Development of a Therapist Adherence/Competence Rating Scale for Supportive-Expressive Dynamic Psychotherapy: A Preliminary Report

Abstract

This paper reports on the development of the Penn Adherence/Competence Scale for Supportive-Expressive (SE) Dynamic Psychotherapy. The rating scale includes 45 items which are rated separately for both frequency (adherence) and quality (competence) of therapists' application. Audiotaped from four SE therapists who saw a total of 33 depressed patients were rated by two independent judges. The same judges also rated four cognitive (CT) therapists who saw a total of seven patients. Interjudge reliability for the six subscales and the two total scale scores ranged from .35 to .79, and internal consistency coefficients ranged from .62 to .95. While SE therapists used more expressive and interpretative techniques than did CT therapists, the two groups did not differ in their use of supportive and general techniques. In addition, SE therapists were judged to be more competent in their use of SE specific techniques than were CT therapists. SE therapists' adherence and competence were not associated with patients' level of psychiatric severity as indicated by pretreatment and concurrent levels of depression, comorbid personality disorder, or level of psychological health. Therapists' adherence and competence were unrelated to a concurrent measure of the therapeutic alliance.

Different Perspectives of the Therapeutic Alliance and Therapist Technique in 2 Forms of Dynamically Oriented Psychotherapy

“…Five were women. The therapists' average age was 43.6 years (SD 6.1, range 37-52), and their average experience practising individual psychotherapy was 11.8 years (SD 4.9, range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Each therapist treated 9 interpretive therapy patients and 9 supportive therapy patients.…”

Psychoanalytic-Interactional Therapy versus Psychodynamic Therapy by Experts for Personality Disorders: A Randomized Controlled Efficacy-Effectiveness Study in Cluster B Personality Disorders

“…Having seen the videos, they rated (1) whether PIT or E-PDT was applied and (2) the overall therapist's competence in applying principles of PIT. For the latter, a 4-point Likert rating scale was used comparable to the overall competence rating scale of the Penn Adherence and Competence Scale [44]. …”

Training and fidelity monitoring of behavioral interventions in multi-site addictions research

“…The Cocaine Collaborative reported initial reliability and validity data for adherence and competence scales developed for individual drug counseling, one of its three interventions (Barber et al, 1996b). For a second intervention, supportive expressive therapy, it used a scale with previously established reliability/validity data (Barber and Crits-Christoph, 1996). Other studies used unpublished, but previously developed scales (e.g., Seeking Safety Adherence Scale by Najavits, (2003) for CTN's Women's Treatment for Trauma, the Family Therapy Skills Rating System for BSFT by Santisteban), adapted previously published instruments (CTN MI/MET), or developed new scales to assess adherence (CTN Smoking Cessation study).…”