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Patient activation in psychotherapy interactions: Developing and validating the consultation interactions coding scheme

Malins, Sam; Moghaddam, Nima; Morriss, Richard; Schr�der, Thomas; Brown, Paula; Boycott, Naomi; Atha, Chris

Patient activation in psychotherapy interactions: Developing and validating the consultation interactions coding scheme Thumbnail


Authors

Sam Malins

Nima Moghaddam

RICHARD MORRISS richard.morriss@nottingham.ac.uk
Professor of Psychiatry and Community Mental Health

THOMAS SCHRODER THOMAS.SCHRODER@NOTTINGHAM.AC.UK
Professor of Clinical Psychology and Psychological Therapies

Paula Brown

Naomi Boycott

Chris Atha



Abstract

Objective

We describe the development of an instrument aiming to offer interaction‐level feedback based on “patient activation”: client confidence and perceived ability to manage their health.

Method

Twenty‐two session‐transcripts from cognitive behavioral therapy with high‐users of healthcare were analyzed thematically, producing themes describing in‐session interactions. Themes were subcategorized using patient activation theory into high and low activation presentations. Two coders new to the process were trained to use this consultation interactions coding scheme (CICS). Inter‐rater reliability (IRR), convergent validity, and clinical utility were assessed and illustrated with extreme cases.

Results

Good‐to‐excellent IRR was achieved. The CICS, therapeutic alliance, and therapist competence were correlated. Client engagement in session‐structuring interactions correlated with outcome. The highest CICS scorer showed multiple outcome‐improvements, the lowest scorer reported deteriorations.

Conclusions

This study presents the CICS's psychometric properties and indicates the value of client engagement in session‐structuring.

Journal Article Type Article
Acceptance Date Nov 21, 2019
Online Publication Date Dec 11, 2019
Publication Date 2020-04
Deposit Date Jan 9, 2020
Publicly Available Date Dec 12, 2020
Journal Journal of Clinical Psychology
Print ISSN 0021-9762
Electronic ISSN 1097-4679
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 76
Issue 4
Pages 646-658
DOI https://doi.org/10.1002/jclp.22910
Keywords Arts and Humanities (miscellaneous); Clinical Psychology
Public URL https://nottingham-repository.worktribe.com/output/3694989
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1002/jclp.22910
Additional Information This is the peer reviewed version of the following article: Malins, S, Moghaddam, N, Morriss, R, et al. Patient activation in psychotherapy interactions: Developing and validating the consultation interactions coding scheme. J. Clin. Psychol. 2019; 1– 13, which has been published in final form at https://doi.org/10.1002/jclp.22910. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.