Therapeutic adherence and competence scales for Developmentally Adapted Cognitive Processing Therapy for adolescents with PTSD
Therapeutic adherence and competence scales for Developmentally Adapted Cognitive Processing Therapy for adolescents with PTSD
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DOI：
10.3402/ejpt.v6.26632
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发表时间：
2015-01-01
影响因子：
5
通讯作者：
Steil, Regina
中科院分区：
文献类型：
--
作者：
Gutermann, Jana;Schreiber, Franziska;Steil, Regina
背景资料：在心理治疗研究中，特别是在儿童和青少年中，治疗依从性和能力的评估往往被忽视;然而，这两个变量对于解释治疗效果至关重要。目的：我们的目标是开发，适应和试点两个量表，以评估最近的创新计划，发展适应认知加工疗法（D-CPT）的治疗依从性和能力，为遭受童年虐待后的创伤后应激障碍（PTSD）的青少年提供服务。方法：两名独立的评估者评估了30个随机选择的疗程，涉及12名D-CPT患者（年龄13-20岁，M年龄= 16.75，91.67%女性）在一项多中心研究的试点阶段内由11名治疗师治疗。依从性（组内相关系数[ICC] = 0.76-1.00）和能力（ICC = 0.78-0.98）的所有项目和总分均产生了良好至优秀的评分者间可靠性。Cronbach的α为0.59的依从性量表和0.96的能力scale.Conclusions：量表可靠地评估青少年PTSD患者的D-CPT的依从性和能力。这些评级有助于解释治疗效果，评估中介变量，以及识别和培训对实现良好治疗结果至关重要的治疗技能。在未来的D-CPT试验中，依从性和能力将被评估为治疗成功的可能预测变量。
Background: The assessment of therapeutic adherence and competence is often neglected in psychotherapy research, particularly in children and adolescents; however, both variables are crucial for the interpretation of treatment effects.Objective: Our aim was to develop, adapt, and pilot two scales to assess therapeutic adherence and competence in a recent innovative program, Developmentally Adapted Cognitive Processing Therapy (D-CPT), for adolescents suffering from posttraumatic stress disorder (PTSD) after childhood abuse.Method: Two independent raters assessed 30 randomly selected sessions involving 12 D-CPT patients (age 13-20 years, M age = 16.75, 91.67% female) treated by 11 therapists within the pilot phase of a multicenter study.Results: Three experts confirmed the relevance and appropriateness of each item. All items and total scores for adherence (intraclass correlation coefficients [ICC] = 0.76-1.00) and competence (ICC = 0.78-0.98) yielded good to excellent inter-rater reliability. Cronbach's alpha was 0.59 for the adherence scale and 0.96 for the competence scale.Conclusions: The scales reliably assess adherence and competence in D-CPT for adolescent PTSD patients. The ratings can be helpful in the interpretation of treatment effects, the assessment of mediator variables, and the identification and training of therapeutic skills that are central to achieving good treatment outcomes. Both adherence and competence will be assessed as possible predictor variables for treatment success in future D-CPT trials.