Journal of Humanistic Psychology, Ahead of Print.
Fifteen years ago, Pfaffenberger (2006) applied five implicit paradigmatic assumptions identified by Slife of the dominant positivistic medical model paradigm—hedonism, universalism, atomism, materialism, and objectivism—to psychotherapy outcome research and its practice implications. Her applied theoretical essay revealed critical issues involving hidden power and privilege dynamics therein. Furthermore, Levitt et al.’s (2005) research examined nine then-common outcome instruments to determine the extent to which their item content reflected humanistic psychology principles in nine domains derived from the authors’ systematic review and thematic analysis of the humanistic literature. Their content analysis revealed that the majority of those domains were inadequately represented. In this article, using thematic discourse analysis (aka latent thematic analysis), I first identify how the philosophical and political assumptions summarized by Pfaffenberger are apparent in three outcome instruments that are commonly used in U.S. community mental health settings today: the Adult Needs and Strengths Assessment, the Ohio Mental Health Consumer Outcomes System, and the DSM-5 assessment measures. As part of my analysis, I contrast paradigmatic assumptions of the medical model with those of humanistic/existential psychology as a basis for contextualizing and understanding the implications of measurement-based care as articulated through the two discourses. Then, second, based on a summative content analysis of the three instruments, I report on the progress that both has been and remains to be made in their item content since Levitt et al. noted the general dearth of humanistic principles in mental health outcome measurement. Suggestions for future research and instrument development are discussed.