The forth step involves a structured expert rating by applying the 22 items to the “expert therapy sessions”. A further group of about 9-12 experts (psychodynamic therapists and psychoanalysts with 5 years clinical experience at least) will be divided into six varying rater groups (three raters in each group). Ratings are based on three psychodynamic and three psychoanalytic “expert therapy sessions” (middle part sequences). Each expert listened to one or more sequences of “expert therapy sessions” and assessed each item of the therapist’s attitudes and interventions on a 4-point rating scale (0 = “not at all characteristic” to 3 = “extremely characteristic”). The most consensually rated items, both within raters’ groups and within treatment approach, are the most discriminative items and are appropriate for the adherence measure. @)15-1.*$#! To date an empirically robust adherence measure to discriminate between psychodynamic psychotherapy and psychoanalytic psychotherapy is still lacking. The majority of the currently used adherence scales are suitable for discriminating cognitive-behavioral and psychodynamic approaches but fail to provide reliably discrimination between different psychoanalytic approaches. Because of an increasing interest in effectiveness studies of high external validity of unmanualized long-term treatments, the measurement of adherence is of major importance for psychotherapy research of high scientific standard. G$#.1/.\!
Melanie Ratzek, Dr. Dipl.-Psych. International Psychoanalytic University (IPU), Stromstrasse 3, 10555 Berlin, Germany. E,mail: melanie.ratzek@ipu-berlin.de
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