What is "clinical significance" and how does it differ from statistical significance in counseling outcomes?

• A. Clinical significance refers to meaningful change in functioning that matters to the client; statistical significance is about probability that observed change is not due to chance.
• B. Clinical significance is only about sample size
• C. Statistical significance means change is large
• D. They are the same

Answer: (A)

Clinical significance asks whether the client’s change is meaningful in real life. It focuses on whether the improvement actually matters to the person—does it move them into a healthier range of functioning, reduce distress in a way they notice and value, and translate into better daily life outcomes.

Statistical significance, by contrast, is about probability. It asks whether the observed change would be unlikely to occur by chance if there were no true effect. This depends on the data’s variability and the sample size, so a result can be statistically significant even if the actual change is small and not practically important.

In counseling, you want change that matters to the client (clinical significance), not just a low p-value. A result can be statistically significant with a large sample but not produce meaningful improvement in daily functioning. Conversely, a change that is clearly meaningful for the client might not reach statistical significance in a small study due to limited power. Clinicians often assess clinical significance by checking if post-treatment functioning falls into a non-clinical range and whether the amount of change is reliable, such as using the reliable change index or established cutoffs.