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The main objective of this study is to evaluate the utility of a new qualitative scale development methodology—Three-Step Test-Interview (TSTI)—in its first application in the validation of a psychotherapy scale: The Relational Depth Frequency Scale (RDFS). The TSTI is a cognitive pretesting method designed to uncover potential problems in scale construction. The RDFS is a six-item unidimensional scale of in-depth therapeutic relating, designed for use in large-scale outcome studies. Following the creation of an item pool and “expert ratings,” a purposive sample of four therapists and four clients (five females, three males, mean age: 49 years) was recruited to take part in the TSTI with the view to refine the original 36-item RDFS prior to psychometric exploration. Structured observations pointed to problems in test-takers’ patterns of responses in relation to theoretical knowledge of the relational depth construct …