Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-24T17:56:10.145Z Has data issue: false hasContentIssue false

Assessing Therapeutic Competence in Cognitive Therapy for Social Phobia: Psychometric Properties of the Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP)

Published online by Cambridge University Press:  03 November 2011

Katrin von Consbruch*
Affiliation:
University of Frankfurt, Germany
David M. Clark
Affiliation:
Kings College London, UK
Ulrich Stangier
Affiliation:
University of Frankfurt, Germany
*
Reprint requests to Katrin von Consbruch, Department of Psychology, University of Frankfurt, Varrentrappstr. 40–42, D-60054 Frankfurt, Germany. E-mail: consbruch@gmx.net

Abstract

Background: There has been considerable acknowledgement in treatment outcome research that, although the assessment of treatment integrity is essential in many respects, it requires great effort as well as resources and is therefore often neglected. Aims: In order to fill this gap, the Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP) was developed, based on the Cognitive Therapy Scale, to measure therapist competence in delivering cognitive therapy for social phobia. The aim of the present study was to investigate interrater reliability, internal consistency and retest reliability of the scale. Method: Raters evaluated therapist competence from 161 videotaped sessions (98 patients) selected from 234 cognitive treatments within a multi-centre study. Results: Interrater-reliability was found to be high for the overall score (ICC = .81) and moderate for individual items (ICC = .62–.92). Internal consistency and retest reliability were also found to be high (Cronbach's alpha = .89; (ICCretest = .86). Conclusions: The results indicate that the CTCS-SP is highly reliable. As even individual items yield satisfactory reliability, the scale can be used in various fields of research, including the measurement of changes in skill acquisition and the impact of competence on outcome criteria.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barber, J. P., Liese, B. S. and Abrams, M. J. (2003). Development of the cognitive therapy adherence and competence scale. Psychotherapy Research, 13, 205221.CrossRefGoogle Scholar
Barber, J. P., Sharpless, B. A., Klostermann, S. and McCarthy, K. S. (2007). Assessing intervention competence and its relation to therapy outcome: a selected review derived from the outcome literature. Professional Psychology: Research and Practice, 38, 493500.CrossRefGoogle Scholar
Barber, J. P., Triffleman, E. and Marmar, C. (2007). Considerations in treatment integrity: implications and recommendations for PTSD research. Journal of Traumatic Stress, 20, 793805.CrossRefGoogle ScholarPubMed
Bellg, A. J., Resnick, B., Minicucci, D. S., Ogedegbe, G., Ernst, D., Borelli, B., et al. (2004). Enhancing treatment fidelity in health behavior studies: best practices and recommendations from the NIH behavior change consortium. Health Psychology, 23, 443451.CrossRefGoogle ScholarPubMed
Blackburn, I.-M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A., et al. (2001). The revised cognitive therapy scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431446.CrossRefGoogle Scholar
Borge, F. M., Hoffart, A., Sexton, H., Clark, D. M., Markowitz, J. C. and McManus, F. (2008). Residential cognitive therapy versus residential interpersonal therapy for social phobia: a randomized clinical trial. Journal of Anxiety Disorders, 22, 9911010.CrossRefGoogle ScholarPubMed
Bryant, M. J., Simons, A. D. and Thase, M. E. (1999). Therapist skill and patient variables in homework compliance: controlling an uncontrolled variable in cognitive therapy outcome research. Cognitive Therapy and Research, 23, 381399.CrossRefGoogle Scholar
Castonguay, L. G., Goldfried, M. R., Wiser, S., Raue, P. J. and Hayes, A. M. (1996). Predicting the effect of cognitive therapy for depression: a study of unique and common factors. Journal of Consulting and Clinical Psychology, 64, 497504.CrossRefGoogle ScholarPubMed
Clark, D. M. (2002). Cognitive Therapy for Panic: checklist of therapist competency. Unpublished manuscript. Oxford: University of Oxford.Google Scholar
Clark, D. M., Consbruch, K. von, Hinrichs, J. and Stangier, U. (2007). Cognitive Therapy of Social Phobia: checklist of therapist competency. Unpublished manuscript. London: Kings College London. Available from the author.Google Scholar
Clark, D. M., Ehlers, A., Hackmann, A., McManus, F., Fennell, M., Grey, N., et al. (2006). Cognitive therapy versus exposure and applied relaxation in social phobia: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 74, 568578.CrossRefGoogle ScholarPubMed
Clark, D. M., Ehlers, A., McManus, F., Hackmann, A., Fennell, M. J. V., Campbell, H., et al. (2003). Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial. Journal of Consulting and Clinical Psychology, 71, 10581067.CrossRefGoogle ScholarPubMed
Clark, D. M. and Wells, A. (1995). A cognitive model of social phobia. In Heinberg, R., Liebowitz, M., Hope, D. A. and Schneier, F. R. (Eds.), Social Phobia: diagnosis, assessment and treatment. New York: Guilford Press.Google Scholar
Consbruch, K. von, Clark, D. M. and Stangier, U. (2007). Ratermanual zur Handhabung der Cognitive Therapy Competence Scale for Social Phobia. (Raters' Manual for the Cognitive Therapy Competence Scale for Social Phobia). Unpublished manuscript. Frankfurt, GER: Goethe University.Google Scholar
Davidson, K., Scott, J., Schmidt, U., Tata, P., Thornton, S. and Tyrer, P. (2004). Therapist competence and clinical outcome on the prevention of parasuicide by manual assisted cognitive behaviour therapy trial: the POPMACT study. Psychological Medicine, 34, 855863.CrossRefGoogle ScholarPubMed
Gordon, P. K. (2006). A comparison of two versions of the Cognitive Therapy Scale. Behavioural and Cognitive Psychotherapy, 35, 343353.CrossRefGoogle Scholar
Haddock, G., Devane, S., Bradshaw, T., McGovern, J., Tarrier, N., Kinderman, P., et al. (2001). An investigation into the psychometric properties of the cognitive therapy scale for psychosis (CTS-Psy). Behavioural and Cognitive Psychotherapy, 29, 221233.CrossRefGoogle Scholar
James, I. A., Blackburn, I.-M., Milne, D. L. and Reichfelt, F. K. (2001). Moderators of trainee therapists'competence in cognitive therapy. British Journal of Clinical Psychology, 40, 131141.CrossRefGoogle ScholarPubMed
Leichsenring, F., Hoyer, J., Beutel, M., Herpetz, S., Hiller, W., Irle, E., et al. (2009). The social phobia psychotherapy network. Psychotherapy and Psychosomatics, 78, 3541.CrossRefGoogle ScholarPubMed
Miller, S. J. and Binder, J. L. (2002). The effects of manual-based training on treatment fidelity and outcome: a review of the literature on adult individual psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 39, 184198.CrossRefGoogle Scholar
Moncher, F. J. and Prinz, R. J. (1991). Treatment fidelity in outcome studies. Clinical Psychology Review, 11, 247266.CrossRefGoogle Scholar
Mörtberg, E., Clark, D. M., Sundin, O. and Wistedt, A. A. (2007). Intensive group cognitive therapy and individual cognitive therapy versus treatment as usual in social phobia: a randomized controlled trial. Acta Psychiatrica Scandinavica, 115, 142154.CrossRefGoogle Scholar
Perepletchikova, F. and Kazdin, A. E. (2005). Treatment integrity and therapeutic change: issues and research recommendations. Clinical Psychology Science and Practice, 12, 365383.CrossRefGoogle Scholar
Perepletchikova, F., Treat, T. A. and Kazdin, A. E. (2007). Treatment integrity in psychotherapy research: analysis of the studies and examination of the associated factors. Journal of Consulting and Clinical Psychology, 75, 829841.CrossRefGoogle ScholarPubMed
Reichelt, F. K., James, I. A. and Blackburn, I.-M. (2003). Impact of training on rating competence in cognitive therapy. Journal of Behavior Therapy and Experimental Psychiatry, 34, 8799.CrossRefGoogle ScholarPubMed
Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., et al. (2009). Mind the gap: improving the dissemination of CBT. Behaviour Research and Therapy, 47, 902909.CrossRefGoogle Scholar
Shrout, P. E. and Fleiss, J. L. (1979). Intraclass correlations: uses in assessing rater reliability. Psychological Bulletin, 86, 420428.CrossRefGoogle ScholarPubMed
Stangier, U., Clark, D. M. and Ehlers, A. (2006). Soziale Phobie. Fortschritte der Psychotherapie. Göttingen: Hogrefe.Google Scholar
Stangier, U., Consbruch, K. von, Schramm, E. and Heidenreich, T. (2010). Common factors of cognitive therapy and interpersonal psychotherapy in the treatment of social phobia. Anxiety, Stress and Coping, 23, 289301.CrossRefGoogle ScholarPubMed
Stangier, U., Heidenreich, T., Peitz, M., Lauterbach, W. and Clark, D. M. (2003). Cognitive therapy for social phobia: individual versus group treatment. Behaviour Research and Therapy, 41, 9911007.CrossRefGoogle ScholarPubMed
Stein, D. M. and Lambert, M. J. (1995). Graduate training in psychotherapy: are therapy outcomes enhanced? Journal of Consulting and Clinical Psychology, 63, 182196.CrossRefGoogle ScholarPubMed
Svartberg, M. (1999). Therapist competence: its temporal course, temporal stability, and determinants in short-term anxiety-provoking psychotherapy. Journal of Clinical Psychology, 55, 13131319.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Vallis, T. M., Shaw, B. F. and Dobson, K. S. (1986). The cognitive therapy scale: psychometric properties. Journal of Consulting and Clinical Psychology, 54, 381385.CrossRefGoogle ScholarPubMed
Waltz, J., Addis, M., Koerner, K. and Jacobson, N. S. (1993). Testing the integrity of a psychotherapy protocol: assessment of adherence and competence. Journal of Consulting and Clinical Psychology, 61, 620630.CrossRefGoogle ScholarPubMed
Webb, C. A., De Rubeis, R. J. and Barber, J. P. (2010). Therapist adherence/competence and treatment outcome: a meta-analytic review. Journal of Consulting and Clinical Psychology, 78, 200211.CrossRefGoogle ScholarPubMed
Wu, S. M., Whiteside, U. and Neighbors, C. (2007). Differences in inter-rater reliability and accuracy for a treatment adherence scale. Cognitive Behaviour Therapy, 36, 230239.CrossRefGoogle ScholarPubMed
Young, J. and Beck, A. (1980). Cognitive Therapy Scale: rating manual. Unpublished manuscript. Philadelphia, PA: Center for Cognitive Therapy.Google Scholar
Submit a response

Comments

No Comments have been published for this article.