Development and Initial Validation of the in-Session Patient Affective Reactions Questionnaire (SPARQ) and the Rift In-Session Questionnaire (RISQ)

The patient’s perception of and reaction to the therapist (i.e., the transference) is theoretically and empirically associated with the psychotherapy process and outcome, regardless of the therapeutic approach. However, there are very few measures of transference, and the existing ones are observer- or clinician-report. The current project sought to develop and validate a short self-report inventory. We wrote a set of 131 items, examined the quality of the new measure using subject matter experts, and then collected validation data from a clinical sample of adult patients in individual therapy (N = 701). We used exploratory factor analyses and graded response model item response theory models to select items, confirmatory factor analyses to show that the factor structure fit the data well, and k-fold cross-validation to verify the robustness of our model. Three factors produced short scales retaining the strongest items. The Relationship In-Session Questionnaire (RISQ) has a two-factor structure, yielding a five-item Negative affect scale and a five-item Positive affect scale. The Assessing Risk of Relationship Rupture (ARRR) scale is made up of five items from the third factor with dichotomized responses; it should be used as a warning sign for ruptures in the patient-therapist relationship. Both scales showed excellent psychometric properties. Overall, this study provides an initial validation of both the RISQ and the ARRR scale that can be used in clinical or research settings, with particular value for capturing the patient’s perspectives about their therapist and session-level emotional processes.