Introduction and evaluation of a therapeutic adherence and competence scale for grief-focused cognitive behavioural therapy

Figures & data

Table 1. Therapeutic Adherence and Competence scale for Grief-focused cognitive behavioural therapy (TACs-G): Adherence items only: intraclass correlation coefficient, number of ratings, mean and standard deviation of items, range and mean and standard deviation of final expert ratings.

Item		ICC2,1 (CI 95%)	N	Mean (SD)	Min/Max	Appropriateness Mean (SD)	Relevance Mean (SD)
1.	Agenda	.796* (.663–.880)	96	2.51 (0.68)	1/3	4.20 (0.45)	4.60 (0.55)
2.	Time management	.925* (.870–.957)	96	2.22 (0.84)	1/3	4.20 (0.84)	4.60 (0.55)
3.	Dealing with ambivalence	.800* (.670–.883)	96	2.68 (0.61)	1/3	4.20 (0.84)	4.80 (0.45)
4.	Dealing with/addressing stressors	.989* (.980–.994)	32	2.75 (0.44)	2/3	4.20 (0.45)	4.40 (0.55)
5.	Psychoeducation regarding PGD, comorbidities and PG-CBT	.994* (.990–.997)	34	2.74 (0.45)	2/3	4.80 (0.45)	5.00 (0.00)
6.	Working with cognitions	.907* (.840–.947)	42	2.57 (0.55)	1/3	4.80 (0.45)	4.80 (0.45)
7.	Feelings of grief/Perception of emotions	.938* (.893–.965)	23	2.83 (0.39)	2/3	4.60 (0.55)	4.60 (0.55)
8.	Promoting self-help	.822* (.703–.896)	51	2.51 (0.70)	1/3	4.80 (0.45)	5.00 (0.00)
9.A	Getting to know the patient and his grief reaction	1.0* (1.0–1.0)	2	3.00 (0.00)	3/3	4.40 (0.55)	5.00 (0.00)
10.A.	Introducing the deceased person	.953* (.918–.973)	11	2.91 (0.30)	2/3	5.00 (0.00)	5.00 (0.00)
11.B	Exposure: Worst moment	1.0 (1.0–1.0)	12	2.83 (0.39)	2/3	5.00 (0.00)	5.00 (0.00)
12.B	Visiting the grave	.805* (.677–.886)	14	2.79 (0.43)	2/3	4.60 (0.55)	5.00 (0.00)
13.C	Legacy, remembrance, dedication	.870* (.780–.925)	18	2.67 (0.49)	2/3	4.80 (0.45)	5.00 (0.00)
14.C	Future prospects	1.0 (1.0–1.0)	18	2.67 (0.49)	2/3	4.80 (0.45)	5.00 (0.00)
15.	Proscribed interventions	1.0 (1.0–1.0)	96	1.00 (0.00)	1/1	4.25 (0.50)	4.00 (0.82)
	Total score	.889* (.810–.936)	96	14.58 (3.11)	7/23

The letter (A, B, C) next to the item number refers to the therapy phase, ICC_2,1 = intraclass correlation coefficients for both raters, Min = lowest rating score on a scale of 1–3, Max = highest rating score on a scale of 1–3. Relevance and appropriateness were assessed on a scale ranging from 1 to 5. *p< .001.

Table 2. Therapeutic Adherence and Competence scale for Grief-focused cognitive-behavioural therapy (TACs-G): Competence items only: intraclass correlation coefficient, number of ratings, mean and standard deviation of items, range and mean and standard deviation of final expert ratings.

Item		ICC2,1 (CI 95%)	N	Mean (SD)	Min/Max	Appropriateness Mean (SD)	Relevance Mean (SD)
1.	Agenda	.946* (.906–.969)	96	3.58 (1.07)	1/5	4.60 (0.55)	4.60 (0.55)
2.	Time management	.916* (.854–.952)	96	3.83 (0.84)	2/5	4.40 (0.55)	4.80 (0.45)
3.	Dealing with ambivalence	.901* (.831–.943)	96	3.76 (1.10)	1/5	4.40 (0.89)	4.80 (0.45)
4.	Dealing with/addressing stressors	.988* (.979–.993)	32	4.41 (0.67)	3/5	4.60 (0.55)	4.60 (0.55)
5.	Psychoeducation regarding PGD, comorbidities and PG-CBT	.988* (.979–.993)	34	4.21 (0.81)	3/5	4.80 (0.45)	5.00 (0.00)
6.	Working with cognitions	.903* (.834–.945)	42	3.93 (0.97)	2/5	4.80 (0.45)	4.80 (0.45)
7.	Feelings of grief/Perception of emotions	.918* (.858–.953)	23	4.26 (0.92)	2/5	4.00 (0.71)	4.60 (0.55)
8.	Promoting self-help	.825* (.707–.898)	51	3.39 (1.19)	1/5	4.60 (0.55)	4.80 (0.45)
9.A	Getting to know the patient and his grief reaction	1.0* (1.0–1.0)	2	4.00 (0.00)	4/4	4.60 (0.55)	4.80 (0.45)
10.A	Introducing the deceased	.892* (.816–.938)	11	4.82 (0.41)	4/5	5.00 (0.00)	5.00 (0.00)
11.B	Exposure: Worst moment	.969* (.946–.983)	12	4.17 (1.03)	2/5	4.60 (0.55)	5.00 (0.00)
12.B	Visiting the grave	.824* (.707–.898)	14	3.86 (0.95)	2/5	4.80 (0.45)	4.80 (0.45)
13.C	Legacy, remembrance, dedication	.815* (.692–.892)	18	4.22 (0.88)	2/5	4.80 (0.45)	5.00 (0.00)
14.C	Future prospects	.951* (.914–.972)	18	4.39 (0.85)	2/5	4.20 (0.45)	4.60 (0.55)
15.	Dealing with ‘avoidance behaviour’	.509* (.266–.692)	57	3.75 (1.14)	2/5	5.00 (0.00)	5.00 (0.00)
16.	Grief specific resource activation	.678* (.490–.806)	70	3.67 (1.05)	1/5	4.40 (0.55)	4.80 (0.45)
	Total score	.782* (.642–.872)	96	26.92 (6.61)	13/45

The letter (A, B, C) next to the item number refers to the therapy phase, ICC_2,1 = intraclass correlation coefficients for both raters, Min = lowest rating score on a scale of 1–5, Max = highest rating score on a scale of 1–5. Relevance and appropriateness were assessed on a scale ranging from 1 to 5. *p< .001.

Table 3. Stability over time for the Therapeutic Adherence and Competence scale for Grief-focused cognitive behavioural therapy (TACs-G), Adherence items only.

Item		ICC2,1 (CI 95%)	N	Mean (SD)	Min/Max
1.	Agenda	1.000	20	2.70 (0.47)	2/3
2.	Time management	1.000	20	2.30 (0.92)	1/3
3.	Dealing with ambivalence	0.724	20	2.35 (0.75)	1/3
4.	Dealing with/addressing stressors	0.974	6	2.82 (0.41)	2/3
5.	Psychoeducation regarding PGD, comorbidities/& PG-CBT	1.000	6	3.00 (0.00)	3/3
6.	Working with cognitions	1.000	8	2.00 (0.76)	1/3
7.	Feelings of grief/Perception of emotions	1.000	2	2.00 (0.00)	2/2
8.	Promoting self-help	0.972	11	2.09 (1.04)	1/3
9.A	Getting to know the patient and his grief reaction	–	0	–	–
10.A	Introducing the deceased	1.000	4	3.00 (0.00)	3/3
11.B	Exposure: Worst moment	1.000	4	2.50 (0.57)	2/3
12.B	Visiting the grave	0.947	4	2.25 (0.50)	2/3
13.C	Legacy, remembrance, dedication	0.923	2	2.50 (0.71)	2/3
14.C	Future prospects	0.964	4	2.75 (0.50)	2/3
15.	Proscribed interventions	1.000	20	1.00 (0.00)	1/1
	Total score	0.970	20	13.60 (3.73)	7/21

The letter (A, B, C) next to the item number refers to the therapy phase, ICC_2,1 = Intraclass correlation coefficients Model 2, Min = lowest rating score on a scale of 1–3, Max = highest rating score on a scale of 1–3.

Table 4. Retest Reliability for the Therapeutic Adherence and Competence scale for Grief-focused cognitive behavioural therapy (TACs-G), Competence items only.

Item		ICC2,1 (CI 95%)	N	Mean	Min/Max
1.	Agenda	0.685	20	4.00 (0.97)	2/5
2.	Time management	0.835	20	4.00 (1.08)	2/5
3.	Dealing with ambivalence	0.925	20	3.05 (1.43)	1/5
4.	Dealing with/addressing stressors	1.000	6	4.33 (0.52)	4/5
5.	Psychoeducation regarding PGD, comorbidities & PG-CBT	0.991	6	4.83 (0.41)	4/5
6.	Working with cognitions	0.882	8	2.75 (1.28)	1/5
7.	Feelings of grief/Perception of emotions	1.000	2	3.00 (0.00)	3/3
8.	Promoting self-help	0.951	11	2.81 (1.40)	1/5
9.A	Getting to know the patient and his grief reaction	–	0	–	–
10.A	Introducing the deceased	0.985	4	4.25 (0.50)	4/5
11.B	Exposure: Worst moment	0.983	4	3.75 (1.50)	2/5
12.B	Visiting the grave	0.948	4	3.00 (0.82)	2/4
13.C	Legacy, remembrance, dedication	1.000	2	4.00 (0.00)	4/4
14.C	Future prospects	1.000	4	4.00 (1.55)	3/5
15.	Dealing with ‘avoidance behaviour’	0.530	14	3.07 (1.28)	2/5
16.	Grief-specific resource activation	0.985	14	3.50 (0.85)	2/5
	Total score	0.965	20	24.65 (8.01)	16/44

The letter (A, B, C) next to the item number refers to the therapy phase, ICC_2,1 = Intraclass correlation coefficients Model 2, Min = lowest rating score on a scale of 1–3; Max = highest rating score on a scale of 1–3.

Data availability statement

The rating data and analysis code can be obtained J. Haneveld ([email protected]).