From concept to measure
OPERATIONALISING THE CAPP CONCEPT MAP
Having developed the concept map the next step was to develop methods for collecting information that would allow us to operationalise the model. We have prepared a series of procedures to this end; these include a detailed manual, a semi-structured clinical interview, and an informant rating form. These items are or have been translated into a number of languages. We will provide brief descriptions of these instruments and describe their purposes.
The manual not only describes the conceptual basis of the model but also provides detailed instructions on how to carry out a CAPP assessment. Instructions are provided about how to establish time-lines for the period under consideration and how to use ‘life-event’ methods to increase the reliability of recall of key events or incidents. The key information sources required are described, the rules for dealing with conflicting information are established and the criteria for defining symptom severity are specified.
The procedures for this assessment include a detailed semi-structured clinical interview, organised in terms of life themes rather than a symptom-by-symptom approach. The CAPP Interview is administered by a qualified and trained practitioner with some background knowledge of the client and with a client in any setting (prison, hospital, the community) willing to engage.
The interview examines the current psychological wellbeing of the client, and goes on to consider plans and goals,and day-to[DJ1] -day activities, and it concludes with an examination of his or her relationships with others. We developed questions to target specific symptoms; these are colour coded within the interview protocol, with subsidiary symptoms that might be informed by the question being noted in parenthesis. A list of illustrative indicators is provided to support the rater in their judgements about the presence and severity of the symptoms of the disorder. Adjectival descriptive ratings in which the rater determines the extent to which specific trait descriptive adjectives apply are also solicited.
Once the CAPP Interview has been completed, a CAPP Symptom Rating Sheet is available to help the interviewer summarise their observations and review the symptoms for which there is prominent evidence in the client and summarise their overall appraisal of the client’s disorder.
CAPP-Informant RATING FORM
Informants – practitioners working with the client in institutions or in the community, family members – have a central role in providing relevant information about presentation. In order to tap into this knowledge, we developed the CAPP-Informant Rating form (CAPP-IRF). Informants rate the presence of symptoms in terms of severity, the applicability of trait descriptive adjectives, the presence of absence of illustrative indicators, and the presence of any idiosyncratic indicators. These idiosyncratic indicators can be used for research purposes to increase the bank of indicators that can be used, they can be used clinically when risk management plans are being developed.
A Glossary is also available, which contains dictionary definitions of each of the trait descriptive adjectives used in the CAPP. The Glossary provides essential support to the assessment process by helping assessors be clear about the differences among the traits on which they are rating their clients. The Glossary is therefore a contribution towards ensuring the consistency with which the CAPP is applied, which will be evident in measurements of the reliability of the instrument.