Patient and Therapist Assessment of Psychotherapy Questionnaire

Abstract

The Patient and Therapist Assessment of Psychotherapy Questionnaire (PTAPQ), developed by Feifel and Eells in 1963, is a foundational, open-ended instrument designed to capture the divergent and convergent perspectives regarding the outcomes and processes of psychotherapy. The original study focused specifically on veterans who had recently concluded a course of individual psychotherapy. Uniquely, the instrument solicited direct responses from patients concerning their experience and change, while simultaneously requiring therapists to answer similar questions and predict their patients’ responses.

This comparative structure allowed researchers to assess congruence and discrepancies in therapeutic perception. A significant feature of the original research included a four-year follow-up survey, providing longitudinal data on the lasting impact of the therapy. The questionnaire demonstrated acceptable Interrater Reliability, with 79% agreement among coders for categorizing the qualitative responses.

Keywords

Patient and Therapist Assessment of Psychotherapy Questionnaire, PTAPQ, Patient Attitudes, Therapist Attitudes, Therapeutic Processes, Interrater Reliability, Test Development, Assessment Inventory, individual psychotherapy.

Authors

Herman Feifel, Janet Eells

Purpose

The primary purpose of the PTAPQ was to systematically evaluate the subjective experiences and attitudes toward therapeutic outcomes held by both the patient and the clinician following the conclusion of treatment. It was specifically designed for use with veterans who had undergone individual psychotherapy.

A secondary, yet crucial, purpose was to investigate the degree of congruence between the patient’s subjective assessment of change and the therapist’s professional assessment and prediction of that change. By comparing these two perspectives, the authors aimed to gain deeper insight into the effectiveness of communication and the shared understanding within the therapeutic dyad during psychotherapy.

Construct

The core construct measured by the PTAPQ is the assessment of Patient and Therapist Attitudes toward Therapy. This construct is fundamentally qualitative, encompassing the subjective evaluation of therapeutic success and failure from the perspective of both parties involved.

The instrument captures qualitative data reflecting psychological adjustment and satisfaction derived from the treatment, focusing on perceived changes, helpful elements, unhelpful elements, and recommended improvements to the therapeutic process.

Validity

The original research detailing the Patient and Therapist Assessment of Psychotherapy Questionnaire did not explicitly report formal measures of validity, such as content validity, criterion validity, or construct validity.

As an early, open-ended instrument designed to capture narrative data regarding therapeutic outcomes, the focus of the initial assessment was primarily on the reliability of coding the complex, subjective responses rather than standardized psychometric validation typical of fixed-response scales.

Reliability

Reliability for the PTAPQ was established through the calculation of Interrater Reliability (IRR). This measure was essential due to the instrument’s open-ended format, which required qualitative data to be categorized and quantified by human coders.

Two independent investigators were employed to assign identical category numbers to the responses provided by the participants. The resulting agreement rate was 79%. This finding was deemed acceptable by the authors, confirming a reasonable degree of consistency in the interpretation and coding of patient and therapist perceptions of the psychotherapy process.

Factor Analysis

Formal factor analysis was not indicated or reported for the Patient and Therapist Assessment of Psychotherapy Questionnaire.

The instrument’s design—a brief, four-item, open-ended questionnaire—precludes the application of standard exploratory or confirmatory factor analysis, which is typically reserved for structured scales comprising numerous items designed to measure underlying latent factors.

Instrument

Test Type: Inventory/Questionnaire

Format: Open-ended questionnaire consisting of four core questions administered separately to patients and their respective therapists. The instrument facilitates the collection of narrative, qualitative responses.

Language Available: English (Original research location: United States)

Population Group: Human; Male; Female; Outpatient

Age Group: Adulthood (18 years & older)

Population Details: The initial sample included patients, specifically veterans, who had completed a course of individual psychotherapy, alongside their treating psychotherapists.

Test Methodology: The methodology involves administering four identical questions to patients regarding their experience. Therapists receive the same four questions, but they are instructed both to answer the questions based on their own professional judgment and to predict how their patient would respond. This dual response method allows for direct comparison between patient self-report and therapist prediction/assessment of attitudes toward treatment outcome.

Keywords

Client Attitudes, Psychotherapeutic Processes, Psychotherapist Attitudes, Questionnaires, Test Construction, Veterans Administration, Outcome Assessment, Longitudinal Study, Feifel and Eells.

Authors

Author ORCID Identifier: Not available/Indicated in source material.

Affiliation Email addresses: Not available/Indicated in source material.

Correspondence Address: Veterans Administration Outpatient Clinic, Los Angeles, California (Affiliation at time of publication).

Permissions & Fee and Test Year

Test Year: 1963

Permissions and Fee: Information regarding current licensing or fees for the use of the Patient and Therapist Assessment of Psychotherapy Questionnaire is not explicitly provided in the original publication. Given its age and status as an academic instrument published in the Journal of Consulting Psychology, the items are generally considered available for research use, provided proper citation is given to the original authors (Feifel & Eells, 1963).

Reference’s

• Feifel, H., & Eells, J. (1963). Patients and therapists assess the same psychotherapy. Journal of Consulting Psychology, 27(4), 310–318. The official DOI for the reference is: https://doi.org/10.1037/h0046645

Items of the Patient and Therapist Assessment of Psychotherapy Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. What changes, if any, do you feel occurred in you because of your therapy?
2. What about the therapy itself did you find helpful?
3. What about the therapy itself did you find not helpful, or even set you back?
4. Have you any suggestions for ways in which your therapy might have been made more helpful?