Jb. Persons et A. Bertagnolli, Inter-rater reliability of cognitive-behavioral case formulations of depression: A replication, COGN THER R, 23(3), 1999, pp. 271-283
We developed a model of cognitive-behavioral case formulation and tested se
veral hypotheses about therapists' ability to use it to obtain cognitive-be
havioral formulations of cases of depressed patients. We rested whether cli
nicians, using measures we developed, could correctly identify patients' av
ert problems and agree on assessments of patients' underlying schemas. Clin
icians offered cognitive-behavioral formulations for three cases after list
ening to audiotapes of initial interviews with depressed women conducted by
the first author in her private practice. Therapists identified 67% of pat
ients' overt problems. When schema ratings were averaged over five judges,
interrater reliability was good (inter-rater reliability coefficients avera
ged 0.72); single judges showed poor inter-rater agreement on schema rating
s (inter-rater reliability coefficients averaged 0.37). Providing therapist
s with a specific context in which to make ratings did not improve schema a
greement. Ph. D.-trained therapists were more accurate than non-Ph.D.-train
ed therapists in identifying patients' problems. Most findings replicated t
hose obtained in an earlier study.