Jeffrey Young, Ph.D.
Aaron T. Beck, M.D.

General Instructions to Raters
1. The most serious problem we have observed in raters is a "halo effect". When
the rater thinks the therapist is good, he/she tends to rate the therapist high on all
categories. The reverse is true when the rater believes the session is bad.
One of the most important functions of the Cognitive Therapy Scale is to identify
the therapist's specific strengths and weaknesses. It is rare to find a therapist who is
uniformly good or bad. It may be helpful, therefore, for raters to list positive and negative
observations as they listen to a session, rather than concentrate on forming one global
impression.
2. A second problem is the tendency of some raters to rely solely on their own
notions of what a particular scale point means (e.g., 4 is average) and to disregard the
descriptions provided on the form. The problem with this is that we each attach
idiosyncratic meanings to particular numbers on the 6-point scale. The most critical raters
assign a 1 whenever the therapist is "unsatisfactory", while the most generous raters assign
a 5 when the therapist has merely "done a good job" or "tried hard".
The descriptions on the scale should help to insure more uniformity across raters.
Therefore, we urge you to base your numerical ratings on the descriptions provided
whenever possible. Do not be concerned if the resulting numerical score does not match
your overall "gut feeling" about the therapist. (After all, you are free to express your "gut
feeling" in the overall rating on the first page.)
The only exception should be in sessions where the descriptions do not seem to
describe the specific therapist problems and behaviors you observed. When this is the case,
disregard the specific descriptions and rely on the more general scale descriptions supplied
in the directions. With these exceptions, it would be helpful if raters noted why the
descriptions did not seem to apply, so the scale can be refined in the future.
1. AGENDA
Objective
Because cognitive therapy is a relatively short-term, problem-solving therapy, the
limited time available for each interview must be used judiciously. At the beginning of
each session, the therapist and patient together establish an agenda with specific target
problems to focus on during each session. The agenda helps insure that the most pertinent
issues are addressed in an efficient manner.


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