Inter-rater reliability of cognitive-behavioral case formulations of depression: A replication

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.