Behavioural and Cognitive Psychotherapy

Research Article

Measuring Adherence in CBT for Psychosis: A Psychometric Analysis of an Adherence Scale

Rebecca Rollinsona1 c1, Ben Smitha2, Craig Steela2, Suzanne Jolleya3, Juliana Onwumerea3, Philippa A. Garetya3, Elizabeth Kuipersa3, Daniel Freemana3, Paul E. Bebbingtona4, Graham Dunna5, Mike Startupa6 and David Fowlera7

a1 University of East Anglia, UK

a2 University College London, UK

a3 Kings College London, UK

a4 University College London, UK

a5 University of Manchester, UK

a6 University of Newcastle, Australia

a7 University of East Anglia, UK


This paper reports the psychometric properties of a CBT for psychosis adherence scale, the Revised Cognitive Therapy for Psychosis Adherence Scale (R-CTPAS). The scale's factor structure, inter-rater reliability and concurrent validity were analysed in a sample of 67 audiotaped sessions of CBT for psychosis. The concurrent validity of the scale was examined through comparison with the Cognitive Therapy Scale (CTS, Young and Beck, 1980). Principal components analysis of the trial data suggested three factors: “engagement/assessment work”, “relapse prevention work” and “formulation/schema work”. Satisfactory levels of inter-rater reliability were established between rater dyads. Moderate correlations with the CTS provided an indication of concurrent validity. The R-CTPAS is concluded to be a reliable and useful instrument that can assess adherence to CBT for psychosis using the Fowler, Garety and Kuipers (1995) therapy model.


c1 Reprint requests to Rebecca Rollinson, Psychological Therapies and Primary Care Service, Community Resource Centre, Northgate Hospital, Great Yarmouth NR35 1BU, UK. E-mail: