Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
Department of Psychology, Faculty of Life Sciences, Humboldt-University of Berlin, Berlin, Germany.
Eur J Psychotraumatol. 2022 Apr 1;13(1):2055293. doi: 10.1080/20008198.2022.2055293. eCollection 2022.
The assessment of therapeutic adherence and competence is essential to understand mechanisms that contribute to treatment outcome. Nevertheless, their assessment is often neglected in psychotherapy research.
AIMS/OBJECTIVE: To develop an adherence and a treatment-specific competence rating scale for Dialectical Behaviour Therapy for Posttraumatic Stress Disorder (DBT-PTSD), and to examine their psychometric properties. Global cognitive behavioural therapeutic competence and disorder-specific therapeutic competence were assessed using already existing scales to confirm their psychometric properties in our sample of patients with PTSD and emotion regulation difficulties.
Two rating scales were developed using an inductive procedure. 155 videotaped therapy sessions from a multicenter randomised controlled trial were rated by trained raters using these scales, 40 randomly chosen videotapes involving eleven therapists and fourteen patients were doubly rated by two raters.
Both the adherence scale (Patient-level ICC = .98; α= .65; α = .75) and the treatment-specific competence scale (Patient-level ICC = .98; α= .78; α = .82) for DBT-PTSD showed excellent interrater - and good reliability on the patient level. Content validity, including relevance and appropriateness of all items, was confirmed by experts in DBT-PTSD for the new treatment-specific competence scale.
Our results indicate that both scales are reliable instruments. They will be useful to examine possible effects of adherence and treatment-specific competence on DBT-PTSD treatment outcome.
评估治疗依从性和能力对于理解影响治疗结果的机制至关重要。然而，它们的评估在心理治疗研究中经常被忽视。
目的/目标：为创伤后应激障碍的辩证行为疗法（DBT-PTSD）开发一种依从性和特定于治疗的能力评定量表，并检验其心理测量学特性。使用已经存在的量表评估全球认知行为治疗能力和特定于障碍的治疗能力，以确认它们在我们的 PTSD 和情绪调节困难患者样本中的心理测量学特性。
使用归纳程序开发了两种评定量表。来自多中心随机对照试验的 155 个录像治疗会议由经过培训的评估员使用这些量表进行评估，40 个随机选择的录像涉及 11 名治疗师和 14 名患者，由两名评估员进行双重评估。
DBT-PTSD 的依从性量表（患者水平 ICC=0.98；α=0.65；α=0.75）和特定于治疗的能力量表（患者水平 ICC=0.98；α=0.78；α=0.82）都显示出极好的评估者间和良好的患者水平可靠性。新的特定于治疗的能力量表的内容有效性，包括所有项目的相关性和适当性，都得到了 DBT-PTSD 专家的确认。
我们的结果表明，这两种量表都是可靠的工具。它们将有助于研究治疗依从性和特定于治疗的能力对 DBT-PTSD 治疗结果的可能影响。
