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Clinicians have several therapeutic relationships and patients only one: the effect on their assessments of relationships

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posted on 2023-06-09, 14:31 authored by Lauren Greenberg, Stephen BremnerStephen Bremner, Catherine Carr, Stefan Priebe
Objectives Little attention has been given to the common assessment problem that clinicians assess outcomes of several patients and may rate them in comparison to one another, whereas patients assess only their own outcomes without any comparison. We explored empirically whether this would lead to a greater variability of clinician ratings as compared to patient ratings. Methods Data from two independent samples in which clinicians and patients, using consistent instruments, rated their therapeutic relationships. We present descriptive statistics of variability and intracluster correlation coefficients. Results The Helping Alliance Scale was completed at baseline and follow-up by 20 clinicians and 103 patients in an observational study and by 88 clinicians and 431 patients in a trial. Patients tended to rate their relationship 5–10% more highly than their clinicians, but with 50–100% more variability. Intraclinician Helping Alliance Scale ratings were more correlated than those by patients (intracluster correlation coefficients 0.3–0.7 vs. 0.0–0.2). Conclusion Contrary to our assumption, clinicians' ratings of therapeutic relationships were in both samples less variable than those of their patients. When clinicians rate outcomes of several patients, a cluster effect of ratings may have to be considered in the design and analysis.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

International Journal of Methods in Psychiatric Research

ISSN

1049-8931

Publisher

Wiley

Issue

4

Volume

27

Page range

1-7

Article number

e1722

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2018-08-13

First Open Access (FOA) Date

2019-06-06

First Compliant Deposit (FCD) Date

2018-08-10

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