Evaluating adherence is as a central quality aspect in studies examining the outcomes of therapy. Consequently, the objective of this study is to create a scale designed for the assessment of adherence and treatment differentiation within analytical (AP) and depth-psychologically based (TP) psychotherapy, known as the APP scale. The development of the APP scale went through six stages:
1. systematic literature review for the development of items with procedure-typical content for TP and AP.
2. group discussion with N=6 experts (training analysts) about the specially developed items, followed by a consensual assessment of the items with regard to their discriminatory ability in relation to TP and AP.
3. assessment of procedural affiliation: To enable the application of the developed items to therapy sessions considered prototypical for each procedure, audiographed TP and AP sessions were assessed by two external, independent, experienced raters with regard to their procedural affiliation. Only those therapy sessions were both raters concurred with the therapy method indicated by the treating therapist formed the data basis for stage 4.
4. Application of the items to the audiographed TP and AP expert therapy sessions:
Psychotherapists for AP and TP (at least 5 years of professional experience) assessed the extent to which the item contents were actually realized in the actual AP and TP treatments conducted.
5. revision of the item pool on the basis of the ratings.
6. recruitment of a further group of raters who received intensive training in the scale.
Nine trainees underwent rigorous rater training. Once they achieved an interrater reliability of ICC [2,1] > 0.60, seven of these trainees were selected as raters for the psychometric evaluation of the APP scale.
Results revealed that trained psychology students and postgraduates could reliably distinguish between the conceptually closely related AP and TP psychoanalytic procedures using the APP scale.
In the fall of 2022, a construct validity test commenced in collaboration with the University of Klagenfurt. As part of their master's thesis, students from IPU Berlin and the University of Klagenfurt applied the APP scale to sessions from the Munich Psychotherapy Study (MPS). The therapists' provided information on therapy methods (TP/AP) was then compared with the corresponding assessments made using the APP scale.
Original language: German