Goethe University, Department of Clinical Psychology and Intervention, Institute of Psychology, Frankfurt am Main, Germany.
Humboldt-Universität, Department of Psychotherapy and Somatopsychology, Berlin, Germany.
J Trauma Stress. 2017 Dec;30(6):614-625. doi: 10.1002/jts.22236. Epub 2017 Nov 27.
Although the assessment of therapeutic competence in psychotherapy research is essential for examining its possible associations with treatment outcomes, it is often neglected due to high costs and a lack of valid instruments. This study aimed to develop two therapeutic competence scales that assess disorder-specific and treatment-specific therapeutic competence, and to examine these scales' psychometric properties along with those of the already established Cognitive Therapy Scale (CTS) in a posttraumatic stress disorder (PTSD) sample. Using an inductive procedure, two rating scales for assessing disorder-specific and treatment-specific competence were constructed. The psychometric properties of these scales and those of the CTS were assessed in a sample of 30 videotaped sessions of eight patients from a multicenter study in which PTSD related to child abuse was treated using cognitive processing therapy. Two raters assessed therapeutic competence in 30 videotaped psychotherapy sessions. Interrater reliability, internal consistency, and content validity were determined. The scales (all items and total scores) demonstrated good to excellent interrater reliability, intraclass correlation coefficients (ICCs) = .67 to .97, and internal consistency, Cronbach's α = .73 to .92. The PTSD experts' ratings confirmed good internal validity. We found statistically significant associations with therapeutic adherence, r = .62 to .85; p < .001; and therapeutic alliance, r = .47, p < .001. These preliminary data imply that the two newly developed competence scales and the CTS can be reliably used to assess different types of therapeutic competence in PTSD samples and may be useful as possible predictors of treatment outcomes.
尽管在心理治疗研究中评估治疗能力对于检查其与治疗结果的可能关联至关重要，但由于成本高和缺乏有效工具，往往被忽视。本研究旨在开发两种治疗能力量表，评估特定障碍和特定治疗的治疗能力，并在创伤后应激障碍（PTSD）样本中检查这些量表与已建立的认知治疗量表（CTS）的心理测量特性。使用归纳程序，构建了两种评估特定障碍和特定治疗能力的评分量表。这些量表和 CTS 的心理测量特性在一项多中心研究的 30 个录像治疗会议样本中进行了评估，该研究使用认知加工疗法治疗与儿童虐待相关的 PTSD。两名评估者对 30 个录像心理治疗会议中的治疗能力进行了评估。确定了评分者间信度、内部一致性和内容效度。量表（所有项目和总分）表现出良好到优秀的评分者间信度，组内相关系数（ICC）=.67 至.97，以及内部一致性，克朗巴赫的 α =.73 至.92。PTSD 专家的评分证实了良好的内部有效性。我们发现与治疗依从性呈统计学显著关联，r =.62 至.85；p<0.001；以及治疗联盟，r =.47，p<0.001。这些初步数据表明，新开发的两种能力量表和 CTS 可以可靠地用于评估 PTSD 样本中的不同类型的治疗能力，并且可能作为治疗结果的可能预测指标有用。
