Li, Elizabeth;
McCollum, James;
Kealy, David;
Baity, Matthew R;
Silberschatz, George;
(2025)
How Patients Guide Therapy: A Pilot Study on the
Development and Reliability of the Patient Coaching
Rating System.
American Journal of Psychotherapy
, Article appi.psychotherapy.20250009. 10.1176/appi.psychotherapy.20250009.
(In press).
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Abstract
OBJECTIVE: Patient coaching refers to patient-initiated communication that helps therapists understand therapy goals, maladaptive beliefs, personal challenges, and preferred therapeutic approaches. Despite its theoretical significance, empirical research remains limited, with a few recent studies relying on labor-intensive methods involving extensive training of raters and detailed case analysis. To support broader empirical research, this study introduces the Patient Coaching Rating System (PCRS) to assess two dimensions of patient coaching: information coaching (what and why) and direction coaching (how). METHODS: Seven raters used the PCRS to rate 22 segments from an early psychotherapy session. Each segment was rated on two dimensions-information coaching and direction coaching-with a 0-4 scale. RESULTS: The raters achieved interrater reliability scores of 0.86 for information coaching and 0.68 for direction coaching. Whereas information coaching demonstrated excellent reliability, direction coaching showed moderate to good reliability, highlighting the need for further refinement of the coding manual. CONCLUSIONS: This pilot study provides a structured method for assessing patient coaching and represents an initial step toward facilitating empirical investigation within therapy sessions.
| Type: | Article |
|---|---|
| Title: | How Patients Guide Therapy: A Pilot Study on the Development and Reliability of the Patient Coaching Rating System |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1176/appi.psychotherapy.20250009 |
| Publisher version: | https://doi.org/10.1176/appi.psychotherapy.2025000... |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Coding Manual, Control-Mastery Theory, Patient Coaching, Rating Scale, Reliability Assessment |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Psychology and Human Development |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10219221 |
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