Validation of the intersession alliance measure: Individual, couple, and family versions

Monitoring the therapeutic alliance throughout treatment can improve client outcomes and lead to improved care. The individual, couple, and family versions of the intersession alliance measure (IAM) were developed to facilitate routine monitoring of the expanded therapeutic alliance. Psychometric properties of the three versions of the IAM were examined using a clinical sample. Participants were drawn from clinics in the United States participating in the Marriage and Family Therapy Practice Research Network. Using this sample, results indicate that items on each version of the IAM load on one factor, are invariant across sex, and that each version has good internal consistency, test-retest reliability, and concurrent validity. The IAM-C and IAM-F also have good predictive validity, while the IAM-I has more limited evidence for its predictive validity. These results suggest that the IAMs are valid and reliable measures that can facilitate the routine monitoring of the expanded therapeutic alliance in psychotherapy.

The development of a reliable change index and cutoff score for the SCORE-15

The Systemic Clinical Outcome and Routine Evaluation version 15 (SCORE-15) is a measure used to assess family-level change in family therapy. The SCORE-15 has been demonstrated to be a reliable and valid measure, with high clinical utility; however, the SCORE-15 lacks the ability to determine whether the change in family functioning during the course of therapy is clinically significant. This study aimed to establish a reliable change index (RCI) and clinical cutoff score so that researchers and clinicians can determine clinically significant change in family therapy. US samples of 71 clinical participants and 244 community participants completed the SCORE-15. Results indicated a cutoff score of 40.37 and an RCI of 9.52. Consequently, family members who improve their SCORE-15 score during the course of therapy by at least 9 points and who cross the threshold of 40 during the course of therapy are considered to have experienced clinically significant change.

The Couple Relationship Scale: A brief measure to facilitate routine outcome monitoring in couple therapy

Routine outcome monitoring (ROM) is an important component of evidence-based practice. To implement ROM in their practice, couple therapists need a brief measure that can quickly assess the relevant aspects of a couple's relationship. The Couple Relationship Scale (CRS) is a 10-item measure of relational functioning that assesses emotional intimacy, commitment, trust, safety, cohesion, acceptance, conflict, physical intimacy, overall happiness, and personal well-being. Three studies examined the initial psychometric properties of the CRS. Study One used a sample of 300 individuals to examine the concurrent validity, factor structure, and reliability of the CRS. In Study Two, 53 individuals completed the CRS twice to establish test-retest reliability. In Study Three, 214 distressed individuals and 135 non-distressed individuals were used to identify a clinical cutoff and reliable change index (RCI). Results indicated that the CRS has a strong concurrent and construct validity and good reliability. The clinical cutoff was 70.9 with an RCI of 16.

Improving Measurement in Couple and Family Therapy: An Item Response Theory Primer

The valid and reliable assessment of individual and relational functioning relies on high-quality assessment tools. Most assessments used in the field of couple and family therapy were developed using Classical Test Theory (CTT). An alternate theory for guiding the creation, evaluation, and scoring of assessments is Item Response Theory (IRT). IRT has several advantages over CTT and can be used to improve measurement in the field. For example, the IRT approach creates measures that are significantly more precise, yet uses fewer items, than scales created using CTT. This manuscript provides an overview of how IRT differs from CTT and describes the fundamental concepts and assumptions of IRT. Following this summary, we provide a step-by-step example of how IRT can be used to reduce the length of the Marital Disaffection Scale from 21 to 6 items without losing a significant amount of information about the construct.