The Inter-Rater Consistency of Clinician Ratings of Posttraumatic Stress Disorder (PTSD) Therapy Content
- PDF / 285,997 Bytes
- 12 Pages / 439.37 x 666.142 pts Page_size
- 85 Downloads / 195 Views
The Inter-Rater Consistency of Clinician Ratings of Posttraumatic Stress Disorder (PTSD) Therapy Content Manoj Thogesan 1 & David Berle 1,2 & Dominic Hilbrink 3 & Rachael Kiely 3 & Clare Russell-Williams 3 & Natasha Garwood 3 & Zachary Steel 1,3,4
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
Effective communication between clinicians is essential for the success of mental health interventions in multidisciplinary contexts. This relies on a shared understanding of concepts, diagnoses and treatments. A major assumption of clinicians when discussing psychological treatments with each other is that both parties have a shared understanding of the theory, rationale and application of the respective technique. We aimed to determine to what extent there is inter-rater agreement between clinicians in describing the content of group therapy sessions. Pairs of clinicians, drawn from a large multidisciplinary team (13), were asked to provide ratings of the therapeutic content and emphasis of N = 154 group therapy sessions conducted during an intensive residential treatment program for post-traumatic stress disorder (PTSD). In most therapeutic content domains there was a moderate level of agreement between clinicians regarding session content (Cohen’s Kappa 0.4 to 0.6), suggesting that clinicians have a broad shared understanding of therapeutic content, but that there are also frequent discordant understandings. The implications of these findings on multidisciplinary team communication, patient care and clinical handovers are discussed and directions for further research are outlined. Keywords CBT . PTSD . Therapy . Group psychotherapy
* David Berle [email protected]
1
School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
2
Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
3
St John of God Health Care, Richmond Hospital, North Richmond, NSW, Australia
4
Black Dog Institute, Randwick, NSW, Australia
Psychiatric Quarterly
When therapists communicate with each other through written case notes or at clinical handover meetings, a key assumption is that there is a shared understanding of what each therapeutic concept refers to and how it is applied in therapy. In the case of cognitivebehaviour therapy (CBT) based treatment approaches for PTSD, there are multiple separate treatment components which can each be described broadly as cognitive or behavioural in focus – or a mixture of the two. For instance, “psychoeducation” – where the clinician provides a detailed overview of the nature of PTSD and the way in which a person’s thinking and behaviours may maintain their symptoms, is sometimes considered to be a “cognitive” intervention, in that one of the aims is to change the way the person understands and appraises their PTSD symptoms. In addition to this, therapists might describe an intervention differently according to the intended purpose of the therapy. Therapeutic exercises might also have more than one intended
Data Loading...
