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The Dialectical Behavior Therapy Adherence Coding Scale (DBT ACS): Psychometric properties.

Melanie S Harned1, Kathryn E Korslund2, Sara C Schmidt1

  • 1VA Puget Sound Health Care System.

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This summary is machine-generated.

The Dialectical Behavior Therapy Adherence Coding Scale (DBT ACS) reliably measures therapist adherence to DBT. This scale is valid across diverse settings and populations, ensuring consistent treatment delivery.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Psychotherapy Research

Background:

  • The Dialectical Behavior Therapy Adherence Coding Scale (DBT ACS) is crucial for assessing adherence to manualized Dialectical Behavior Therapy (DBT).
  • Limited data exists on the psychometric properties of the DBT ACS despite its widespread use in clinical trials.

Purpose of the Study:

  • To evaluate the psychometric properties of the DBT ACS.
  • To assess the reliability, validity, and generalizability of the DBT ACS across various settings and populations.

Main Methods:

  • Analysis of data from six clinical trials involving 1,271 individual and 180 group DBT sessions.
  • Utilized internal consistency, interrater reliability, confirmatory factor analysis, and generalizability coefficients.

Main Results:

  • The DBT ACS demonstrated good internal consistency (α = .81) and excellent interrater reliability (ICC = .93).
  • A single-factor model showed acceptable fit, and the scale differentiated between treatments and therapist types.
  • Therapist variability accounted for more adherence score variance (33%) than patient variability (15%).
  • 5 sessions are needed for patient-level adherence, while 9-15 sessions are required for therapist-level generalizability.

Conclusions:

  • The DBT ACS is a reliable, valid, and dependable measure for assessing adherence to individual and group DBT.
  • Its utility is confirmed across diverse clinical settings, therapist types, and patient populations.