Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, Canada.
Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Canada; Doctorate Programme in Clinical Research, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Gen Hosp Psychiatry. 2023 Jul-Aug;83:101-108. doi: 10.1016/j.genhosppsych.2023.04.002. Epub 2023 Apr 5.
To examine: (1) the psychometric properties of two therapist competence measures-multiple choice questionnaire (MCQ) and standardized role-plays; (2) whether therapist competence differed between non-specialist (NSPs) and specialist (SPs) providers; and (3) the relations between therapist competence and patient outcomes among perinatal patients receiving brief psychotherapy.
This study is embedded within the SUMMIT Trial-a large, ongoing psychotherapy trial for perinatal women with depressive and anxiety symptoms. We assessed the: (1) psychometric properties of therapist competence measures using Cronbach's alpha and inter-class correlation; (2) differences in therapist competence scores between n = 23 NSPs and n = 22 SPs using a two-sample t-test; and (3) relations between therapist competence measures and perinatal patient outcomes through a linear regression model.
Internal consistency for role-play was acceptable (α = 0.71), whereas MCQ was excellent (α = 0.97). Role-play showed good inter-rater reliability (ICC = 0.80) and scores were higher for SPs compared with NSPs (t(2,38) = -2.86, p = 0.0069) and associated with outcomes of anxiety (B = 1.52, SE = 0.60, p = 0.01) and depressive (B = 0.96, SE = 0.55, p = 0.08) symptom scores.
Our study highlights the importance of demonstrating psychological treatment skills through standardized role-plays over knowledge-based competence to predict perinatal patient outcomes. Using well-defined evidence-based tools is critical for deploying NSPs to provide high-quality psychotherapy and increase accessibility to psychological treatments for perinatal populations worldwide.
（1）检验两个治疗师能力评估工具——多项选择问卷（MCQ）和标准化角色扮演的心理测量学特性；（2）非专业治疗师（NSPs）和专业治疗师（SPs）之间的治疗师能力是否存在差异；（3）在接受简短心理治疗的围产期患者中，治疗师能力与患者结局之间的关系。
本研究嵌入 SUMMIT 试验中，这是一项针对有抑郁和焦虑症状的围产期女性的大型、正在进行的心理治疗试验。我们评估了：（1）使用 Cronbach's alpha 和组内相关系数评估治疗师能力评估工具的心理测量学特性；（2）使用两样本 t 检验评估 n=23 名 NSPs 和 n=22 名 SPs 之间治疗师能力评分的差异；（3）通过线性回归模型评估治疗师能力评估工具与围产期患者结局之间的关系。
角色扮演的内部一致性可接受（α=0.71），而 MCQ 则极好（α=0.97）。角色扮演表现出良好的评分者间信度（ICC=0.80），SPs 的评分高于 NSPs（t(2,38)=-2.86，p=0.0069），并且与焦虑（B=1.52，SE=0.60，p=0.01）和抑郁（B=0.96，SE=0.55，p=0.08）症状评分的结局相关。
我们的研究强调了通过标准化角色扮演而非基于知识的能力来展示心理治疗技能对预测围产期患者结局的重要性。使用定义明确的基于证据的工具对于部署 NSP 以提供高质量的心理治疗以及增加全球围产期人群获得心理治疗的机会至关重要。
