Stefana Alberto, Fusar-Poli Paolo, Langfus Joshua, Vieta Eduard, Youngstrom Eric
Department of Brain and Behavioral Sciences, University of Pavia.
Department of Brain and Behavioral Sciences, University of Pavia, Italy; OASIS Service, South London and Maudsley NHS Foundation Trust, London; Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London.
Res Psychother. 2024 Mar 21;27(1):736. doi: 10.4081/ripppo.2024.736.
The present study reports on the development and validation of the clinician affective response (CARE) scale. The CARE scale was designed as a self-report measure of therapists' patterns of thoughts, feelings, and behaviors toward the patient during an individual psychotherapy session. An initial pool of 116 items was generated, and its quality was evaluated by subject matter experts. Validation data were gathered from licensed psychotherapists (n=554). We used exploratory factor analysis and item response theory-graded response modeling to select items, confirmatory factor analysis to test how well the factor structure fit the data, and k-fold cross-validation to ascertain the robustness of the model. Criterion validity was evaluated by correlating the scores of the scale with the characteristics of therapists, patients, and treatment. The selected model consists of 15 items and a 3-factor structure, which showed excellent model fit, good internal consistency, and evidence of criterion validity. The CARE scale, short and quick to complete, enables therapists to reflect on and recognize their inner experiences and quantify these experiences in ways conducive to statistical analysis and research. Furthermore, the monitoring of these affective reactions toward their patients can guide therapeutic interventions and inform clinical supervisors.
本研究报告了临床医生情感反应（CARE）量表的开发与验证情况。CARE量表旨在作为一种自我报告测量工具，用于评估治疗师在个体心理治疗过程中对患者的思维、情感和行为模式。最初生成了116个项目的题库，并由主题专家对其质量进行评估。验证数据来自有执照的心理治疗师（n = 554）。我们使用探索性因素分析和项目反应理论分级反应模型来选择项目，使用验证性因素分析来检验因素结构与数据的拟合程度，并使用k折交叉验证来确定模型的稳健性。通过将量表得分与治疗师、患者和治疗的特征进行关联来评估效标效度。所选模型由15个项目和一个三因素结构组成，显示出良好的模型拟合、良好的内部一致性以及效标效度的证据。CARE量表简短且易于完成，使治疗师能够反思并认识自己的内心体验，并以有利于统计分析和研究的方式对这些体验进行量化。此外，监测对患者的这些情感反应可以指导治疗干预并为临床督导提供信息。
