Translation and validation of the Greek version of the Outcome Questionnaire-45.2
Published:
Jul 2, 2025
Keywords:
Outcome questionnaire, translation, greek, confirmatory factor analysis, validity, reliability
Abstract
The present study aimed to translate and validate the original English version of the Outcome Questionnaire (OQ-45.2) for use in the Greek context. A sample of 385 psychotherapy trainees (102 men and 283 women), aged 18 to 65 years, was recruited from a systemic/family psychotherapy training center in Greece. Participants completed the Greek version of the OQ-45.2 (OQ-45.2-GR), the World Health Organization Quality-of-Life Scale (WHOQOL-BREF), and a demographic questionnaire. Confirmatory factor analysis supported a three-factor structure consistent with the original English version, yielding satisfactory robust fit indices (χ2/df, p = .001; RMSEA = .060; SRMR = .091). The OQ-45.2-GR demonstrated high internal consistency (Cronbach’s α = .912) and acceptable test-retest reliability (r = .64, p < .01). Concurrent validity was evidenced through significant negative correlations between the OQ-45.2-GR and WHOQOL-BREF total and subscale scores (r ranging from -.29 to -.69, p < .01). These findings provide preliminary evidence for the reliability and validity of the OQ-45.2-GR as a measure of psychotherapy outcomes in Greek-speaking populations. The OQ-45.2 is a widely utilized instrument for evaluating psychotherapy outcomes and serves additionally as a screening tool to assess client needs at therapy initiation, thereby informing clinical decision-making and optimizing treatment planning. The availability of a validated Greek version of the OQ-45.2 is expected to enhance clinical assessment practices, contribute to evidence-based treatment planning, and facilitate further research into psychotherapy processes and outcomes within Greece.
Article Details
- How to Cite
-
Katakis, L., Vogazianos, P., Parpottas, P., Anagnostou, M., Chryssicopoulou, M., Dragioti, E., & Tsitsas, G. (2025). Translation and validation of the Greek version of the Outcome Questionnaire-45.2. Psychology: The Journal of the Hellenic Psychological Society, 30(1), 141–155. https://doi.org/10.12681/psy_hps.39687
- Section
- RESEARCH PAPERS
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The journal PSYCHOLOGY adopts a Platinum open-access policy. Submission, processing or publication costs are waived by the Hellenic Psychological Society. Papers published in the journal PSYCHOLOGY are licensed under a 'Creative Commons Attribution-ShareAlike 4.0 International' licence. The authors reserve the copyright of their work and grant the journal the right of its first publication. Third-party licensees are allowed to use the published paper immediately after publication as they wish, provided they retain the defined by the license copyright formalities, regarding the reference to its author(s) and its initial publication in the journal PSYCHOLOGY. Moreover, any adjusted work should be shared under the same reuse rights, so with the same CC license.
Downloads
Download data is not yet available.
References
Beck, A. T., & Steer, R. A. (1993) Beck Depression Inventory Manual. Psychological Corporation.
Bludworth, J. L., Tracey, T. J., & Glidden-Tracey, C. (2010). The bilevel structure of the Outcome Questionnaire-45. Psychological assessment, 22(2), 350–355. https://doi.org/10.1037/a0019187
Brosseau-Liard, P. É., Vandette, M.-P., Jamshidi, P., Kogan, C. S., & Aubry, T. (2020). Propriétés psychométriques de la version française (Mesure d’impact; MI-45) du Outcome Questionnaire-45 (OQ-45) en milieu clinique et universitaire [Psychometric properties of the French version (Measure of Impact; MI-45) of the Outcome Questionnaire-45 (OQ-45) in clinical and university settings]. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 52(1), 78–83. https://doi.org/10.1037/cbs0000138
Burlingame, G. M., & Beecher, M. E. (2008). New directions and resources in group psychotherapy: Introduction to the issue. Journal of Clinical Psychology, 64(11), 1197–1205. https://doi.org/10.1002/jclp.20534
Burlingame, G. M., Strauss, B. M., & Joyce, A. (2013). Change mechanisms and effectiveness of small group treatments. In M. J. Lambert (Ed.), Bergin and Garfield's handbook of psychotherapy and behavior change (pp. 640–689). John Wiley & Sons.
Burlingame, G. M., Whitcomb, K. E., Woodland, S. C., Olsen, J. A., Beecher, M., & Gleave, R. (2018). The effects of relationship and progress feedback in group psychotherapy using the Group Questionnaire and Outcome Questionnaire-45: A randomized clinical trial. Psychotherapy (Chicago, Ill.), 55(2), 116–131. https://doi.org/10.1037/pst0000133
de Beurs, E., den Hollander-Gijsman, M., Buwalda, V., Trijsburg, W., & Zitman, F. (2005). De Outcome Questionnaire OQ-45 Psychodiagnostisch gereedschap [The Outcome Questionnaire (OQ-45): Measuring psychiatric symptoms and interpersonal functioning]. Psycholoog, 40(7-8), 393–400.
de Jong, K., Nugter, M.A., Polak, M.G., Wagenborg, J.E.A., Spinhoven, P. and Heiser, W. (2007). The Outcome Questionnaire-45 in a Dutch population: A cross cultural validation. Clinical Psychology & Psychotherapy, 14, 288–301. https://doi.org/10.1002/cpp.529
Derogatis, L. R. (1977). SCL-90-R: Administration, scoring and procedures manual. Clinical Psychometric Research.
Derogatis, L. R., & Melisaratos, N. (1983). The Brief Symptom Inventory: An introductory report. Psychological Medicine, 13(3), 595–605. https://doi.org/10.1017/S0033291700048017
Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95(3), 542–575. https://doi.org/10.1037/0033-2909.95.3.542
Evans, C., Mellor-Clark, J., Margison, F., Barkham, M., Audin, K., Connell, J., & McGrath, G. (2000). CORE: Clinical outcomes in routine evaluation. Journal of Mental Health, 9(3), 247–255. http://doi.org/10.1080/jmh.9.3.247.255.
Feldman, L. A. (1993). Distinguishing depression and anxiety in self-report: Evidence from confirmatory factor analysis on nonclinical and clinical samples. Journal of Consulting and Clinical Psychology, 61(4), 631–638. https://psycnet.apa.org/doi/10.1037/0022-006X.61.4.631
Gillaspy, J. A., Wright, A. R., Campbell, C., Stokes, S., & Adinoff, B. (2002). Group alliance and cohesion as predictors of drug and alcohol abuse treatment outcomes. Psychotherapy Research, 12(2), 213–229. https://doi.org/10.1093/ptr/12.2.213
Ginieri-Coccossis, M., Triantafillou, E., Tomaras, V., Soldatos, C., Mavreas, V., & Christodoulou, G. (2012). Psychometric properties of WHOQOL-BREF in clinical and health Greek populations: Incorporating new culture-relevant items. Psychiatrike = Psychiatriki, 23(2), 130–142.
Hatfield, D. & Ogles, B.M. (2004). The use of outcome measures by psychologists in clinical practice. Professional Psychology, Research and Practice, 35, 485–491. http://dx.doi.org/10.1037/0735-7028.35.5.485
Horowitz L. M. (1979). On the cognitive structure of interpersonal problems treated in psychotherapy. Journal of Consulting and Clinical Psychology, 47(1), 5–15. https://doi.org/10.1037//0022-006x.47.1.5
Horowitz, L. M., Rosenberg, S. E., Baer, B. A., Ureño, G., & Villaseñor, V. S. (1988). Inventory of interpersonal problems: psychometric properties and clinical applications. Journal of Consulting and Clinical Psychology, 56(6), 885–892. https://doi.org/10.1037//0022-006x.56.6.885
Hu, L.-t., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
Huag, S., Puschner, B., Lambert, M. J., & Kordy, H. (2004). Veraderungs messung in der psychotherapie mit dem Ergebnis Frage Bogen (EB-45). Assessment of change in psychotherapy with the German version of the Outcome Questionnaire (OQ-45). Zeitschrift fur Differenttielle und Diagnosfische Psychologie, 25(3), 141–151. https://doi.org/10.1024/0170-1789.25.3.141
Kafetsios, K. (2004). Attachment and emotional intelligence abilities across the life course. Personality and Individual Differences, 37(1), 129–145. https://doi.org/10.1016/j.paid.2003.08.006
Kim, S.-H., Beretvas, S. N., & Sherry, A. R. (2010). A validation of the factor structure of OQ-45 scores using factor mixture modeling. Measurement and Evaluation in Counseling and Development, 42(4), 275–295. https://doi.org/10.1177/0748175609354616
Kivlighan, D. M., Jr., Lo Coco, G., Oieni, V., Gullo, S., Pazzagli, C., & Mazzeschi, C. (2017). All bonds are not the same: A response surface analysis of the perceptions of positive bonding relationships in therapy groups. Group Dynamics: Theory, Research, and Practice, 21(3), 159–177. https://doi.org/10.1037/gdn0000071
Lambert, M. J. (2013). Outcome in psychotherapy: The past and important advances. Psychotherapy, 50(1), 42–51. https://doi.org/10.1037/a0030682
Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training, 38(4), 357–361. https://doi.org/10.1037/0033-3204.38.4.357
Lambert, M. J., Kahler, M., Harmon, C., Burlingame, G., Shimokawa, K., & White, M. (2013). Administration and scoring manual outcome questionnaire– 45. OQ Measures.
Laska, K. M., Gurman, A. S., & Wampold, B. E. (2014). Expanding the lens of evidence-based practice in psychotherapy: A common factors perspective. Psychotherapy, 51(4), 467–481. https://doi.org/10.1037/a0034332
Li, Y.-J., & Luo, H. (2009). The reliability and validity of the Outcome Questionnaire-Chinese version. Chinese Mental Health Journal, 23(2), 105–107.
Lo Coco, G., Chiappelli, M., Bensi, L., Gullo, S., Prestano, C. & Lambert, M. J. (2008). The factorial structure of the Outcome Questionnaire-45: A study with an Italian sample. Clinical Psychology & Psychotherapy. 15(6), 418–23. https://doi.org/10.1002/cpp.601
Lo Coco, G., Gullo, S., & Kivlighan, D. M. (2012). Examining patients' and other group members' agreement about their alliance to the group as a whole and changes in patient symptoms using response surface analysis. Journal of counseling psychology, 59(2), 197–207. https://doi.org/10.1037/a0027560
Matavovszky, D., Nguyen Luu, L. A., & Karner, O. (2024). Development of an instrument to assess the mental health of university students: validation of the Outcome Questionnaire-45 in a Hungarian sample. Frontiers in Psychology, 15, Article 1334615. https://doi.org/10.3389/fpsyg.2024.1334615
Ponterotto, J. G., & Ruckdeschel, D. E. (2007). An overview of coefficient alpha and a reliability matrix for estimating adequacy of internal consistency coefficients with psychological research measures. Perceptual and Motor Skills, 105(3), 997–1014. https://doi.org/10.2466/pms.105.3.997-1014
Power, M., & Kuyken, W. (1998). World Health Organization Quality of Life Assessment (WHOQOL): Development and general psychometric properties. Social Science and Medicine, 46(12), 1569–1585. https://doi.org/10.1016/S0277-9536(98)00009-4
Raz Gross, M. D., Glasser, S., Jacobson, D. M., Levitan, G., & Ponizovsky, A. M. (2015). Validation of the Hebrew and Arabic versions of the Outcome Questionnaire (OQ-45). Israel Journal of Psychiatry, 52(1), 33.
Rosseel, Y. (2012). lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1–36. https://doi.org/10.18637/jss.v048.i02
Simon, W., Śliwka, P., Sobański, J. A., Klasa, K., Sala, P., Żak, W., Busath, G., & Lambert, M. J. (2015). The orthogonal-oblique bi-level model of the Outcome Questionnaire (OQ-45.2): Polish adaptation based on factor analysis. Psychiatria polska, 49(5), 1043–1070. https://doi.org/10.12740/PP/59064
Skevington, S. M., Lotfy, M., & O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial a report from the WHOQOL Group. Quality of Life Research, 13(2), 299–310. https://doi.org/10.1023/B:QURE.0000018486.91360.00
Takara, R., Beecher, M. E., Okiishi, J. C., Shimokawa, K., Lambert, M. J., & Griner, D. (2017). Translation of the Outcome Questionnaire-45 (OQ) into Japanese: A cultural adaptation. Psychotherapy Research, 27(2), 154–166. https://doi.org/10.1080/10503307.2015.1080876
Tzouvara, V., & Papadopoulos, C. (2014). Public stigma towards mental illness in the Greek culture. Journal of Psychiatric and Mental Health Nursing, 21(10), 931–938. https://doi.org/10.1111/jpm.12146
Tzouvara, V., Papadopoulos, C., & Randhawa, G. (2016). Systematic review of the prevalence of mental illness stigma within the Greek culture. The International Journal of Social Psychiatry, 62(3), 292–305. https://doi.org/10.1177/0020764016629699
Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., & Erikson, P. (2005). Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: Report of the ISPOR task force for translation and cultural adaptation. Value in health: the journal of the International Society for Pharmacoeconomics and Outcomes Research, 8(2), 94–104. https://doi.org/10.1111/j.1524-4733.2005.04054.x
Yusof, Y., & Carpenter, J. (2014). The Impact of Family Therapists’ Adult Attachment Styles on Their Career Choice and Approach to Therapy: An Interpretive Phenomenological Analysis. Journal of Social Work Practice, 29 (4), 395–412. https://doi.org/10.1080/02650533.2014.922059
Zautra, A. J. (1983). Social resources and the quality of life. American Journal of Community Psychology, 11(3), 275–289. https://doi.org/10.1007/BF00893368
