Psychiatr Prax 2011; 38(4): 178-184
DOI: 10.1055/s-0030-1265979
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

„Scale to Assess Therapeutic Relationships, STAR”: Evaluation der deutschen Skalenversion zur Beurteilung der therapeutischen Beziehung

Evaluation of the German Version of the STAR ScaleStefanie  Kristiane  Gairing1 , 2 * Matthias  Jäger1 * Daniel  Ketteler1 , Wulf  Rössler1 , Anastasia  Theodoridou1 * S. Gairing und M. Jäger haben in gleichem Ausmaß zu dieser Arbeit beigetragen
  • 1Klinik für Soziale Psychiatrie und Allgemeinpsychiatrie, Psychiatrische Universitätsklinik Zürich
  • 2Forensisch Psychiatrischer Dienst, Psychiatrische Universitätsklinik Zürich
Further Information

Publication History

Publication Date:
05 May 2011 (online)

Zusammenfassung

Anliegen Ziel war die Evaluation einer deutschsprachigen Version der STAR-Skala zur Erfassung der therapeutischen Beziehung im psychiatrischen Setting. Methode Es wurde eine Übersetzung der Skala erstellt und bei 100 Patienten und deren Behandlern angewandt. Die Daten wurden im Hinblick auf die psychometrischen Eigenschaften ausgewertet. Ergebnisse Wir fanden eine zufriedenstellende Reliabilität der Gesamtskalen. Die Subskalen waren bei der Hauptkomponentenanalyse jedoch nicht extrahierbar und wiesen hohe Interkorrelationen auf. Schlussfolgerungen Wir beurteilen die psychometrischen Eigenschaften der Gesamtskalen des STAR als zufriedenstellend.

Abstract

Objective The assessment of the therapeutic relationship has become increasingly important due to evidence suggesting that it has a direct therapeutic effect and may improve outcome indirectly. In Great Britain and Sweden the STAR (Scale To Assess Therapeutic Relationship) was developed for pantheoretical assessment of therapeutic relationships from both clinicians' and patients' points of view. We translated the English version of the instrument into German and made an analysis of its feasibility and reliability. Methods The German translation (STAR-D) was generated in a consensus procedure. The STAR-D was then administered to 100 patients admitted to the Psychiatric University Hospital Zurich (STAR-P) and their clinicians in charge (STAR-C). The psychometric qualities of feasibility and reliability were assessed. Results The overall results for the scales in terms of feasibility and reliability were satisfactory. We did, however, find shortcomings concerning the subscales. They could not be extracted in the principal component analysis and showed high inter-correlation coefficients. Conclusions STAR can serve as an important tool in research concerning the therapeutic relationship. We suggest conducting further analyses concerning the validity of the subscales in the German version.

Literatur

  • 1 Martin D, Garske J, Davis M. Relation of the therapeutic alliance to outcome and other variables: A metanalytic review.  J Consult & Clin Psychol. 2000;  68 438-450
  • 2 Freud S. Zur Dynamik der Übertragung. (Auflage 2006). Frankfurt: Fischer; 1912
  • 3 Catty J. „The vehicle of success”: theoretical and empirical perspectives on the therapeutic alliance in psychotherapy and psychiatry.  Psychol Psychother. 2004;  77 255-272
  • 4 Jäger M, Rössler W. Informeller Zwang zur Verbesserung der Behandlungsbereitschaft psychiatrischer Patienten.  Neuropsychiatr. 2009;  23 206-215
  • 5 McCabe R, Priebe S. The therapeutic relationship in the treatment of severe mental illness: a review of methods and findings.  Int J Soc Psychiatry. 2004;  50 115-128
  • 6 Castonguay L BL. Principles of therapeutic change that work.. New York: Oxford University Press; 2006
  • 7 Frank A F, Gunderson J G. The role of the therapeutic alliance in the treatment of schizophrenia. Relationship to course and outcome.  Arch Gen Psychiatry. 1990;  47 228-236
  • 8 Hansson L, Berglund M. Stability of therapeutic alliance and its relationship to outcome in short-term inpatient psychiatric care.  Scand J Soc Med. 1992;  20 45-50
  • 9 Klinkenberg W D, Calsyn R J, Morse G A. The helping alliance in case management for homeless persons with severe mental illness.  Community Ment Health J. 1998;  34 569-578
  • 10 Priebe S, Gruyters T. Patients' assessment of treatment predicting outcome.  Schizophr Bull. 1995;  21 87-94
  • 11 Weiss M, Gaston L, Propst A et al. The role of the alliance in the pharmacologic treatment of depression.  J Clin Psychiatry. 1997;  58 196-204
  • 12 McCabe R, Priebe S. Are therapeutic relationships in psychiatry explained by patients' symptoms? Factors influencing patient ratings.  Eur Psychiatry. 2003;  18 220-225
  • 13 Catty J, Winfield H, Clement S. The therapeutic relationship in secondary mental health care: a conceptual review of measures.  Acta Psychiatr Scand. 2007;  116 238-252
  • 14 Couture S M, Roberts D L, Penn D L et al. Do baseline client characteristics predict the therapeutic alliance in the treatment of schizophrenia?.  J Nerv Ment Dis. 2006;  194 10-14
  • 15 McCabe R, Priebe S. Are therapeutic relationships in psychiatry explained by patients' symptoms? Factors influencing patient ratings.  Eur Pschiatr. 2003;  18 220-225
  • 16 Sartorius N K. Translation of health status instruments.. In: Orley J, Kuyken W Quality of Life Assessment: International Perspectives.. Heidelberg: Springer; 1994: 3-18
  • 17 Internationale Klassifikation Psychischer Störungen ICD-10.. Bern: Verlag Hans Huber; 2004
  • 18 Guy W. ECDEU Assessment manual for psychopharmacology – revised.. Rockville U.S.: Department of Health and Welfare; 1976
  • 19 SPSS for Windows.. Chicago: SPSS Incorporated; 2005
  • 20 Landis J R, Koch G G. The measurement of observer agreement for categorical data.  Biometrics. 1977;  33 159-174
  • 21 Fleiss J L, Cohen C. The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability.  Educ Psychol Meas. 1973;  33 613-619
  • 22 Neale M S, Rosenheck R A. Therapeutic alliance and outcome in a VA intensive case management program.  Psychiatr Serv. 1995;  46 719-721
  • 23 Priebe S, McCabe R. Therapeutic relationships in psychiatry: the basis of therapy or therapy in itself?.  Int Rev Psychiatry. 2008;  20 521-526
  • 24 Sikorski C, Glaesmer H, Bramesfeld A. Quantität versus Qualität. Zum Stand der Methodendebatte in der Versorgungsforschung.  Psychiat Prax. 2010;  37 322-328
  • 25 Wallace J E, Lemaire J B, Ghali W A. Physician wellnesss: a missing quality indicator.  Lancet. 2009;  274 1714-1721
  • 26 McGuire-Snieckus R, McCabe R, Catty J et al. A new scale to assess the therapeutic relationship in community mental health care: STAR.  Psychol Med. 2007;  37 85-95

Dr. med. Anastasia Theodoridou

Psychiatrische Universitätsklinik

Lenggstraße 31

8032 Zürich, Schweiz

Email: anastasia.theodoridou@puk.zh.ch