Abstract
Policy-makers, payers, and consumers often make decisions based on therapists’ reported theoretical orientations, but little is known about whether these labels represent actual or potential skills. Prior to CBT training, therapists (n = 321) reported theoretical orientations. Experts rated CBT competency using the Cognitive Therapy Rating Scale Therapy at pre-, mid-, and post-training. CBT- and non-CBT identified therapists showed equivalent, non-competent baseline CBT skills. CBT-identified therapists showed greater CBT skills at mid-training, but by end of training, groups evidenced equivalent achieved competency. Baseline CBT orientations were neither valid, nor useful markers of later competency. Policy, clinical and research implications are discussed.
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References
APA Presidential Task Force on Evidence Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271–285.
Barber, J. P., Foltz, C., Crits-Christoph, P., & Chittams, J. (2004). Therapists’ adherence and competence and treatment discrimination in the NIDA Collaborative Cocaine Treatment Study. Journal of Clinical Psychology, 60, 29–41.
Bearman, S. K., Weisz, J. R., Chorpita, B. F., Hoagwood, K., Ward, A., Ugueto, A. M., et al. (2013). More practice, less preach? The role of supervision process and therapist characteristics in EBP implementation. Administration and Policy in Mental Health and Mental Health Services Research, 40, 518–519.
Beutler, L. E., Malik, M., Alimohamed, S., Harwood, T. M., Talebi, H., Noble, S., & Wong, E. (2004). Therapist variables. In M. J. Lambert (Ed.), Handbook of psychotherapy and behavior change (pp. 227–306). New York: Wiley.
Brookman-Frazee, L., Garland, A. F., Taylor, R., & Zofness, R. (2009). Therapists’ attitudes toward psychotherapeutic strategies in community-based psychotherapy with children with disruptive behavior problems. Administration and Policy in Mental Health and Mental Health Services Research, 36, 1–12.
Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.
Clark, D. M. (2011). Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: The IAPT experience. International Review of Psychiatry, 23, 375–384.
Creed, T. A., Jager-Hyman, S., Pontoski, K., Feinberg, B., Rosenberg, Z., Evans, A. C., et al. (2013). The Beck Initiative: A strength-based approach to training school-based mental health staff in cognitive therapy. International Journal of Emotional Education, 5, 49–66.
Creed, T.A., Stirman, S.W., Evans, A.C., & Beck, A.T. (2014). A model for implementation of cognitive therapy in community mental health: The Beck initiative. The Behavior Therapist, 37, 56–64.
Davis, D., O’Brien, M. A., Freemantle, N., Wolfe, F. M., Mazmanian, P., & Taylor-Vaisey, A. (1999). Impact of formal continuing medication education: Do conferences, workshops, rounds and other traditional continuing education activities change physician behavior or health care outcomes? Journal of the American Medical Association, 282, 867–874.
Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., & Addis, M. E. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670.
Great Britain Department of Health. (2008). Improving access to psychological therapies: Implementation Plan: National Guidelines for regional delivery. London: Department of Health.
H.R. 3590–111th Congress: Patient Protection and Affordable Care Act. (2009). Retrieved January 4, 2014, from http://www.govtrack.us/congress/bills/111/hr3590.
Herschell, A. D., Kolko, D. J., Baumann, B., & Davis, A. C. (2010). The role of therapist training in the implementation of psychosocial treatments: A review and critique with recommendations. Clinical Psychology Review, 30, 448–466.
Karlin, B. E., Ruzek, J. I., Chard, K. M., Eftekhari, A., Monson, C. M., Hembree, E. A., & Foa, E. B. (2010). Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the veterans health administration. Journal of Traumatic Stress, 23(6), 663–673.
Layard, R. (2006). The case for psychological treatment centres. British Journal of Medicine, 332, 1030–1032.
Mark, T. L., Levit, K. R., Vandivort-Warren, R., Buck, J. A., & Coffey, R. M. (2011). Changes in US spending on mental health and substance abuse treatment, 1986–2005, and implications for policy. Health Affairs, 30, 284–292.
McCarthy, K. S., & Barber, J. P. (2009). The Multitheoretical list of therapeutic interventions (MULTI): Initial Report. Psychotherapy Research, 19, 96–113.
McHugh, R. K., & Barlow, D. H. (2010). The dissemination and implementation of evidence- based psychological treatments. A review of current efforts. American Psychology, 65(2), 73–84.
Orlinsky, D. E., Ronnestad, M. H., & Willutzki, U. (2004). Fifty years of psychotherapy process- outcome research: Continuity and change. In M. J. Lambert (Ed.), Handbook of psychotherapy and behavior change (pp. 307–389). New York: Wiley.
President’s New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Rockville, MD: President’s New Freedom Commission on Mental Health.
Roth, A., & Fonagy, P. (2004). What Works for Whom? A Critical Review of Psychotherapy Research (2nd ed.). London: Guilford.
Rozensky, R. H. (2014). Implications of the Affordable Care Act for education and training in professional psychology. Training and Education in Professional Psychology, 8, 83–94.
Sackett, D. L., Rosenberg, W. M., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. British Journal of Medicine, 312, 71–72.
Shaw, B. F., Elkin, J., Yamaguchi, J., Olmsted, M., Vallis, T. M., Dobson, K. S., et al. (1999). Therapist competence ratings in relation to clinical outcome in cognitive therapy of depression. Journal of Consulting and Clinical Psychology, 67, 837–846.
Simons, A. D., Padesky, C. A., Montemarano, J., Lewis, C. C., Murakami, J., Lamb, K., & Beck, A. T. (2010). Training and dissemination of cognitive behavior therapy for depression in adults: A preliminary examination of therapist competence and client outcomes. Journal of Consulting and Clinical Psychology, 78, 751–756.
Stewart, R. E., & Chambless, D. L. (2007). Does psychotherapy research inform treatment decisions in private practice? Journal of Clinical Psychology, 63, 267–281.
Vallis, T. M., Shaw, B. F., & Dobson, K. S. (1986). The cognitive therapy scale: Psychometric properties. Journal of Consulting and Clinical Psychology, 54, 381–385.
Weissman, M. M., Verdeli, H., Gameroff, M. J., Bledsoe, S. E., Betts, K., Mufson, L., et al. (2006). National survey of psychotherapy training in psychiatry, psychology and social work. Archives of General Psychiatry, 63, 925–934.
Williams, R. M., Moorey, S., & Cobb, J. (1991). Training in cognitive behavior therapy: Pilot evaluation of a training course using the cognitive therapy scale. Behavioural Psychotherapy, 19, 373–376.
Young, J., & Beck, A. (1980). Cognitive therapy scale: Rating manual. Unpublished manuscript. Philadelphia: Center for Cognitive Therapy.
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This work was supported by the Philadelphia Department of Behavioral Health and Intellectual disAbilities under a training grant for the Beck Initiative.
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Creed, T.A., Wolk, C.B., Feinberg, B. et al. Beyond the Label: Relationship Between Community Therapists’ Self-Report of a Cognitive Behavioral Therapy Orientation and Observed Skills. Adm Policy Ment Health 43, 36–43 (2016). https://doi.org/10.1007/s10488-014-0618-5
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DOI: https://doi.org/10.1007/s10488-014-0618-5