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Interrater relability of cognitive-behavioral case formulations

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Abstract

This study tested the hypothesis that clinicians can agree on two aspects of a cognitive-behavioral case formulation: the client's overt problems and underlying cognitive mechanisms. To test this hypothesis, 46 clinicians listened to part or all of an initial interview for two anxious, depressed clients and then listed each client's overt difficulties and rated each client's underlying cognitive mechanisms. When groups of five clinicians were considered, clinicians showed moderate agreement in listing overt problems, and, except for one type of belief (dysfunctional attitudes) for one client, high agreement on ratings of underlying cognitive mechanisms.

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References

  • Beck, A. T. (1983). Cognitive theory of depression: New perspectives. In P. J. Clayton & J. E. Barrett (Eds.),Treatment of depression: Old controversies and new approaches (pp. 265–290). New York: Raven Press.

    Google Scholar 

  • Beck, A. T., Emery, G., & Greenberg, R. (1985).Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.

    Google Scholar 

  • Beck, A. T., Freeman, A., and Associates. (1990).Cognitive therapy of personality disorders. New York: Guilford Press.

    Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979).Cognitive therapy of depression. New York: Guilford Press.

    Google Scholar 

  • Beck, J. S. (1994).Cognitive therapy: Basics and beyond. New York: Guilford Press.

    Google Scholar 

  • Beckham, E. E., Boyer, J. L., Cook, J. B., Leber, W. R., & Watkins, J. T. (1984, June).Development of instrumentation for process research in cognitive therapy of depression. Paper presented at Society for Psychotherapy Research, Lake Louise, Ontario, Canada.

  • Caston, J. (1986). The reliability of the diagnosis of the patient's unconscious plan. In J. Weiss, H. Sampson, & the Mount Zion Psychotherapy Research Group (Eds.),The psychoanalytic process: Theory, clinical observation and empirical research (pp. 241–255). New York: Guilford Press.

    Google Scholar 

  • Collins, W. D., & Messer, S. B. (1991). Extending the plan formulation method to an object relations perspective: Reliability, stability, and adaptability.Psychological Assessment, 3, 75–81.

    Article  Google Scholar 

  • Crits-Christoph, P., Cooper, A., & Luborsky, L. (1988). The accuracy of therapists' interpretations and the outcome of dynamic psychotherapy.Journal of Consulting and Clinical Psychology, 56, 490–495.

    Article  PubMed  Google Scholar 

  • Crits-Christoph, P., Luborsky, L., Dahl, L., Popp, C., Mellon, J., & Mark, D. (1988). Clinicians can agree in assessing relationship patterns in psychotherapy.Archives of General Psychiatry, 45, 1001–1004.

    PubMed  Google Scholar 

  • Curtis, J. T., Silberschatz, G., Sampson, H., & Weiss, J. (in press). The plan formulation method.Psychotherapy Research.

  • Curtis, J. T., Silberschatz, G., Sampson, H., Weiss, J., & Rosenberg, S. E. (1988). Developing reliable psychodynamic case formulations: An illustration of the plan diagnosis method.Psychotherapy, 25, 256–265.

    Google Scholar 

  • Fretter, P. B. (1984). The immediate effects of transference interpretations on patients' progress in brief, psychodynamic psychotherapy (Doctoral dissertation, University of San Francisco, 1984).Dissertation Abstracts International, 46(6) (University Microfilms No. 85–12, 112).

    Google Scholar 

  • Glantz, S. A., & Slinker, B. K. (1990).Primer of applied regression and analysis of variance. New York: McGraw-Hill.

    Google Scholar 

  • Hay, W. M., Hay, L. R., Angle, H. V., & Nelson, R. O. (1979). The reliability of problem identification in the behavioral interview.Behavioral Assessment, 1, 107–118.

    Article  Google Scholar 

  • Hayes, S. C., Nelson, R. O., & Jarrett, R. B. (1987). The treatment utility of assessment: A functional approach to evaluating assessment quality.American Psychologist, 42, 963–974.

    Article  PubMed  Google Scholar 

  • Horowitz, L. M., Rosenberg, S. E., Ureno, G., Kalehzan, B. M., & O'Halloran, P. (1989). Psychodynamic formulation, consensual response method, and interpersonal problems.Journal of Consulting and Clinical Psychology, 57, 599–606.

    Article  PubMed  Google Scholar 

  • Horowitz, M., Marmar, C., Krupnick, J., Wilner, N., Kaltreider, N., & Wallerstein, R. (1984).Personality styles and brief psychotherapy. New York: Basic Books.

    Google Scholar 

  • Leventhal, H. (1984). A perceptual motor theory of emotion. In K. R. Scherer, & P. Ekman (Eds.),Approaches to emotion (pp. 271–291). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Luborsky, L. (1984).Principles of psychoanalytic psychotherapy: A manual for supportive-expressive (SE) treatment. New York: Basic Books.

    Google Scholar 

  • Muran, J. C., & Segal, Z. V. (1992). The development of an idiographic measure of self-schemas: An illustration of the construction and use of self-scenarios.Psychotherapy, 29, 524–535.

    Google Scholar 

  • Muran, J. C., Segal, Z. V., & Samstag, L. W. (1994). Self-scenarios as a repeated measure outcome measurement of self-schemas in short-term cognitive therapy.Behavior Therapy, 25, 255–274.

    Google Scholar 

  • Padesky, C. A., & Mooney, K. A. (1990). Clinical tip: Presenting the cognitive model to clients.International Cognitive Therapy Newsletter, 6, 1.

    Google Scholar 

  • Persons, J. B. (1989).Cognitive therapy in practice: A case formulation approach. New York: Norton.

    Google Scholar 

  • Persons, J. B. (1993) Case conceptualization in cognitive-behavior therapy. In K. T. Kuehlwein & H. Rosen (Eds.),Cognitive therapy in action: Evolving innovative practice. (pp. 33–53). San Francisco: Jossey-Bass.

    Google Scholar 

  • Rosenberg, S. E., Silberschatz, G, Curtis, J. T. Sampson, H., & Weiss, J. (1986). A method for establishing reliability of statements from psychodynamic case formulations.American Journal of Psychiatry, 143, 1454–1456.

    PubMed  Google Scholar 

  • Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability.Psychological Bulletin, 86, 420–428.

    Article  Google Scholar 

  • Silbertschatz, G., Fretter, P. B., & Curtis, J. T. (1986). How do interpretations influence the process of psychotherapy?Journal of Consulting and Clinical Psychology, 54, 646–652.

    Article  PubMed  Google Scholar 

  • Strupp, H. H., & Binder, J. L. (1984).Psychotherapy in a new key: A guide to time-limited dynamic psychotherapy. New York: Basic Books.

    Google Scholar 

  • Stuart, S., Pilkonis, P., Heape, C., Smith, K., & Fischer, B. (1991, November).The patient-therapist match in psychotherapy: Effects of security of attachment and personality style. Paper presented at the meetings of the North American Chapter, Society for Psychotherapy Research, Panama City, FL.

    Google Scholar 

  • Turkat, I. D. (Ed.) (1985).Behavioral case formulation. New York: Plenum Press.

    Google Scholar 

  • Weiss, J., Sampson, H., and the Mount Zion Psychotherapy Research Group. (Eds.) (1986).The psychoanalytic process: Theory, clinical observations, and empirical research. New York: Guilford Press.

    Google Scholar 

  • White, K. J., Haun, S. A., Horsman, N. G., Wong, S. D. (1988).SHAZAM econometrics computer program user's reference manual. New York: McGraw-Hill.

    Google Scholar 

  • Wilson, F. E., & Evans, I. A. (1983). The reliability of target-behavior selection in behavioral assessment.Behavioral Assessment, 5, 15–32.

    Google Scholar 

  • Wolpe, J. (1980). Behavioral analysis and therapeutic strategy. In A. Goldstein & E. B. Foa (Eds.),Handbook of behavioral interventions (pp. 7–37). New York: Wiley.

    Google Scholar 

  • Wright, J. C., & Mischel, W. (1988). Conditional hedges and the intuitive psychology of traits.Journal of Personality and Social Psychology, 55, 454–469.

    Article  PubMed  Google Scholar 

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We thank Alan Bostrom of Crunch Software, for statistical assistance, and the clients and clinicians participating in the study. This paper was presented at the meetings of the Association for Advancement of Behavior Therapy, November 21–24, 1991, New York.

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Persons, J.B., Mooney, K.A. & Padesky, C.A. Interrater relability of cognitive-behavioral case formulations. Cogn Ther Res 19, 21–34 (1995). https://doi.org/10.1007/BF02229674

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