The Authenticity Scale as an Outcome Measure for Psychotherapy: A Psychometric Evaluation

Abstract

We aimed to evaluate how the Authenticity Scale, a measure of authenticity based on humanistic psychology, functioned as an outcome measure for psychological therapies. Ninety participating clients completed the Authenticity Scale at set intervals throughout their therapy. We considered the measure’s reliability, construct validity, acceptability, and sensitivity to therapeutic intervention. The Authenticity Scale and each of its subscales (Authentic Living, Accepting External Influences, and Self-Alienation) were found to have excellent internal reliability and very high completion rates. The full scale was also found to be sensitive to psychotherapeutic intervention, along with two of its three subscales. However, subscale intercorrelations revealed issues with the factor structure of the measure, with one subscale not correlating with the other two, drawing into question whether the Authenticity Scale should be seen to operationalize a single, multi-faceted construct as intended. Our study provides preliminary evidence that the Authenticity Scale can be used as an outcome measure in clinical practice, though caution and further psychometric testing are strongly recommended.

Keywords

authenticity outcome measure routine outcome monitoring sensitivity to intervention humanistic psychology positive psychology

Get full access to this article

View all access options for this article.

References

Barkham

Bewick

Mullin

Gilbody

Connell

Cahill

Mellor-Clark

Richards

Unsworth

Evans

(2013). The CORE-10: A short measure of psychological distress for routine use in the psychological therapies. Counselling and Psychotherapy Research, 13(1), 3–13. https://doi.org/10.1080/14733145.2012.729069

Barnett

M. D.

Deutsch

J. T.

(2016). Humanism, authenticity, and humor: Being, being real, and being funny. Personality and Individual Differences, 91, 107–112. https://doi.org/10.1016/j.paid.2015.12.004

Barrett-Lennard

G. T.

(1998). Carl Rogers’ helping system: Journey & substance. SAGE.

Bayliss-Conway

Price

Murphy

Joseph

(2020). Client-centred therapeutic relationship conditions and authenticity: A prospective study. British Journal of Guidance & Counselling, 49(5), 637–647. https://doi.org/10.1080/03069885.2020.1755952

Bohart

A. C.

(2013). The actualizing person. In Cooper

O’Hara

Schmid

P. F.

Bohart

A. C.

(Eds.), The handbook of person-centred psychotherapy and counselling (pp. 84–101). Palgrave Macmillan.

Bond

M. J.

Strauss

N. E.

Wickham

R. E.

(2018). Development and validation of the Kernis-Goldman authenticity inventory-short form (KGAI-SF). Personality and Individual Differences, 134, 1–6. https://doi.org/10.1016/j.paid.2018.05.033

Boswell

J. F.

Kraus

D. R.

Miller

S. D.

Lambert

M. J.

(2015). Implementing routine outcome monitoring in clinical practice: Benefits, challenges, and solutions. Psychotherapy Research, 25(1), 6–19. https://doi.org/10.1080/10503307.2013.817696

Boyraz

Kuhl

M. L.

(2015). Self-focused attention, authenticity, and well-being. Personality and Individual Differences, 87, 70–75. https://doi.org/10.1016/j.paid.2015.07.029

Boyraz

Waits

J. B.

Felix

V. A.

(2014). Authenticity, life satisfaction, and distress: A longitudinal analysis. Journal of Counseling Psychology, 61(3), 498–505. https://doi.org/10.1037/cou0000031

10.

Carlier

I. V.

Meuldijk

Van Vliet

I. M.

Van Fenema

Van der Wee

N. J.

Zitman

F. G.

(2012). Routine outcome monitoring and feedback on physical or mental health status: Evidence and theory. Journal of Evaluation in Clinical Practice, 18(1), 104–110. https://doi.org/10.1111/j.1365-2753.2010.01543.x

11.

Carlier

I. V.

van Eeden

W. A.

(2017). Routine outcome monitoring in mental health care and particularly in addiction treatment: Evidence-based clinical and research recommendations. Journal of Addiction Research and Therapy, 8(4), 1–7. https://doi.org/10.4172/2155-6105.1000332

12.

Corrie

(2010). What is evidence? In Woolfe

Strawbridge

Douglas

Dryden

(Eds.), Handbook of counselling psychology (3rd ed., pp. 44–61). SAGE.

13.

Evans

Mellor-Clark

Margison

Barkham

Audin

Connell

McGrath

(2000). CORE: Clinical outcomes in routine evaluation. Journal of Mental Health, 9(3), 247–255. https://doi.org/10.1080/jmh.9.3.247.255

14.

Fat

L. N.

Scholes

Boniface

Mindell

Stewart-Brown

(2017). Evaluating and establishing national norms for mental wellbeing using the short Warwick–Edinburgh mental well-being scale (SWEMWBS): Findings from the health survey for England. Quality of Life Research, 26(5), 1129–1144. https://doi.org/10.1007/s11136-016-1454-8

15.

Freire

(2007, January). The Strathclyde Inventory: Validation of a person-centred outcome measure [Paper presentation]. BACP Research Conference, Birmingham, UK.

16.

Harter

(2002.). Authenticity. In Snyder

C. R.

Lopez

S. J.

(Eds.), Handbook of positive psychology (pp. 382–394). Oxford University.

17.

Horney

(1951). Neurosis and human growth: The struggle toward self-realization. Routledge.

18.

Husted

J. A.

Cook

R. J.

Farewell

V. T.

Gladman

D. D.

(2000). Methods for assessing responsiveness: A critical review and recommendations. Journal of Clinical Epidemiology, 53, 459–468. https://doi.org/10.1016/S0895-4356(99)00206-1

19.

Hutchinson

D. S.

(1995). Ethics. In Barnes

(Ed.), The Cambridge companion to Aristotle (pp. 195–232). The Press Syndicate of the University of Cambridge.

20.

IBM Corp. (2017). IBM SPSS statistics for Macintosh (Version 28.0.1.1) [Computer software].

21.

Joseph

Murphy

(2013). Person-centered approach, positive psychology, and relational helping: Building bridges. Journal of Humanistic Psychology, 53(1), 26–51. https://doi.org/10.1177/0022167812436426

22.

Joseph

Wood

(2010). Assessment of positive functioning in clinical psychology: Theoretical and practical issues. Clinical Psychology Review, 30, 830–838. https://doi.org/10.1016/j.cpr.2010.01.002

23.

Kernis

M. H.

Goldman

B. M.

(2006). A multicomponent conceptualization of authenticity: Theory and research. Advances in Experimental Social Psychology, 38, 283–357. https://doi.org/10.1016/S0065-2601(06)38006-9

24.

Kim

Joseph

Price

(2020). The positive psychology of relational depth and its association with unconditional positive self-regard and authenticity. Person-Centered & Experiential Psychotherapies, 19(1), 12–21. https://doi.org/10.1080/14779757.2020.1717983

25.

Kyriazos

(2018). Applied psychometrics: Sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in General. Psychology, 9(8), 2207–2230. https://doi.org/10.4236/psych.2018.98126

26.

Lambert

M. J.

Burlingame

G. M.

Umphress

Hansen

N. B.

Vermeersch

D. A.

Clouse

G. C.

Yanchar

S. C.

(1996). The reliability and validity of the Outcome Questionnaire. Clinical Psychology & Psychotherapy, 3(4), 249–258. https://doi.org/10.1002/(SICI)1099-0879(199612)3:4<249::AID-CPP106>3.0.CO;2-S

27.

Lenton

A. P.

Bruder

Slabu

Sedikides

(2013). How does “being real” feel? The experience of state authenticity. Journal of Personality, 81(3), 276–289. https://doi.org/10.1111/j.1467-6494.2012.00805.x

28.

Litman

J. A.

Robinson

O. C.

Demetre

J. D.

(2016). Intrapersonal curiosity: Inquisitiveness about the inner self. Self and Identity, 16(2), 231–250. https://doi.org/10.1080/15298868.2016.1255250

29.

Markus

Nurius

(1986). Possible selves. American Psychologist, 41, 954–969. https://doi.org/10.1037/0003-066X.41.9.954

30.

Maslow

A. H.

(1968). Toward a psychology of being (2nd ed.). Van Nostrand Reinhold.

31.

May

(1981). Freedom and destiny. Basic Books.

32.

McCormick

W. H.

Turner

L. A.

Foster

J. D.

(2015). A model of perceived, authenticity, contingent self-worth and internalized aggression among college students. Personality and Individual Differences, 86, 504–508. https://doi.org/10.1016/j.paid.2015.06.050

33.

Patterson

T. G.

Joseph

(2006). Development of a measure of unconditional positive self-regard. Psychology and Psychotherapy: Theory, Research and Practice, 79, 557–570. https://doi.org/10.1348/147608305X89414

34.

Patterson

T. G.

Joseph

(2007). Outcome measurement in person-centred practice. In Worsley

Joseph

(Eds.), Person-centred practice: Case studies in positive psychology (pp. 200–217). PCCS.

35.

Pillow

D. R.

Hale

W. J.

Jr. Crabtree

M. A.

Hinojosa

T. L.

(2017). Exploring the relations between self-monitoring, authenticity, and well-being. Personality and Individual Differences, 116, 393–398. https://doi.org/10.1016/j.paid.2017.04.060

36.

Pinto

D. G.

Maltby

Wood

A. M.

(2011). Exploring the tripartite model of authenticity within Gray’s approach and inhibition systems and Cloninger’s bio-social model of personality. Personality and Individual Differences, 51(2), 194–197. https://doi.org/10.1016/j.paid.2011.03.040

37.

Robinson

O. C.

Demetre

J. D.

Litman

J. A.

(2017). Adult life stage and crisis as predictors of curiosity and authenticity: Testing inferences from Erikson’s lifespan theory. International Journal of Behavioral Development, 41(3), 426–431. https://doi.org/10.1177/0165025416645201

38.

Rogers

C. R.

(1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 95–103.

39.

Rogers

C. R.

(1959). A theory of therapy, personality and interpersonal relationships as developed in the client-centered framework. In Koch

(Ed.), Psychology: A study of science (pp. 184–256). McGraw-Hill.

40.

Rogers

C. R.

(1961a). On becoming a person: A therapist’s view of psychotherapy. Houghton Mifflin.

41.

Rogers

C. R.

(1961b). The process-equation of psychotherapy. American Journal of Psychotherapy, 15, 27–45.

42.

Slabu

Lenton

A. P.

Sedikides

Bruder

(2014). Trait and state authenticity across cultures. Journal of Cross-Cultural Psychology, 45(9), 1347–1373. https://doi.org/10.1177/0022022114543520

43.

Stephen

Elliott

(2022). The Strathclyde Inventory: Development of a brief instrument for assessing outcome in counseling according to Rogers’ concept of the fully functioning person. Measurement and Evaluation in Counseling and Development, 55, 187–206. https://doi.org/10.1080/07481756.2021.1955213

44.

Stratford

P. W.

Riddle

D. L.

(2005). Assessing sensitivity to change: Choosing the appropriate change coefficient. Health and Quality of Life Outcomes, 3, 23–30. https://doi.org/10.1186/1477-7525-3-23

45.

Tarescavage

A. M.

Ben-Porath

Y. S.

(2014). Psychotherapeutic outcomes measures: A critical review for practitioners. Journal of Clinical Psychology, 70(9), 808–830. https://doi.org/10.1002/jclp.22080

46.

Tennant

Hillier

Fishwick

Platt

Joseph

Weich

Parkinson

Secker

Stewart-Brown

(2007). The Warwick–Edinburgh Mental Well Being Scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes, 5, Article 63. https://doi.org/10.1186/1477-7525-5-63

47.

Wampold

B. E.

(2015). Routine outcome monitoring: Coming of age—With the usual developmental challenges. Psychotherapy, 52(4), 458–462. https://doi.org/10.1037/pst0000037

48.

Winnicott

(1965). The maturational process and the facilitating environment. Hogarth.

49.

Wood

A. M.

Linley

P. A.

Maltby

Baliousis

Joseph

(2008). The authentic personality: A theoretical and empirical conceptualization and the development of the authenticity scale. Journal of Counseling Psychology, 55(3), 385–399. https://doi.org/10.1037/0022-0167.55.3.385