Revisiting How We Assess Therapist Competence in Cognitive Therapy
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We report on two approaches to addressing the problem of low reliability in the assessment of therapist competence in cognitive therapy (CT). In Study 1, we utilized ratings of a session from each of six therapists and investigated how CT experts evaluate specific therapist behaviors in making ratings on the Cognitive Therapy Scale (CTS). Departures from the consensus on judgments of these therapist behaviors were associated with more discrepant competence ratings. We take these results to suggest that, at least among experts, providing greater clarity about which therapist behaviors are relevant to each CTS item may enhance reliability. In Study 2, we utilize a sample of 14 therapists and pilot test a standardized assessment of therapist competence. The standardized assessment exhibited an intra-class correlation coefficient of 0.89 for a single rater. Standardized assessments of competence were related to four measures of therapist experience and qualifications, whereas the CTS was only related to two of these measures. With these promising initial results, we encourage future research to examine the predictive validity of standardized competence assessments in CT.
KeywordsTherapist competence Assessment Cognitive therapy Depression
This study was funded in part by the Aaron T. Beck Foundation.
Compliance with Ethical Standards
Conflict of Interest
Iony D. Schmidt, Daniel R. Strunk, Robert J. DeRubeis, Laren R. Conklin, and Justin D. Braun declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
This article does not contain any studies with animals performed by any of the authors.
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