Investigating the relationship between competence and patient outcome with CBT

https://doi.org/10.1016/j.brat.2015.03.002Get rights and content
Under a Creative Commons license
open access

Highlights

  • Training as part of the IAPT programme increases CBT competence.

  • Competence was not generally associated with patient outcome.

  • There are important differences in outcomes between the most and least competent therapists.

  • Therapist characteristics were unrelated to mean change in PHQ-9 and GAD-7 scores.

Abstract

Little is understood about the relationship between therapist competence and the outcome of patients treated for common mental health disorders. Understanding the relationship between competence and patient outcome is of fundamental importance to the dissemination and implementation of Cognitive Behavioural Therapy (CBT). The current study extends existing literature by exploring the relationship between CBT competence and patient outcome in routine clinical practice within the framework of the British Government's Improving Access to Psychological Therapies (IAPT) programme. Participants comprised 43 therapists treating 1247 patients over a training period of one year. Results found little support of a general association between CBT competence and patient outcome; however significantly more patients of the most competent therapists demonstrated a reliable improvement in their symptoms of anxiety than would be expected by chance alone, and fewer experienced no reliable change. Conversely, significantly more patients treated by the least competent therapists experienced a reliable deterioration in their symptoms than would be expected. The implications of these results for the dissemination and implementation of CBT are discussed.

Keywords

Training
CBT
Competence
Outcome
IAPT
Depression
Anxiety

Cited by (0)