Table 3.
Characteristics of process factor measures used in included studies
| Process factor | Measure | Included studies that used measure | Measurement timing | Mode of administration | Scale description |
|---|---|---|---|---|---|
| Family accommodation | Family Accommodation Scale (Calvocoressi et al., 1995) | Jassi et al. (2021), Jones and Jassi (2020) |
Pre- and post-treatment During treatment |
Parent report |
13 items assessing family members' accommodation of OCD symptoms Two subscales: Involvement in Compulsions; Avoidance of Triggers 5-point Likert-type scale (0 = Never, 4 = Daily) Overall and subscale sums; Higher scores = greater accommodation Score > 13 indicates clinically significant accommodation |
| Pediatric Accommodation Scale (Benito et al., 2015) | Storch et al. (2015) | Pre- and post-treatment | Parent report (clinician-administered) |
14 items assessing frequency of family accommodation and impact on child/family functioning Three subscales: Frequency (frequency over previous week, across all items); Parent Impact (4 items); Child Impact (7 items) Three global items: Accommodation from primary and secondary caregivers, and first sibling 4-point Likert-type scale (0 = Never/None; 4 = Always/Extreme) Subscale mean scores; Higher scores = greater accommodation |
|
| Parent-therapist alliance | TPOCS-A (McLeod & Weisz, 2005) | Burnham Riosa et al. (2019) | During treatment (early, middle, and late sessions) | Independent-observer-report |
9 items assessing two aspects of therapeutic alliance: Therapeutic Bond (6 items) and Task Collaboration (3 items) 6-point Likert-type scale (0 = Not at all; 5 = Great deal) Overall sum; Higher scores = stronger alliance |
| TASC-R (Shirk & Saiz, 1992) | Kerns et al. (2018); Klebanoff et al. (2019) |
During treatment (following at least two sessions; Klebanoff et al., 2019) Post-treatment (Kerns et al., 2018) |
Parent report |
12 items assessing two aspects of alliance between therapist and parent: Task (6 items) and Bond (6 items); Kerns et al. (2018) used 7-item version 4-point Likert-type scale (1 = Not at all; 4 = Very much) Overall sum; Higher scores = stronger alliance |
|
| Single-item used in two related studies | Burnham Riosa et al. (2019), Thomson et al. (2015) | During treatment (following each session) | Therapist-report |
"How would you describe the quality of the therapeutic relationship during the session with the parent?" 7-point Likert-type scale (1 = Very poor; 7 = Very good) Single-item rating; Higher scores = stronger alliance |
|
| Treatment satisfaction | Various unnamed questionnaires used in ten studies (two related) | Backman et al. (2018), Gordon et al. (2015), Hillier et al. (2012), Jassi et al. (2021), Pahnke et al. (2014), Swain et al. (2019), Thomson et al. (2015), Walsh et al. (2018), Weiss et al. (2018), White et al. (2013) |
During treatment (following each session; Backman et al., 2018; Thomson et al., 2015; Walsh et al., 2018; Weiss et al., 2018) Post-treatment (Gordon et al., 2015; Hillier et al., 2012; Jassi et al., 2021; Swain et al., 2019; White et al., 2013) NR (Pahnke et al., 2014) |
Parent report (Hillier et al., 2012; Jassi et al., 2021; Swain et al., 2019; Thomson et al., 2015; Walsh et al., 2018; Weiss et al., 2018; White et al., 2013) Therapist-report (Thomson et al., 2015; Walsh et al., 2018) Youth-report (Backman et al., 2018; Gordon et al., 2015; Hillier et al., 2012; Jassi et al., 2021; Pahnke et al., 2014; Thomson et al., 2015; Walsh et al., 2018; Weiss et al., 2018; White et al., 2013) |
Variable across studies |
| Youth-therapist alliance | TPOCS-A (McLeod & Weisz, 2005) | Albaum et al. (2020), Brown et al. (2015), Burnham Riosa et al. (2019), Kang et al. (2021) | During treatment (multiple time points per participant for all studies except Brown et al., 2015) | Independent-observer-report |
9 items assessing two aspects of therapeutic alliance: Therapeutic Bond (6 items) and Task Collaboration (3 items) 6-point Likert-type scale (0 = Not at all; 5 = Great deal) Overall sum; Higher scores = stronger alliance |
| TASC-R (Shirk & Saiz, 1992) | Kang et al. (2021), Kerns et al. (2018), Klebanoff et al. (2019) |
During treatment (following at least two sessions; Kang et al., 2021; Klebanoff et al., 2019) Post-treatment (Kerns et al., 2018) |
Therapist-report Youth-report |
12 items assessing two aspects of alliance between therapist and youth: Task (6 items) and Bond (6 items); Kang et al. (2021) used 13-item version 4-point Likert-type scale (1 = Not at all; 4 = Very much) Overall sum; Higher scores = stronger alliance |
|
| Vanderbilt Therapeutic Alliance Scales Revised, Short Form (Shelef & Diamond, 2008) | Brewe et al. (2021) | During treatment (four time points) | Independent-observer-report |
5 items assessing aspects of therapeutic alliance 6-point Likert-type scale (anchors NR) Overall sum; Higher scores = stronger alliance |
|
| Single-item used in two related studies | Burnham Riosa et al. (2019), Thomson et al. (2015) | During treatment (following each session) | Therapist-report |
"How would you describe the quality of the therapeutic relationship during the session with the child?" 7-point Likert-type scale—Anchors indicate quality (1 = Very poor; 7 = Very good) Single-item rating; Higher scores = stronger alliance |
|
| Youth treatment engagement (i.e., adherence; involvement) | Percentage of homework completion used in four separate studies | Gordon et al. (2015), Lordo et al. (2017), McNally Keehn et al. (2013), White et al. (2013) | During treatment (following each session) |
Therapist-report (White et al., 2013) NR (Gordon et al., 2015; Lordo et al., 2017; McNally Keehn et al., 2013) |
At least partial completion of between-session assignments (White et al., 2013); Completion not defined (Gordon et al., 2015; Lordo et al., 2017; McNally Keehn et al., 2013) Frequency count; Percentage/number of sessions for which homework was completed |
| Rate of participation for between-session skills practice | Pahnke et al. (2014) | During treatment | NR |
Number of training occasions at school, between sessions Frequency count |
|
| Single-item rating homework completion used in three related studies | Burnham Riosa et al. (2019); Thomson et al. (2015); Weiss et al. (2018) | During treatment (following each session) | Therapist-report |
"Did the client complete the home mission that was assigned?" 3-point scale (1 = None; 2 = Partially; 3 = Fully) Single-item rating; Higher scores = greater adherence |
|
| Single-item rating in-session involvement used in four studies (three related) | Burnham Riosa et al. (2019), Thomson et al. (2015), Weiss et al. (2018), White et al. (2013) | During treatment (following each session) | Therapist-report |
Three related studies "How involved was the client during the session?" 5-point Likert-type scale (1 = Completely uninvolved; 5 = Actively involved) Single-item rating; Higher scores = greater involvement White et al. (2013) Item description NR 4-point Likert-type scale (1 = Uninvolved; 4 = Actively involved) Single-item rating; Higher scores = greater involvement |
|
| Youth treatment expectations | Treatment Credibility Scale (Borkovec & Nau, 1972) | Backman et al. (2018) | Pre- and post-treatment | Youth-report |
5 items assessing expectations of improvement and treatment credibility 11-point visual analogue scale (0 = Low credibility/Not at all; 10 = High credibility/Very much) Overall mean; Higher scores = greater credibility |
| Youth treatment readiness | Three items used in one study | Albaum et al. (2020) | Pre-treatment | Youth-report |
3 items assessing interest, readiness, and willingness to participate in treatment 9-point Likert Scale (0 = Not at all; 8 = Very, very much) Overall mean; Higher scores = greater readiness |
NR Not reported, OCD Obsessive compulsive disorder, TASC-R Therapeutic Alliance Scale for Children, Revised, TPOCS-A Therapy Process Observational Coding Scheme, Alliance scale