Barriers to cognitive behavioral therapy homework completion scale-depression version: Development and psychometric evaluation

We conducted a two-phase study to develop and evaluate the psychometric properties of an instrument to identify barriers to Cognitive Behavioral Therapy (CBT) homework completion in a depressed sample. In Phase I, we developed an item pool by interviewing 20 depressed patients and 20 CBT therapists. In Phase II, we created and administered a draft instrument to 56 people with depression. Exploratory Factor Analysis revealed a two-factor oblique solution of "Patient Factors" and "Therapy/Task Factors." Internal consistency coefficients ranged from .80 to .95. Temporal stability was demonstrated through Pearson correlations of.72 (for the therapist/task subscale) to.95 (for the patient subscale) over periods of time that ranged from 2 days to 3 weeks. The patient subscale was able to satisfactorily classify patients (75% to 79%) with low and high adherence at both sessions. Specificity was.66 at both time points. Sensitivity was.80 at session B and.77 at session C. There were no consistent predictors of assignment compliance when measured by the Assignment Compliance Rating Scale (ACRS; Primakoff, Epstein, & Covi, 1986). The Rating Scale and subscale scores did, however, correlate significantly with assignment noncompliance.