ABSTRACT
This article presents the development of a new 82-item rating scale of therapist adherence and competence for supportive-expressive (SE) dynamic psychotherapy for the treatment of cocaine dependence. Sixty-four items are rated for adherence, appropriateness, and quality of prescribed interventions. As part of the pilot/training phase of the National Institute on Drug Abuse Collaborative Cocaine Treatment Study, two independent expert judges rated 32 audiotapes of SE therapy sessions with cocaine-dependent patients, 10 tapes of cognitive therapy (CT) sessions, and 10 tapes of individual drug counseling (IDC) sessions. Reliability was acceptable for adherence but poor for quality and appropriateness. SE therapists used more expressive (interpretative) techniques than did either CT therapists or IDC counselors, and they used more supportive techniques than did IDC counselors.
Subject(s)
Cocaine , Psychotherapy , Substance-Related Disorders/diagnosis , Substance-Related Disorders/therapy , Humans , Observer Variation , Professional Competence , Psychometrics , Reproducibility of ResultsABSTRACT
This paper reports on the development of a 43 item rating scale that assesses therapist adherence and competence in individual drug counseling (IDC) for the treatment of cocaine dependence. Three independent judges rated 41 audiotaped IDC sessions from the pilot/training phase of the NIDA collaborative cocaine study. Judges also rated 11 tapes of Cognitive sessions and ten tapes of Supportive Expressive psychodynamic sessions. Interjudge reliability for the total scale score and subscales ranged from 0.55 to 0.89 and internal consistency coefficients ranged from 0.43 to 0.95. Ratings indicated that IDC counselors used IDC techniques more frequently and competently than did therapists from other modalities.
