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November 1988

Clinicians Can Agree in Assessing Relationship Patterns in Psychotherapy: The Core Conflictual Relationship Theme Method

Author Affiliations

From the Department of Psychiatry, University of Pennsylvania, Philadelphia.

Arch Gen Psychiatry. 1988;45(11):1001-1004. doi:10.1001/archpsyc.1988.01800350035005

• This study examines interjudge agreement on formulations of dynamic themes in psychotherapy, using a sessionbased method, namely, the Core Conflictual Relationship Theme. Agreement was assessed by two methods: one was based on themes that were tailor-made for each case, while the other was based on coding themes into a standard set of categories. To assess agreement on the tailor-made formulations, a paired-comparisons procedure was used. For a sample of 35 patients, the similarity ratings for matched cases were significantly higher than for purposely mismatched cases. Using the standard set of categories, agreement was also good; weighted K values ranged from.61 to.70. The results also demonstrate reliability for the location of the relationship episodes, which form the database for the Core Conflictual Relationship Theme. Our positive results suggest that this guided clinical method can be used reliably as a measure of relationship patterns in psychotherapy; our results provide the first moderate-sized sample demonstration of clinicians' agreement in formulating this complex concept.

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