Open AccessReliability, factor structure, and validity of an observer-rated alliance scale with youth.
Author(s) -
Bryce D. McLeod,
Jennifer Cecilione,
Amanda JensenDoss,
Michael A. SouthamGerow,
Philip C. Kendall
Publication year - 2021
Publication title -
psychological assessment
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.96
H-Index - 140
eISSN - 1939-134X
pISSN - 1040-3590
DOI - 10.1037/pas0001036
Subject(s) - psychology , discriminant validity , clinical psychology , inter rater reliability , psycinfo , convergent validity , alliance , incremental validity , observational study , test validity , psychometrics , construct validity , exploratory factor analysis , psychosocial , developmental psychology , psychiatry , rating scale , medline , medicine , pathology , political science , law , internal consistency
Measurement limitations lessen the conclusions about the role of the alliance in youth psychosocial treatment. This article examined the score reliability, factor structure, and validity of the 9-item Therapy Process Observational Coding System for Child Psychotherapy-Alliance scale (TPOCS-A). The sample, 51 youth aged 7-15 years ( M age = 10.36 years, SD = 1.90; 86.3% White; 60.8% male, 39.2% female), met diagnostic criteria for a principal anxiety disorder and received cognitive-behavioral therapy. Treatment sessions ( N = 463) were coded by independent coders using the TPOCS-A along with observational measures of treatment adherence and therapist competence. Youth and therapists also completed self-report alliance measures at the end of each session. Reliability estimates, ICC(2,2), at the item level indicated a mean interrater reliability of .68 ( SD = .10) and a mean coder stability of .64 ( SD = .11). An exploratory factor analysis identified a one-factor solution with five items. TPOCS-A scores evidenced convergent validity with the therapist and adolescent reports of alliance but did not converge with the child-report alliance measure. TPOCS-A scores evidenced discriminant validity when compared with scores on adherence and competence measures. The reliability and validity profile of the 9- and 5-item versions of the TPOCS-A were similar. Overall, findings support the reliability and validity of the TPOCS-A scores, but questions remain about how best to assess the alliance with children. (PsycInfo Database Record (c) 2021 APA, all rights reserved).