Weck Florian, Hilling Christine, Schermelleh-Engel Karin, Rudari Visar, Stangier Ulrich
Department of Clinical Psychology and Psychotherapy, University of Frankfurt, Frankfurt, Germany.
J Nerv Ment Dis. 2011 Apr;199(4):276-9. doi: 10.1097/NMD.0b013e3182124617.
The use of highly experienced expert judges was suggested for the assessment of therapists' adherence and competence. However, such an approach implies high costs. It can be questioned whether only experts are able to evaluate therapists' adherence and competence reliably. To test this, 4 judges evaluated therapist adherence and competence in 30 randomly selected videotapes of cognitive therapy sessions for depression. In that, 2 judges exhibited high clinical experience (experts), whereas 2 judges did not (novices). We could demonstrate that novices evaluated an aggregated adherence and competence measure with high reliability. However, several adherence and competence aspects were not assessed with satisfactory reliability by novices. Although adherence ratings of experts and novices showed high concordance, the concordance of competence ratings was only moderate. Results revealed that therapists' adherence could be evaluated satisfactorily by trained novices with some restrictions, but not their competence.
有人建议使用经验丰富的专家评委来评估治疗师的依从性和能力。然而，这种方法意味着高昂的成本。仅专家是否能够可靠地评估治疗师的依从性和能力是值得怀疑的。为了测试这一点，4名评委对30段随机挑选的抑郁症认知治疗 session 的录像带进行了治疗师依从性和能力评估。其中，2名评委具有丰富的临床经验（专家），而2名评委没有（新手）。我们可以证明，新手对综合依从性和能力测量的评估具有很高的可靠性。然而，新手对几个依从性和能力方面的评估可靠性并不令人满意。虽然专家和新手的依从性评分显示出高度一致性，但能力评分的一致性仅为中等。结果表明，经过培训的新手可以在一定限制下令人满意地评估治疗师的依从性，但不能评估其能力。
