• Louise J Andony, Elaine Tay, Karina L Allen, Tracey D Wade, Phillipa Hay, Stephen Touyz, Virginia V W McIntosh, Janet Treasure, Ulrike H Schmidt, Christopher G Fairburn, David M Erceg-Hurn, Anthea Fursland, Ross D Crosby, and Susan M Byrne.
• School of Psychology, University of Western Australia, Perth, Western Australia.
• Int J Eat Disord. 2015 Dec 1; 48 (8): 1170-5.

ObjectiveTo develop a psychotherapy rating scale to measure therapist adherence in the Strong Without Anorexia Nervosa (SWAN) study, a multi-center randomized controlled trial comparing three different psychological treatments for adults with anorexia nervosa. The three treatments under investigation were Enhanced Cognitive Behavioural Therapy (CBT-E), the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), and Specialist Supportive Clinical Management (SSCM).MethodThe SWAN Psychotherapy Rating Scale (SWAN-PRS) was developed, after consultation with the developers of the treatments, and refined. Using the SWAN-PRS, two independent raters initially rated 48 audiotapes of treatment sessions to yield inter-rater reliability data. One rater proceeded to rate a total of 98 audiotapes from 64 trial participants.ResultsThe SWAN-PRS demonstrated sound psychometric properties, and was considered a reliable measure of therapist adherence. The three treatments were highly distinguishable by independent raters, with therapists demonstrating significantly more behaviors consistent with the actual allocated treatment compared to the other two treatment modalities. There were no significant site differences in therapist adherence observed.DiscussionThe findings provide support for the internal validity of the SWAN study. The SWAN-PRS was deemed suitable for use in other trials involving CBT-E, MANTRA, or SSCM.The Authors. International Journal of Eating Disorders Published by Wiley Periodicals, Inc.

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