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

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.

Citation

Malins, S., Moghaddam, N., Morriss, R., Schröder, T., Brown, P., Boycott, N., & Atha, C. (2020). Patient activation in psychotherapy interactions: Developing and validating the consultation interactions coding scheme. Journal of Clinical Psychology, 76(4), 646-658. https://doi.org/10.1002/jclp.22910

• 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.