Measuring Therapist Adherence in Exploratory Psychotherapy

The demonstration of treatment integrity in comparative outcome research requires measurement of the therapist's adherence to the treatment protocol. Prior research has accomplished this via ratings of sessions of such explicitly structured methods as Cognitive Behavior Therapy and Interpersonal Psychotherapy. This paper presents a scale designed to measure adherence to Exploratory therapy, a psychodynamic/experiential method with an interpersonal focus, that has been studied within the Sheffield Psychotherapy Projects. Acceptable inter-rater reliability was obtained for the scale and it was found to contribute significantly to the discrimination of Exploratory and Prescriptive therapies. Factor analysis indicated that the Exploratory scale was largely indpendent of the common factors tapped by a Facilitative Conditions scale, and yielded an interpretable structure highlighting Exploratory therapy's integration of psychodynamic, experiential, and interpersonal constructs.