Chapter 5: Measurement in CBT Flashcards
Empirical Nature of CBT
View treatment as an experiment in which thoughts, feelings, and behavikor, and the relationships between them, can be investigated during both assessment and treatment
Assessment
Ask client to collect data about the nature of the problem, to supplement and fine-tune what he reports in the assessment interview
Main Goals of Data from Client
Help elaborate Formulation
Provide baseline against which the problem can be compared in the future
Regular Measures
Allow both client and therapist to evaluate the impact of interventions; gather data at the end of treatment so overall progress can be assessed
Reasons it is helpful to gather data to supplement information derived from interviews
Regular measures allow you to obtain a baseline of important aspects of the problem and then use that to assess effects of future intervention
Observations of behaviors, thoughts, and feelings made at the time they occur are more reliable than retrospective estimates
Direct observations by the client in real life can have therapeutic effects in themselves
Once they have improved, many clients lose awareness of how disabling the problem was initially; Baseline measures help client to assess his progress more accurately
If intervention does not have impact, measurement can help therapist and client to figure out why
Psychometric Aspects of Monitoring
Reactivity of Measurement
Reliability and Validity
Reactivity of Measurement
Process of monitoring can have positive or negative effect on what is being measured
Validity and Reliability
Valid - measures what it purports to measure and not some irrelevant feature
Reliable - achieves the same result or score when repeated under the same conditions at another time, or with another assessor
Low Reliability
Affected by extraneous features and produces inconsistent findings
Useful and Accurate Measures
Simple Consider measures in more than one system Specific, clearly defined targets Provide clear and simple instructions Use sensitive and meaningful measures Provide aids to recording Train Client to use the measure Collect data as soon as possible after the event Pay attention to the monitoring
Sort of Information to Collect
Frequency Counts Duration of event/experience Self-ratings Diaries Questionnaires
Other sources of Information
Other Informants
Live observations of behavior
Physiological Data
Problems When Using Measurements
Client does not appreciate its potential value
Client cannot read or write
Poor reliability or validity of a questionnaire
