Aim In this mixed‐methods study, we examined client descriptions of counselling outcomes and how they corresponded with a quantitative measure of change (i.e., Outcome Questionnaire‐45; OQ‐45). Method Using purposeful sampling at a university counselling training centre, we compared 17 clients who had reliably improved, deteriorated or did not change to qualitative outcomes based on post‐counselling interviews using the Change Interview protocol. Results Qualitative outcomes included two Central change categories, the first of which included interpersonal, cognitive and behavioural, affective, and attitude changes. The second Central category of outcomes comprised four areas of change that varied by degree of change expressed (i.e., Problem Resolution, Confidence, Happiness and Changes Affirmed by Others). Congruence was not present between OQ‐45 and Central 1 changes but was present for three of the four Central 2 changes (Problem Resolution, Happiness and Changes Affirmed by Others), all correlating above .60. Conclusion OQ‐45 change scores showed congruence with three qualitative outcomes: degree of expressed improvement in Happiness, Problem resolution and changes noticed by significant others. However, the lack of congruence for Central 1 changes (i.e., Interpersonal, Cognitive and Behavioural, Affective, and Attitude Change) suggests a diverse range of outcomes important to clients that go undetected using the OQ‐45. We strongly encourage further mixed design research to better understand how best to appraise clinical improvement.

Objective The aim was to develop and test a novel screen of adult ADHD, with a focus on clinical use. We designed a series of three studies to accomplish this aim. Method Study One (n = 155) and Study Two (n = 591) collected data via surveys to conduct exploratory and confirmatory factor analyses respectively. Study Three analyzed the scale's psychometrics in a clinical sample (n = 151). Results Study One and Study Two identified a 10-item scale with a two-factor structure. Study Three found good discriminant validity, sensitivity = 80.0%, specificity = 80.2%, and convergent validity with the Brown Executive Function/Attention Scales, r (131) = .76, p < .001, and the Conner’s Adult ADHD Rating Scales r (131) = .71, p < .001. Conclusion The scale demonstrated effectiveness in screening for ADHD in a psychiatric outpatient population. Its results may be used to identify patients that may benefit from thorough ADHD diagnostic procedures. Keywords: adult ADHD, assessment, decision making