Not all patients are able to report their well-being in the nonclinical range, yet achieve substantial gains from treatment.Therefore, a less conservative definition of improvement may also be used for those patients who simply show a change score of at least 8.5 points. This is especially pertinent for patients who begin treatment with a markedly low (high distress) SOS-10 score or have a baseline level of well-being or distress in the clinical range. Alternatively, a drop in 8.5 points or more represents a significant decline in well-being form the previous measurement period. Using the mean group scores in the Interpretive Database (reported in Table 1) along with the established clinical cutoff score (41), the range of SOS-10 scores (0-60) was divided into 4 severity levels. These levels are as follows: Minimal (non-patient range of 41-59), Mild (33-40) was thought to encompass the range from the clinical cutoff to just below the outpatient mean, Moderate (25 – 32) distress includes scores that fall between the inpatient and outpatient mean and Severe (1 – 24) distress was thought to be determined by scores that fall below the mean of the inpatient norms. These ranges are based on the available normative data and are only intended to give a general qualitative description of a patient’s current level of self-reported distress and/or well-being. These descriptors can be used to inform but not replace clinical judgment or other measures of patient functioning (e.g., Global Assessment of Functioning). Although we feel the severity levels offer clinicians a convenient method to quickly, albeit roughly, classify a patient’s degree of distress, future research is needed to determine how congruent these distress levels are with those obtained from other well-validated and accepted instruments.

Psychometric Research with the SOS-10

A number of published studies have documented the reliability of the SOS-10. Blais et al. (1999) reported an internal consistency (coefficient alpha) coefficient of .96 (n = 85), and two later studies (n = 100 and n = 376 respectively) with different samples estimated alpha to be .90 3,6. Laux and Ahern (2003) report a similarly high alpha (.95) in their sample of 151 chemical dependency subjects. Two published studies have reported on the 1-week test-retest reliability (rtt) of the SOS-10. Blais et al., (1999) found the rtt of the SOS-10 to be .87 (n = 32 non-patients) and Young et al., (2003) reported an rtt = .86 (n = 101 college students). The SOS-10 interpretive database, which includes data from Blais et al. (1999) and Young et al., (2003), contains 1-week retest data on 362 non-patients. In this sample, the rtt for the SOS-10 was .88 (p < .001). Not only did the

SOS-10 scores of these 362 non-patients evidence strong retest reliability, the mean score also showed no significant change across the retest interval.