How Patients Guide Therapy: A Pilot Study on the Development and Reliability of the Patient Coaching Rating System.

IF 2.5 Q2 PSYCHOLOGY, CLINICAL

AMERICAN JOURNAL OF PSYCHOTHERAPY Pub Date : 2025-09-26 DOI:10.1176/appi.psychotherapy.20250009

Elizabeth Li, James McCollum, David Kealy, Matthew R Baity, George Silberschatz

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引用次数: 0

Abstract

Objective: Patient coaching refers to patient-initiated communication that helps therapists understand therapy goals, maladaptive beliefs, personal challenges, and preferred therapeutic approaches. Despite its theoretical significance, empirical research remains limited, with a few recent studies relying on labor-intensive methods involving extensive training of raters and detailed case analysis. To support broader empirical research, this study introduces the Patient Coaching Rating System (PCRS) to assess two dimensions of patient coaching: information coaching (what and why) and direction coaching (how).

Methods: Seven raters used the PCRS to rate 22 segments from an early psychotherapy session. Each segment was rated on two dimensions-information coaching and direction coaching-with a 0-4 scale.

Results: The raters achieved interrater reliability scores of 0.86 for information coaching and 0.68 for direction coaching. Whereas information coaching demonstrated excellent reliability, direction coaching showed moderate to good reliability, highlighting the need for further refinement of the coding manual.

Conclusions: This pilot study provides a structured method for assessing patient coaching and represents an initial step toward facilitating empirical investigation within therapy sessions.

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患者如何指导治疗：患者指导评分系统的发展和可靠性的试点研究。

目的：患者指导是指患者主动沟通，帮助治疗师了解治疗目标，适应不良的信念，个人挑战，和首选的治疗方法。尽管具有理论意义，但实证研究仍然有限，最近的一些研究依赖于大量培训评分员和详细案例分析的劳动密集型方法。为了支持更广泛的实证研究，本研究引入患者指导评分系统（PCRS）来评估患者指导的两个维度：信息指导（什么和为什么）和方向指导（如何）。方法：7名评分员使用PCRS对早期心理治疗的22个片段进行评分。每个部分在两个维度上进行评分——信息指导和方向指导——0-4分。结果：信息辅导和方向辅导的信度分别为0.86分和0.68分。尽管信息指导显示了出色的可靠性，但方向指导显示了中等到良好的可靠性，突出了编码手册进一步改进的必要性。结论：这项初步研究提供了一种评估患者指导的结构化方法，代表了在治疗过程中促进实证调查的第一步。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AMERICAN JOURNAL OF PSYCHOTHERAPY PSYCHOLOGY, CLINICAL-

CiteScore

2.90

自引率

4.00%

发文量

期刊介绍： Founded in 1939, the American Journal of Psychotherapy (AJP) has long been a leader in the publication of eclectic articles for all psychotherapists. Transtheoretic in reach (offering information for psychotherapists across all theoretical foundations), the goal of AJP is to present an overview of the psychotherapies, subsuming a host of schools, techniques, and psychological modalities within the larger domain of clinical practice under broad themes including dynamic, behavioral, spiritual, and experiential.