Measuring Congruence in Problem Definition of Latino Patients and Their Psychotherapists: An Exploratory Study

Abstract

The current study developed a mixed-methods coding scheme to explore the degree of correspondence between Latino patients’ and their psychotherapists’ descriptions of the presenting problems. We interviewed 34 patients and clinicians (17 dyads) following an initial therapy session. Using a theoretical thematic approach, we generated a list of problem areas reported in participants’ descriptions. Independent coders reliably rated the presence and salience of these problems using a quantitative index. We then statistically estimated the fit between corresponding narratives. We found poor congruence across dyads’ descriptions of all problem areas, with two exceptions. We also noted patterns of incongruences, primarily characterized by therapists providing explanations that went beyond what their patients said. This study provides an innovative objective approach to estimate the nuanced degrees of concordance within dyads’ narratives. Our findings provide initial evidence of poor match between views held by Latino patients and their clinicians.