University of Wisconsin-Madison.
Brigham Young University.
Behav Ther. 2020 Jan;51(1):113-122. doi: 10.1016/j.beth.2019.05.008. Epub 2019 May 24.
The Cognitive Therapy Rating Scale (CTRS) is an observer-rated measure of cognitive behavioral therapy (CBT) treatment fidelity. Although widely used, the factor structure and psychometric properties of the CTRS are not well established. Evaluating the factorial validity of the CTRS may increase its utility for training and fidelity monitoring in clinical practice and research. The current study used multilevel exploratory factor analysis to examine the factor structure of the CTRS in a large sample of therapists (n = 413) and observations (n = 1,264) from community-based CBT training. Examination of model fit and factor loadings suggested that three within-therapist factors and one between-therapist factor provided adequate fit and the most parsimonious and interpretable factor structure. The three within-therapist factors included items related to (a) session structure, (b) CBT-specific skills and techniques, and (c) therapeutic relationship skills, although three items showed some evidence of cross-loading. All items showed moderate to high loadings on the single between-therapist factor. Results support continued use of the CTRS and suggest factors that may be a relevant focus for therapists, trainers, and researchers.
认知治疗评定量表（CTRS）是一种评估认知行为疗法（CBT）治疗一致性的观察量表。尽管该量表被广泛应用，但它的因子结构和心理测量特性尚未得到充分确立。评估 CTRS 的因子有效性可能会提高其在临床实践和研究中培训和一致性监测方面的实用性。本研究使用多层次探索性因子分析，在一个来自社区为基础的 CBT 培训的大量治疗师（n=413）和观察结果（n=1264）中，考察了 CTRS 的因子结构。模型拟合和因子负荷的检验表明，三个治疗师内部因素和一个治疗师之间因素提供了足够的拟合度，以及最简约和最可解释的因子结构。三个治疗师内部因素包括与（a）治疗会议结构、（b）CBT 特定技能和技术以及（c）治疗关系技能相关的项目，尽管有三个项目显示出一些交叉负荷的证据。所有项目在单一治疗师之间因素上都表现出中等至高度的负荷。结果支持继续使用 CTRS，并提出了可能是治疗师、培训师和研究人员关注的相关因素。
