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Originalarbeit

Entwicklung und Validierung von Skalen zur Erfassung der Adhärenz im transdiagnostischen Gruppensetting für ACT und KVT

Published Online:September 16, 2020https://doi.org/10.1026/1616-3443/a000566

Abstract

Zusammenfassung.Theoretischer Hintergrund: Therapeutische Adhärenz ist eine zentrale Voraussetzung zur Sicherung der Validität von Psychotherapiestudien. Bisher existieren im deutschsprachigen Raum keine Skalen zur Erfassung der Adhärenz im Bereich der Akzeptanz- und Commitmenttherapie (ACT). Fragestellung: Ziel war es, Skalen zur Erfassung der Adhärenz von Therapeut_innen für ACT und der Kognitiven Verhaltenstherapie (KVT) zu entwickeln und deren Gütekriterien zu überprüfen. Methode: Die Validierung der Adhärenzskalen basierte auf n=38 ACT- und n=31 KVT-Gruppentherapiesitzungen zur Behandlung von depressiven und gemischten Störungsbildern. Die Adhärenz wurde durch zwei Rater_innen anhand von Audioaufzeichnungen bewertet. Ergebnisse: Sowohl für die ACT-Adhärenzskala (ICC=.96) als auch für die KVT-Adhärenzskala (ICC=.98) konnten hohe Interraterreliabilitäten erreicht werden. Die konvergente Validität konnte anhand einer negativen Korrelation zwischen den beiden Skalen sichergestellt werden (r=-.95). Schlussfolgerungen: Beide Adhärenzskalen bieten eine erste Möglichkeit, um manualgetreues Therapeut_innenverhalten in ACT- und KVT-Gruppentherapien für Patient_innen mit gemischten Störungsbildern zu erfassen. Zudem geben die Ergebnisse einen Hinweis darauf, dass sich die beiden Methoden voneinander differenzieren lassen.


Development and Validation of Scales to Assess adherence of Transdiagnostic Group Settings for ACT and CBT

Abstract.Background: Therapeutic adherence is a central condition for ensuring the validity of psychotherapy studies. To date no German scales to assess adherence in the area of Acceptance and Commitment Therapy (ACT) exist. Objective: The aim was to develop scales to measure the adherence of therapists to ACT and Cognitive Behavioral Therapy (CBT) and to examine their psychometric properties. Methods: Validation of the adherence scales was based on n=38 ACT and n=31 CBT group therapies for the treatment of depressive and mixed disorders. Therapists’ adherence was evaluated by two raters using audio recordings. Results: Both ACT adherence scale (ICC=.96) and CBT adherence scale (ICC=.98) achieved high interrater-reliabilities. Convergent validity could be ensured by a negative correlation between both scales (r=-.95). Conclusions: Both adherence scales offer a first possibility to measure adherent therapist behavior in ACT and CBT groups for patients with mixed disorders. Moreover, the results indicate that both psychotherapeutic approaches can be differentiated from each other.

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