Validation of Process-Based Components of the LIBET-Q: An Innovative Instrument for Case Conceptualization

Abstract

Case conceptualization is a widely used tool to describe and organize patient information and plan interventions in psychotherapy. Life themes and semi-adaptive plans: Implications of biased beliefs, elicitation, and treatment (LIBET) is a new method for case conceptualization that validates the diathesis-stress model and incorporates elements from the most important theories in the CBT field. LIBET also includes process-based components as maintaining factors of psychological distress, and it is not anchored to a specific kind of psychotherapeutic approach. The LIBET-Questionnaire (LIBET-Q) is a structured interview which helps clinicians achieve a LIBET case conceptualization, co-constructed with patients. The aim of the present study was to validate the process-based section of the LIBET-Q by analyzing its factorial structure, internal consistency, convergent validity, and clinical relevance. A sample of 396 outpatients was recruited to validate the LIBET-Q, which was administered along with interviews and self-report questionnaires to investigate the presence of diagnoses, anxiety, and depression levels and global functioning and wellbeing. Results from both exploratory and confirmatory factor analyses showed a four-factor structure, with adequate consistency and good convergent validity. Process-based elements investigated with the LIBET-Q resulted in identifying different clinical populations. With satisfactory psychometric properties, the LIBET-Q turned out to be a suitable support for case conceptualization and treatment formulation. The independence of the LIBET method from a specific intervention can improve its sharing between clinicians by offering a common frame in which the rationale of every specific technique can be explained.