Development and Reliability of a Measure of Clinician Competence in Providing Illness Management and Recovery

Objective: Illness management and recovery (IMR) is an evidence-based, manualized illness self-management program for people with severe mental illness. This study sought to develop a measure of IMR clinician competence and test its reliability and validity. Methods: Two groups of subject matter experts each independently created a clinician-level IMR competence scale based on the IMR Fidelity Scale and on two unpublished instruments used to evaluate provider competence. The two versions were merged, and investigators used the initial version to independently rate recordings of IMR sessions. Ratings were compared and discussed, discrepancies were resolved, and the scale was revised through 14 iterations. The resulting IMR Treatment Integrity Scale (IT-IS) includes 13 required items and three optional items rated only when the particular skill is attempted. Four independent raters then used the IT-IS to score tapes of 60 IMR sessions and 20 control group sessions. Results: The IT-IS showed excellent interrater reliability (.92). A factor analysis supported a one-factor model that showed good internal consistency. The scale successfully differentiated between IMR and control groups. Reliability and validity of individual items varied widely. Conclusions: The IT-IS is a promising measure of clinician competence in providing IMR. The scale could be used for research and quality assurance and as a supervisory feedback tool. Future research is needed to examine item-level changes, predictive validity of the IT-IS, discriminant validity compared with other more structured interventions, and the reliability and validity of the scale for nongroup IMR

An empirical test of the dimensionality of self-control

Minimal attention has been devoted to examining the dimensionality of self-control. The present study tested a multidimensional model of self-control in which dimensions were based on the nature of the behavior required (i.e., persistence, initiation, cessation, or prevention). A total of 336 undergraduates completed measures of self-control and psychological well-being. Seventy-four of these participants completed behavioral self-control tasks representing the proposed subtypes. Participants\u27 GPAs were obtained from the Registrar. Stop self-control was inversely related to previously-validated measures of persistence (β = -.61, p = .010) and prevention (β = -.56, p = .040) self-control and demonstrated differential predictive ability of persistence and prevention compared to the other proposed subtypes. Initiation self-control was inversely related to life satisfaction (β = -.35, p = .012) and demonstrated differential predictive ability of life satisfaction compared to stop self-control. These results were interpreted with caution due to inadequate power and questionable validity of several of the behavioral self-control tasks. Both handgrip persistence (r = -.25, p = .033) and blinking prevention (r = -.29, p = .023) were associated with depression. These pairwise correlations were not significantly different from each other, suggesting that no conceptual distinction should be made between persistence and prevention self-control. Confirmatory factor analyses of self-report data revealed that items clustered based on domain rather than on type of behavior required for self-control exertion. Thus, the structure of self-control remains unclear. Limitations of the present study and implications for future research are discussed