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Published on: August 29, 2025
Assessing the Reliability of the CAMS Rating Scale Using a Generalizability Study
Christopher D Corona1,2, Peter M Gutierrez3,4, Barry M Wagner5
11 VISN 2 Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, USA.
The CAMS Rating Scale (CRS) reliably distinguishes between Collaborative Assessment and Management of Suicidality (CAMS) and Enhanced Care-As-Usual (E-CAU) interventions. This measure demonstrates high inter-rater reliability, minimizing measurement error in clinical trials.
Area of Science:
- Clinical Psychology
- Psychiatric Research
- Health Services Research
Background:
- Ensuring treatment differentiation is crucial in randomized controlled trials.
- Direct observation and clinician performance measures aid in verifying distinct interventions.
- The CAMS Rating Scale (CRS) is a tool for assessing the delivery of Collaborative Assessment and Management of Suicidality (CAMS).
Purpose of the Study:
- To evaluate the reliability of the CAMS Rating Scale (CRS).
- To assess the CRS's ability to differentiate between CAMS and Enhanced Care-As-Usual (E-CAU) interventions.
- To determine the generalizability of the CRS in measuring treatment fidelity.
Main Methods:
- Digitally recorded clinical sessions (N=36) were coded using the CRS.
- Sessions involved four clinicians, four time points, and 34 patients across two treatment groups (CAMS and E-CAU).
- Two raters coded each session, and a G coefficient was calculated to assess reliability.
Main Results:
- The CRS demonstrated high inter-rater reliability.
- The scale reliably differentiated between CAMS and E-CAU interventions.
- Measurement error was minimized relative to expected variance sources.
Conclusions:
- The CAMS Rating Scale (CRS) is a reliable measure for treatment differentiation.
- The CRS can be integral in studies evaluating the Collaborative Assessment and Management of Suicidality (CAMS).
- Further research should address limitations such as rater blinding and formal training protocols.
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