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Adherence Rating Scale for Cognitive Processing Therapy – Cognitive Only: Analysis of Psychometric Properties

Published online by Cambridge University Press:  21 February 2017

Clara Dittmann ,
Meike Müller-Engelmann ,
Patricia A. Resick ,
Jana Gutermann ,
Ulrich Stangier ,
Kathlen Priebe ,
Thomas Fydrich ,
Petra Ludäscher ,
Julia Herzog  and
Regina Steil
Clara Dittmann*
Affiliation:
Goethe University, Department of Clinical Psychology and Intervention, Frankfurt Main, Germany
Meike Müller-Engelmann
Affiliation:
Goethe University, Department of Clinical Psychology and Intervention, Frankfurt Main, Germany
Patricia A. Resick
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
Jana Gutermann
Affiliation:
Goethe University, Department of Clinical Psychology and Intervention, Frankfurt Main, Germany
Ulrich Stangier
Affiliation:
Goethe University, Department of Clinical Psychology and Intervention, Frankfurt Main, Germany
Kathlen Priebe
Affiliation:
Humboldt University of Berlin, Department of Psychotherapy and Somatic Psychology, Berlin, Germany
Thomas Fydrich
Affiliation:
Humboldt University of Berlin, Department of Psychotherapy and Somatic Psychology, Berlin, Germany
Petra Ludäscher
Affiliation:
Central Institute of Mental Health, University of Mannheim/Heidelberg, Department of Psychosomatic Medicine and Psychotherapy, Mannheim, Germany
Julia Herzog
Affiliation:
Central Institute of Mental Health, University of Mannheim/Heidelberg, Department of Psychosomatic Medicine and Psychotherapy, Mannheim, Germany
Regina Steil
Affiliation:
Goethe University, Department of Clinical Psychology and Intervention, Frankfurt Main, Germany
*
*Correspondence to Clara Dittmann, Department of Clinical Psychology and Intervention, Goethe University Frankfurt, Institute of Psychology, Varrentrappstraße 40–42. E-mail: Dittmann@psych.uni-frankfurt.de
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Abstract

Background: The assessment of therapeutic adherence is essential for accurately interpreting treatment outcomes in psychotherapy research. However, such assessments are often neglected. Aims: To fill this gap, we aimed to develop and test a scale that assessed therapeutic adherence to Cognitive Processing Therapy – Cognitive Only (CPT), which was adapted for a treatment study targeting patients with post-traumatic stress disorder and co-occurring borderline personality symptoms. Method: Two independent, trained raters assessed 30 randomly selected treatment sessions involving seven therapists and eight patients who were treated in a multicentre randomized controlled trial. Results: The inter-rater reliability for all items and the total score yielded good to excellent results (intraclass correlation coefficient [ICC] = 0.70 to 1.00). Cronbach's α was .56 for the adherence scale. Regarding content validity, three experts confirmed the relevance and appropriateness of each item. Conclusion: The adherence rating scale for the adapted version of CPT is a reliable instrument that can be helpful for interpreting treatment effects, analysing possible relationships between therapeutic adherence and treatment outcomes and teaching therapeutic skills.

Keywords

Post-traumatic stress disorderPTSDcognitive processing therapyCPTtherapeutic adherencetreatment integrity

Information

Type
Brief Clinical Reports
Information
Behavioural and Cognitive Psychotherapy , Volume 45 , Issue 6 , November 2017 , pp. 661 - 670
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

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References

Barber, J. P., Triffleman, E. and Marmar, C. (2007). Considerations in treatment integrity: Implications and recommendations for PTSD research. Journal of Traumatic Stress, 20, 793–805. doi:10.1002/jts.20295 Google Scholar
Cortina, J. M. (1993). What is coefficient alpha? An examination of theory and applications. Journal of Applied Psychology, 7, 98–104. doi:10.1037/0021-9010.78.1.98 CrossRefGoogle Scholar
Dobson, K. S. and Singer, A. R. (2005). Definitional practical issues in the assessment of treatment integrity. Clinical Psychology: Science and Practice, 12, 384–387. doi:10.1093/clipsy/bpi046 Google Scholar
Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M. and Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: Associations with the first onset of DSM-IV disorders. Archives of General Psychiatry, 67, 113–123. doi:10.1001/archgenpsychiatry.2009.186 Google Scholar
Gutermann, J., Schreiber, F., Matulis, S., Stangier, U., Rosner, R. and Steil, R. (2015). Therapeutic adherence and competence scales for Developmentally Adapted Cognitive Processing Therapy for adolescents with PTSD. European Journal of Psychotraumatology, 6, 26632. doi:10.3402/ejpt.v6.26632 Google Scholar
Mcdonald, A., Wiltsey-Stirman, S., Wachen, J. and Resick, P. (2014). CPT therapist adherence and competence protocol – Revised. Washington, DC: Department of Veterans’ Affairs.Google Scholar
Moncher, F. J. and Prinz, R. J. (1991). Treatment fidelity in outcome studies. Clinical Psychology Review, 11, 247–266.Google Scholar
Perepletchikova, F. and Kazdin, A. E. (2005). Treatment integrity and therapeutic change: Issues and research recommendations. Clinical Psychology: Science and Practice, 12, 365–383. doi:10.1093/clipsy.bpi045 Google Scholar
Perepletchikova, F., Treat, T. A. and Kazdin, A. E. (2007). Treatment integrity in psychotherapy research: Analysis of the studies and examination of the associated factors. Journal of Consulting and Clinical Psychology, 75, 829–841. doi:10.1037/0022-006X.75.6.829 Google Scholar
Resick, P. A., Galovski, T. E., Uhlmansiek, M. O., Scher, C. D., Clum, G. A. and Young-Xu, Y. (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for post-traumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology, 76, 243–258. doi:10.1037/0022-006X.76.2.243 Google Scholar
Resick, P. A., Monson, C. M. and Chard, K. M. (2010). Cognitive Processing Therapy: Veteran/Military Version. Washington, DC: Department of Veterans’ Affairs.Google Scholar
Steil, R., Dyer, A., Priebe, K., Kleindienst, N. and Bohus, M. (2011). Dialectical behavior therapy for post-traumatic stress disorder related to childhood sexual abuse: A pilot study of an intensive residential treatment program. Journal of Traumatic Stress, 24, 102–106. doi: 10.1002/jts.20617 Google Scholar
Waltz, J., Addis, M. E., Koerner, K. and Jacobson, N. S. (1993). Testing the integrity of a psychotherapy protocol: Assessment of adherence and competence. Journal of Consulting and Clinical Psychology, 61, 620–630. doi:10.1037/0022-006X.61.4.620 Google Scholar
Weck, F., Bohn, C., Ginzburg, D. M. and Stangier, U. (2011a). Behandlungsintegrität: Implementierung, Messung, Evaluation und Zusammenhänge zum Therapieerfolg [Treatment integrity: Implementation, assessment, evaluation, and correlations with outcome]. Verhaltenstherapie, 21, 99–107. doi:10.1159/000328840 Google Scholar
Weck, F., Weigel, M., Richtberg, S. and Stangier, U. (2011b). Reliability of adherence and competence assessment in psychoeducation treatment: Influence of clinical experience. Journal of Nervous and Mental Disease, 199, 983–986. doi:10.1097/NMD.0b013e3182392da1 Google Scholar
Wittchen, H. U., Zaudig, M. and Fydrich, T. (1997). SKID. Strukturiertes Klinisches Interview für DSM-IV. Achse I und II. Handanweisung. [SKID. Structural clinical interview of DSM-IV. Axe I and II. Manual instruction], Göttingen, Germany: Hogrefe.Google Scholar
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