Rating the outcomes of psychotherapy or psychoanalysis using the Change After Psychotherapy (CHAP) scales. Manual and commentary

In what follows we shall describe the model for rating a kind of psychotherapy change that has been developed at the Institute of Psychotherapy in Stockholm. It has been inspired by American studies with follow-up interviews after psychoanalysis by Pfeffer (1959) and Schlessinger and Robbins (1974), among others. The model has two parts, one (or more) interviews and a set of ratings on the basis of this or these interviews. The interviews are basically focused on the patient’s subjective experience of the state of having changed or not. The patients are encouraged to tell about the way they feel now, compared to what they used to feel, and how their situation in life is at present, compared to what it used to be, and how their life has changed since they began or ter-minated therapy. The interviews are quite informal, unstructured from the point of view of the patient, roughly as in a therapeutic session, but they are also different in the sense that the interview has a defined focus and that there is also an interviewing guide, on paper or in the interviewer’s mind. It is also possible to use regular therapy sessions, on tape or in the form of process notes or similar documents, for the same purpose of rating the experience of change. The method may not only be used for research or more formal evaluation; it may also be important for the therapist once in a while systematically to judge for himself/herself how a therapy is developing. Reliability, norms and psychometric properties are reported.