University of Zurich, Department of Clinical Psychology and Psychotherapy Research, Switzerland.
University of Bern, Institute of Psychology, Clinical Psychology, Switzerland; University Hospital Insel, Bern, Psychosomatic Competence Center, Switzerland.
J Affect Disord. 2018 Feb;227:358-365. doi: 10.1016/j.jad.2017.11.009. Epub 2017 Nov 6.
Although observer-rated instruments assessing therapist's adherence to relapse-preventive treatments are available, they do not adequately cover specific relapse-preventive elements that focus on implementation of strategies after terminating treatment. This study describes the development of the KERI-D (Kodierbogen zur Erfassung Rückfallprophylaktischer Interventionen bei Depression/Coding System to Assess Interventions of Relapse Prevention in Depression). The KERI-D is a new observer-based rating tool for acute or continuation/maintenance-phase sessions and assesses relapse-prevention elements including implementation into patient's daily routines.
The development of the KERI-D included iterative steps referring to theoretical, clinical and empirical sources. It consists of 19 content items within four categories (self-care, early warning signs, triggering events/situations, termination of therapy) and one global item. For empirical analyses, videotaped psychotherapy sessions of 36 psychotherapies were rated by three independent observers and analyzed for their psychometric properties.
Most items showed moderate to good inter-rater reliability (median ICC = .80) and retest reliability (median ICC = .93). Principal-axis factor analysis revealed three subscales, and first evidence of content validity was demonstrated. No associations with clinical follow-up data were found.
Analysis was limited to a relatively small sample of selected psychotherapy sessions. Evaluation of predictive validity is a desirable next step to further examine applicability and scope of the instrument.
The KERI-D is the first observer-based rating instrument measuring specific relapse-prevention strategies in psychotherapy for depression. It may help to identify elements that prove effective in reducing relapse/recurrence in the long-term and thereby help to optimize effect duration of depression treatment.
虽然有评估治疗师遵循预防复发治疗的观察量表，但它们不能充分涵盖特定的预防复发元素，这些元素侧重于治疗结束后策略的实施。本研究描述了 KERI-D（用于评估抑郁症预防复发干预的编码系统）的开发。KERI-D 是一种新的基于观察者的评分工具，适用于急性或延续/维持治疗阶段的治疗，并评估预防复发的元素，包括将其实施到患者的日常生活中。
KERI-D 的开发包括参考理论、临床和经验来源的迭代步骤。它由四个类别（自我保健、预警信号、触发事件/情况、治疗结束）中的 19 个内容项目和一个总体项目组成。为了进行实证分析，对 36 次心理治疗的录像心理治疗会议进行了三位独立观察者的评分，并对其进行了心理测量学特性分析。
大多数项目的观察者间信度（中位数 ICC =.80）和重测信度（中位数 ICC =.93）均为中等至良好。主成分因子分析显示出三个亚量表，初步证明了内容效度。与临床随访数据没有关联。
分析仅限于精选的心理治疗会议的相对较小样本。评估预测效度是进一步研究该工具的适用性和范围的理想下一步。
KERI-D 是第一个用于评估抑郁症心理治疗中特定预防复发策略的基于观察者的评分工具。它可能有助于确定在长期内证明有效的元素，从而有助于优化抑郁症治疗的效果持续时间。
