title: Development of a patient adherence scale for exposure and response prevention therapy.
abstract: Exposure and response prevention (EX/RP) is an evidence-based treatment for obsessive-compulsive disorder (OCD). For EX/RP to be maximally effective, it is believed that patients must adhere outside of sessions to the procedures they learn in therapy. To date, there is no standard measure of patient EX/RP adherence, despite the importance of accurately assessing EX/RP adherence in both clinical research and practice. This paper describes the development of the Patient EX/RP Adherence Scale (PEAS), which assesses the patient's between-session adherence to the therapist's EX/RP instructions, and presents initial data on the scale's reliability and validity. The scale was designed to focus on the key procedures of EX/RP and to be brief enough to be used at each treatment session. The scale demonstrates excellent interrater reliability and good face and content validity. The usefulness of the scale is considered in the context of being an important tool to researchers trying to understand and improve outcomes of EX/RP for OCD as well as to EX/RP therapists in clinical practice. Future research will need to test the scale's reliability and validity in a larger sample of patients over the course of treatment.
authors.affiliation: Anxiety Disorders Clinic, New York Psychiatric Institute, Unit 69, 1051 Riverside Drive, New York, NY 10032, USA. simpson@nyspi.cpmc.columbia.edu
authors.forename: Helen Blair
authors.initials: HB
authors.lastname: Simpson
authors.forename: Michael
authors.initials: M
authors.lastname: Maher
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Page
authors.forename: Carly J
authors.initials: CJ
authors.lastname: Gibbons
authors.forename: Martin E
authors.initials: ME
authors.lastname: Franklin
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D010349:Patient Compliance; D015203:Reproducibility of Results; D055815:Young Adult