title: Development and reliability of a measure of clinician competence in providing illness management and recovery.
abstract: OBJECTIVE
  Illness management and recovery (IMR) is an evidence-based, manualized illness self-management program for people with severe mental illness. This study sought to develop a measure of IMR clinician competence and test its reliability and validity.
  
  
  METHODS
  Two groups of subject matter experts each independently created a clinician-level IMR competence scale based on the IMR Fidelity Scale and on two unpublished instruments used to evaluate provider competence. The two versions were merged, and investigators used the initial version to independently rate recordings of IMR sessions. Ratings were compared and discussed, discrepancies were resolved, and the scale was revised through 14 iterations. The resulting IMR Treatment Integrity Scale (IT-IS) includes 13 required items and three optional items rated only when the particular skill is attempted. Four independent raters then used the IT-IS to score tapes of 60 IMR sessions and 20 control group sessions.
  
  
  RESULTS
  The IT-IS showed excellent interrater reliability (.92). A factor analysis supported a one-factor model that showed good internal consistency. The scale successfully differentiated between IMR and control groups. Reliability and validity of individual items varied widely.
  
  
  CONCLUSIONS
  The IT-IS is a promising measure of clinician competence in providing IMR. The scale could be used for research and quality assurance and as a supervisory feedback tool. Future research is needed to examine item-level changes, predictive validity of the IT-IS, discriminant validity compared with other more structured interventions, and the reliability and validity of the scale for nongroup IMR.
authors.affiliation: ACT Center of Indiana, Department of Psychology, Indiana University-Purdue University Indianapolis, 1481 W 10th St 11H, Room D6014, Indianapolis, IN 46202, USA. abmcguir@iupui.edu
authors.forename: Alan B
authors.initials: AB
authors.lastname: McGuire
authors.forename: Laura G
authors.initials: LG
authors.lastname: Stull
authors.forename: Kim T
authors.initials: KT
authors.lastname: Mueser
authors.forename: Meghan
authors.initials: M
authors.lastname: Santos
authors.forename: Abigail
authors.initials: A
authors.lastname: Mook
authors.forename: Nichole
authors.initials: N
authors.lastname: Rose
authors.forename: Chloe
authors.initials: C
authors.lastname: Tunze
authors.forename: Laura M
authors.initials: LM
authors.lastname: White
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Salyers
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*; D010353:Patient Education as Topic / Q000592:standards*; D015397:Program Evaluation / Q000379:methods; D011594:Psychometrics / Q000295:instrumentation; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000534:rehabilitation; D012648:Self Care / Q000592:standards*