Page 64 - Personality disorders and insecure attachment among adolescents

consistency) of the Dutch version of the C-SRS was satisfactory (Cronbach’s α = 0.86) (Hafkenscheid, Duncan, & Miller, 2010). The therapeutic relationship is defined with three interacting elements: (1) a relational bond between the therapists, the group members and patient; (2) agreement on the goals of therapy; and (3) agreement on the tasks of therapy. In the C-SRS these theoretical ideas are represented by four 10-cm visual analogue scales with emoticons. Respondents are instructed to place a hash mark on a line. Negative responses are placed on the left (frowny faces) and positive responses indicated on the right (smileys). The first item is a relationship scale to rate the session on a continuum from “The therapists and group members did not listen to me” to “The therapists and group members listened to me.” The second item is a goals and topics scale that rates the session on a continuum from “We did not do or talk about the things I wanted to work on or talk about” to “We did do or talk about what I wanted to work on or talk about.” The third item is an approach or method scale asking the patient to rate the session on a continuum from “I did not like the way the therapists and group members approached my problems today” to “I liked the way the therapists and the group members approached my problems today.” The fourth item asks how the patient perceived the session in total and the group alliance along the line from: “Overall, today’s session was not right for me - I did not feel part of the group.” to “Overall, today’s session was right for me – I did feel part of the group.” Because the scores on the four items (the 10 cm line represents scores between 0 and 10) are added, the session total score will vary between 0 and 40: High average total scores are an indication for a high quality of the therapeutic relationship. Procedure The C-SRS was presented to the patients at the end of each weekly group therapy session, after which it was collected and viewed by the therapist. Our purpose was to let the patients fill in the form during every therapy session. Although therapists sometimes forgot to hand out the C-SRS, in general the C-SRS was completed during most of the group therapy sessions. The first C-SRS was completed after the first therapy session. The C-SRS that was completed during the last session (planned in the case of completers and unplanned in the case of dropouts), was marked as the last C- SRS. It largely depended on the length of therapy how many C-SRS forms the patient finally completed. 60