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Can Graduate Students Rate Personality Reliably in Psychoanalytic Treatments Using the Shedler-Westen Assessment
Daniel S Spina1, Katie Aafjes-van Doorn2, Sarah J Horne3
1Pennsylvania State University, Department of Psychology, University Park, Pennsylvania, USA.
Psychodynamic Psychiatry
|March 17, 2025
Summary
Graduate students reliably code psychotherapy sessions but may misjudge personality pathology over time. Their ratings can obscure treatment effects, unlike expert clinician assessments.
Area of Science:
- Psychology
- Psychotherapy Research
Background:
- Graduate students frequently code psychotherapy sessions for research.
- Prior studies examined graduate student reliability in personality dysfunction ratings, but not from transcripts/audio.
- This study assesses graduate student coding reliability and validity for personality assessments.
Purpose of the Study:
- To evaluate graduate student reliability and validity in coding personality assessments using the SWAP-200.
- To compare graduate student ratings with experienced clinician ratings.
Main Methods:
- Utilized an existing dataset of 27 patients in psychoanalytic psychotherapy.
- Compared graduate student SWAP-200 scores with experienced clinician-researcher SWAP-200 scores.
- Employed truth and bias multilevel models to analyze ratings at early and late treatment phases.
Main Results:
- Graduate students underestimated pathology early in treatment and overestimated it late in treatment.
- Graduate student ratings showed smaller effect sizes, masking patient personality changes.
- Experienced clinicians' scores indicated moderate to large effect sizes for personality change.
Conclusions:
- Graduate student coding of personality pathology may deviate from expert judgment.
- These deviations can impact the evaluation of pre- and post-treatment effect sizes in psychotherapy studies.
- Recommendations for research and practice are discussed to improve coding accuracy.
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