Interjudge reliability and agreement about the patient’s central issue in time-limited psychotherapy (TLP) and its relation to tlp outcome

This study addresses three questions related to the central issue (Cl) in Time Limited Psychotherapy (TLP): (a) Will different therapists formulate the same or similar Cl for a given patient? (b) Will therapists agree on the accuracy of the Cl suggested to the patient? (c) Is there a relationship between therapists’ agreement on the Cl and outcome of treatment? Fifteen transcripts of evaluation sessions for TLP were given to 15 TLP therapists. Each case was read by three therapists, who were asked to formulate a Cl for each patient. In the second phase of the study, therapists had to employ a rating scale assessing the accuracy of several Cl’s to a given patient. A possible relationship between accuracy and therapy outcome was checked as well, based on patient outcome measures available from a previous study. The Cl’s formulated by the therapists were different. When the accuracy rating scale was employed, interjudge reliabilities ranged from R =.46 to R =.85 for 12 of fifteen cases. Interrater agreement about accuracy of the Cl was greater than expected by chance for 10 of the 15 cases. A positive relationship was found between agreement and three outcome measures.