HYPOTHESIS: the items belong to the six modes should have acceptable internal consistency, and each mode should form a unidimensional construct representing the underlying latent trait (i.e., therapeutic mode).

RATIONALE: The 30-item Clinical Assessment of Modes (CAM) was developed in two versions: a client outcomes version (CAM–C) and a therapist outcomes version (CAM–T). The purpose of this study is to examine the psychometric properties of both versions and to quantify aspects of therapeutic communication in occupational therapy.

METHOD: This study used a quantitative study design with a single group of participants who were receiving rehabilitation services. The setting was Inpatient and outpatient units at a large urban hospital.

PARTICIPANTS: The CAM–C was administered to 110 neurological and orthopedic patients; the CAM–T was administered to 38 therapists (occupational therapy, physical therapy, and ST) who were the primary therapists for enrolled patients. The mean age of clients was 50.14 yr. The majority of enrolled clients were diagnosed with stroke (15.5%) and fracture (14.5%); 51% were male clients.

MEASURE: The CAM can be divided into six modes, which are the different types of communication styles: Advocating, Collaborating, Empathizing, Encouraging, Instructing and Problem-Solving. It is scored on a 5-point Likert scale.

ANALYSIS: Rasch analysis was used to examine the appropriateness of the rating scales and unidimensionality of the six modes in CAM. The internal consistency and targeting appropriateness were analyzed as well.

RESULTS: All the items in CAM–T and CAM–C fit the Rasch model with acceptable values of MnSq and Zstd, which confirmed their construct validity. The item separation reliabilities for the CAM–C were 0.60–0.99; the item separation reliabilities for the CAM–T were 0.79–0.99. Therefore, each mode in both the CAM–C and the CAM–T showed acceptable internal consistency as well as defined the constructs of each of the different therapeutic communication modes. The rating category disordering was detected.

CONCLUSIONS: Items in each mode formed distinct unidimensional constructs reflecting unique approaches to therapeutic communication. The two versions of the CAM exhibited satisfactory construct validity and internal consistency.