the CAS are encouraged to revise the measure if it is to be used as an outcome questionnaire. In addition, researchers and clinicians should consider these results and take care not to treat this measure as an instrument that is wholly sensitive to therapeutic change for the college population. Items found to be sensitive to therapeutic change can be used to create a new outcome measure specifically for counseling centers.



College and Department

David O. McKay School of Education; Counseling Psychology and Special Education



Date Submitted


Document Type





college counseling, Item sensitivity to change, college adjustment, outcome questionnaire