Description

The Therapist–Patient Relationship Scales with Schizophrenic Patients (TPSS-30) are psychometric instruments designed to evaluate the therapeutic relationship between therapists and patients diagnosed with schizophrenia. The scales are self-administered, easy to complete, and require limited time for administration and scoring.

The Greek version of the TPSS evaluates the therapeutic relationship through the subjective emotional experiences of both members of the therapeutic process. It includes two separate 30-item scales, one completed by the therapist and one completed by the patient.

The patient version evaluates the therapeutic relationship through four dimensions: rejection–incompetence, therapist providing appropriate stimulation, overinclusive–demanding therapist, and distant and unclear therapist. The therapist version reflects the therapist’s perception of the therapeutic relationship and its interpersonal dynamics.

Objective

The primary objective of the TPSS-30 is to examine communication patterns, emotional involvement, and the quality of the therapeutic relationship between therapists and patients with psychotic disorders, particularly schizophrenia.

The instrument aims to identify similarities and differences in how the therapeutic relationship is perceived by therapists and patients and to explore factors that may influence therapeutic outcomes.

Structure and Content

The TPSS-30 consists of two parallel forms:

The Patient Version, which assesses the patient’s perception of the therapist and the therapeutic relationship through four specific factors.

The Therapist Version, which evaluates the therapist’s perception of the therapeutic relationship and its dynamics.

Both versions contain 30 items designed to capture emotional, interpersonal, and relational aspects of psychotherapy.

Scoring Method

Each scale contains 30 items rated on a five-point Likert scale (1–5) according to the degree of agreement with each statement.

Scores for each factor are calculated by summing the corresponding items. Interpretation is based on comparisons of mean scores across factors and on the overall emotional evaluation of the therapeutic relationship.

Higher scores indicate stronger endorsement of the characteristics represented by each dimension.

Data Analysis and Use

The TPSS-30 data can be used to examine differences between subgroups, investigate relationships between therapeutic alliance and treatment outcomes, and qualitatively evaluate collaboration and communication between therapist and patient.

The instrument is suitable for clinical settings, research protocols, and educational applications, particularly within psychiatric institutions and diagnostic evaluation contexts.

Validity

The TPSS-30 demonstrates satisfactory internal consistency, strong theoretical foundations, and adequate construct validity. Criterion validity is supported through correlations with other measures of therapeutic relationship quality and through its ability to differentiate groups with different levels of functioning.

Reliability

The Greek version of the TPSS demonstrated acceptable reliability indices. Cronbach’s alpha was reported as α = 0.53 for the Therapist Version and α = 0.74 for the Patient Version. These values were considered satisfactory, particularly for the patient version, and were consistent with the original validation study.

Applications

The TPSS-30 can be applied in psychiatric services, psychotherapy research, clinical assessment, and training contexts.

It provides an important method for examining the therapeutic alliance from both perspectives, allowing researchers and clinicians to better understand interpersonal processes that may influence treatment engagement and outcomes.

References

Zagantzoudi, K. A. (2000). Psychotherapeutic processes in psychoses: The genesis of delusional ideas in the remission phase of paranoid-type and schizoaffective disorder. Unpublished doctoral dissertation, Department of Psychology, University of Crete.

Zagantzoudi, K. A., & Neotopos, I. N. (1997). Therapist–Patient Relationship Scales with Schizophrenic Patients: Therapist and Patient Versions. Greek translation and adaptation of TPSS by Stark (1992). Rethymno: Laboratory of Clinical & Social Psychology, University of Crete.

Stark, M. F. (1993). The development of the Therapist–Patient Relationship Scales with Schizophrenic Patients. Psychotherapy Research, 3, 150–151.

Zagantzoudi, K. A., & Nestoros, J. N. (1999). The Greek Version of the Therapist–Patient Relationship Scales with Schizophrenic Patients. Paper presented at the 5th European Conference on Psychological Assessment, University of Patras.