DEVELOPMENT OF A THERAPIST ADHERENCE COMPETENCE RATING-SCALE FOR SUPPORTIVE-EXPRESSIVE DYNAMIC PSYCHOTHERAPY - A PRELIMINARY-REPORT/

This paper reports on the development of the Penn Adherence/Competence Scale for Supportive-Expressive (SE) Dynamic Psychotherapy. The ratin g scale includes 45 items which are rated separately for both frequenc y (adherence) and quality (competence) of therapists' application. Aud iotaped from four SE therapists who saw a total of 33 depressed patien ts were rated by two independent judges. The same judges also rated fo ur cognitive (CT) therapists who saw a total of seven patients. Interj udge reliability for the six subscales and the two total scale scores ranged from .35 to .79, and internal consistency coefficients ranged f rom .62 to .95. While SE therapists used more expressive and interpret ative techniques than did CT therapists, the two groups did not differ in their use of supportive and general techniques. In addition, SE th erapists were judged to be more competent in their use of SE specific techniques than were CT therapists. SE therapists' adherence and compe tence were not associated with patients' level of psychiatric severity as indicated by pretreatment and concurrent levels of depression, com orbid personality disorder, or level of psychological health. Therapis ts' adherence and competence were unrelated to a concurrent measure of the therapeutic alliance.