A method of choosing CCRT scorers

Luborsky, Lester; Diguer, Louis; Andrusyna, Tomasz; Friedman, Scott; Tarca, Cristian; Popp, Carol; Ermold, Jenna; Silberschatz, George

doi:10.1093/ptr/kph008

Cited by 13 publications

(7 citation statements)

References 11 publications

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“…Each time they fi rst coded an RE separately and then met to obtain consensus codes. Weighted coeffi cients of agreement, which were calculated based on the weights commonly used in CCRT studies [22] , indicated acceptable correspondence between both coders for the initial codes (Ws = 0.67, ROs = 0.69, RSs = 0.69) [23] . Categories and codes for which the initial coding was different were discussed until consensus coding was obtained.…”

Section: Instruments and Methodsmentioning

confidence: 99%

Relationship Patterns in Alexithymia: A Study Using the Core Conflictual Relationship Theme Method

et al. 2006

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Background: Alexithymia is a disturbance in regulating affective states. Clinical observations suggest that alexithymic patients relate to others in a specific way. This paper explores whether specific relationship or transference patterns are typical of alexithymia. Sampling and Methods: Relationship patterns were assessed by means of the Core Conflictual Relationship Theme method, standard categories version. This method examines transference patterns and was applied to clinical interview data collected from a sample (n = 31) of mental health outpatients. Alexithymia was assessed by means of a score on the 20-item Toronto Alexithymia Scale corrected for the degree of depression (measured by the Beck Depression Inventory-II). Data were analysed by means of the leaps and bounds regression algorithm for selecting optimal subsets of indicators and by bootstrapping to determine 95% confidence intervals. Results: First, we observed that alexithymia can be meaningfully explained by typical wishes, typical subjective perceptions of how others respond and one’s own typical responses to others. This result indicates that the more marked a patient’s alexithymic traits are, the more probable it is that specific transference themes come to the fore. Second, a set of three core indicators of trait alexithymia was mapped: little concern about being good to others, a strong perception of others as cooperative, and weak levels of reacting to others and to conflict by means of somatic symptoms. Conclusion: Alexithymia is related to a double interpersonal indifference: not much is expected from others, nor is there a personal urge to fulfill the expectations of others. Moreover, in alexithymia somatic symptoms proved to be non-reactive to interpersonal situations. Implications for diagnosis and treatment are highlighted. Limitations of our study are that alexithymia was only assessed with a self-report measure and that conclusions are based only upon data from a heterogeneous mental health sample.

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Section: Instruments and Methodsmentioning

confidence: 99%

Relationship Patterns in Alexithymia: A Study Using the Core Conflictual Relationship Theme Method

et al. 2006

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“…As noted above, kappa was shown in the present study, whereas weighted kappa is more permissive of varying measures, and therefore as a rule, presents higher kappa values. A previous study showed a weighted kappa for the CCRT pattern in total [26] while the others (see Table 1), showed kappa or weighted kappa for the separate components. In the present study the mean kappa value for the total CCRT pattern resulted in moderate reliability (0.41).…”

Section: Discussionmentioning

confidence: 80%

Core conflictual relationship theme: the reliability of a simplified scoring procedure

et al. 2020

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Background: Creating a case formulation is an important and basic skill in psychotherapy meant to guide treatment. A patient's interpersonal pattern is an essential part of a case formulation. Core Conflictual Relationship Theme (CCRT) is a well-known structured method to describe interpersonal patterns. The CCRT method is based on the assumption that humans display a central relationship theme, which is shown in most relationships as well as in the patient-therapist relation. The CCRT scoring is based on how the patient describes interactions with others, in therapy sessions or in a specific interview. These descriptions are transcribed. Raters then score the identified relational episodes by choosing elements from the clustered categories of Wishes, Response from Others and Response from Self. The method has shown high validity and reliability. Inter rater reliability is generally good: Cohen's kappa ranging from 0.55 to 0.70. To decide CCRT pattern from transcribed material is time consuming and labour intensive This study investigates a labour-and timesaving version of the method.Methods: This study aimed to investigate rater agreement in a simplified method of scoring the CCRT, based directly on live semi-structured dynamic interviews without transcribing the material. Fifty-two patients referred for psychotherapy in a clinical trial, were scored for CCRT pattern. Based on information that came forth during the two-hour interview, raters scored the patients choosing elements from the clustered categories of Wishes, Response from Others and Response from Self. More than one category in each component could be chosen without ranking. Five raters compared two by two were investigated. Inter rater reliability was measured by Cohen's kappa. Results: Mean kappa for Wishes, Response from Others and Response from Self was .33, .41 and .45 respectively. Mean kappa for CCRT in total was .41 among 5 raters. Conclusion:In this simplified method to score the CCRT based on oral dynamic interviews, fair to moderate IRR was obtained.Trial registration: First Experimental Study of Transference-interpretations (FEST307/95). Registration number: ClinicalTrials.gov Identifier: NCT00423462.

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“…The three CCRT components occur in association with each other, thus creating a linked 'sequence' in which the wishes and responses of the subject comprise a call-and-answer pattern, a kind of dialogue (Mitchell, 1995). It is true that not every patient links his or her relational components together and places every component in a sequence (Luborsky, 1998;Luborsky et al, 2004). For this reason, we decided to analyze only the RD, which had wishes at the start of the sequence, since in these cases the reactions of other people, and even those of the patient herself, are the result of a desire, need, or intention of hers.…”

Section: Discussionmentioning

confidence: 99%

Conflictual relational demands of anaclitic and introjective depressive women

Valdés¹,

Alamo

Reinel

2019

RevPsicología

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The depression is associated with typical ways of relating to and handling conflict with others. This study empirically examined the most frequent relational demands of female depressive patients, depending on their personality configuration and the characteristics of relevant segments within the session: change and stuck episodes. Ten psychotherapies (n = 230 sessions) were observed in order to identify, delimit and code relevant episodes within session (24 change episodes and 26 stuck episodes) using the CCRT-LU-S Category System (Albani et al., 2002), to determine patients’ relational demands. The results showed that introjective patients verbalized more relational demands on themselves as a relational object, and therefore more demands with a subject-subject direction. These patients expressed their needs and wishes centered on questioning themselves, to the detriment of generating significant interpersonal relationships. Furthermore, it was possible to predict a greater presence of relational demands referred to contents about “loving” during the change episodes, confirming that the most frequent themes in patients’ discourse were a strong wish to feel happy, despite their experiences of helplessness. These findings highlight the need for a more dimensional view of depression that takes into account patients’ personality configurations and their association with little and big outcomes.

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A method of choosing CCRT scorers

Cited by 13 publications

References 11 publications

Relationship Patterns in Alexithymia: A Study Using the Core Conflictual Relationship Theme Method

Relationship Patterns in Alexithymia: A Study Using the Core Conflictual Relationship Theme Method

Core conflictual relationship theme: the reliability of a simplified scoring procedure

Conflictual relational demands of anaclitic and introjective depressive women

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