Bastick Emily, Bot Suili, Verhagen Simone J W, Zarbock Gerhard, Farrell Joan, Brand-de Wilde Odette, Arntz Arnoud, Lee Christopher William
Murdoch University,Murdoch,Western Australia.
Maastricht University,Maastricht,The Netherlands.
Behav Cogn Psychother. 2018 Sep;46(5):601-618. doi: 10.1017/S1352465817000741. Epub 2018 Jan 26.
Recent research has supported the efficacy of schema therapy as a treatment for personality disorders. A group format has been developed (group schema therapy; GST), which has been suggested to improve both the clinical and cost-effectiveness of the treatment.
Efficacy studies of GST need to assess treatment fidelity. The aims of the present study were to improve, describe and evaluate a fidelity measure for GST, the Group Schema Therapy Rating Scale - Revised (GSTRS-R).
Following a pilot study on an initial version of the scale (GSTRS), items were revised and guidelines were modified in order to improve the reliability of the scale. Students highly experienced with the scale rated recorded GST therapy sessions using the GSTRS-R in addition to a group cohesion measure, the Harvard Community Health Plan Group Cohesiveness Scale - II (GCS-II). The scores were used to assess internal consistency and inter-rater reliability. Discriminant validity was assessed by comparing the scores on the GSTRS-R with the GCS-II.
The GSTRS-R displayed substantial internal consistency and inter-rater reliability, and adequate discriminate validity, evidenced by a weak positive correlation with the GCS-II.
Overall, the GSTRS-R is a reliable tool that may be useful for evaluating therapist fidelity to GST model, and assisting GST training and supervision. Initial validity was supported by a weak association with GCS-II, indicating that although associated with cohesiveness, the instrument also assesses factors specific to GST. Limitations are discussed.
近期研究支持了图式疗法作为人格障碍治疗方法的有效性。一种团体形式已被开发出来(团体图式疗法;GST),有人认为这种形式能提高治疗的临床效果和成本效益。
GST的疗效研究需要评估治疗的保真度。本研究的目的是改进、描述和评估一种用于GST的保真度测量工具,即修订后的团体图式疗法评定量表(GSTRS-R)。
在对量表的初始版本(GSTRS)进行预试验后,对条目进行了修订,并修改了指南,以提高量表的信度。对该量表有丰富经验的学生除了使用团体凝聚力测量工具哈佛社区健康计划团体凝聚力量表-II(GCS-II)外,还使用GSTRS-R对录制的GST治疗课程进行评分。这些分数用于评估内部一致性和评分者间信度。通过比较GSTRS-R与GCS-II的分数来评估区分效度。
GSTRS-R显示出较高的内部一致性和评分者间信度,以及足够的区分效度,与GCS-II的弱正相关证明了这一点。
总体而言,GSTRS-R是一种可靠的工具,可能有助于评估治疗师对GST模型的保真度,并辅助GST培训和监督。与GCS-II的弱关联支持了初始效度,表明该工具虽然与凝聚力相关,但也评估了GST特有的因素。文中讨论了其局限性。