The Cognitive Therapy Scale and Cognitive Therapy Scale-Revised as Measures of Therapist Competence in Cognitive Behavior Therapy for Depression

Relations with Short and Long Term Outcome

Nikolaos Kazantzis, Xavier Clayton, Timothy J. Cronin, Davide Farchione, Karina Limburg, K. S. Dobson

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Therapist competence is an important factor in treatment integrity. This study reports on a direct comparison of the original Cognitive Therapy Scale (CTS) with the revised version, the Cognitive Therapy Scale-Revised (CTS-R), as observational instruments designed to evaluate therapist competence in a completed trial of Cognitive Behavior Therapy (CBT) for depression. Treatment sessions (N = 94) from 50 depressed participants (M age = 39.2 years, 76% female, with an average of 5.9 depressive episodes) were evaluated on the CTS and CTS-R by trained independent observers who were blind to treatment outcome, as well as to subject, and session numbers. A comprehensive training program and inter-rater reliability monitoring protocol were employed. Two models were used to compare CTS and CTS-R in relation to change in depression symptoms at termination, 12 and 24 month follow-up while controlling for pre-treatment depression levels and working alliance. Both the CTS and CTS-R demonstrated comparable internal reliability, interrater reliability, and when assessed in early treatment phase, both predicted a statistically significant reduction in depressive symptomatology at termination. No significant competence-outcome relations were detected with late CTS and CTS-R ratings, and the significant positive interaction terms indicated relations with depressive symptomatology were not maintained at follow-up. Given these findings, we encourage future research to examine specific competence domains and “therapist drift” with an increased number of session assessments.

Original languageEnglish
Pages (from-to)385-397
Number of pages13
JournalCognitive Therapy and Research
Volume42
Issue number4
DOIs
Publication statusPublished - Aug 2018

Keywords

  • Cognitive Behavior Therapy
  • Cognitive Therapy Scale
  • Cognitive Therapy Scale-Revised
  • Major depressive disorder
  • Therapist competence

Cite this

@article{6eca486b52ca4953ac6adbd7f5e15fc9,
title = "The Cognitive Therapy Scale and Cognitive Therapy Scale-Revised as Measures of Therapist Competence in Cognitive Behavior Therapy for Depression: Relations with Short and Long Term Outcome",
abstract = "Therapist competence is an important factor in treatment integrity. This study reports on a direct comparison of the original Cognitive Therapy Scale (CTS) with the revised version, the Cognitive Therapy Scale-Revised (CTS-R), as observational instruments designed to evaluate therapist competence in a completed trial of Cognitive Behavior Therapy (CBT) for depression. Treatment sessions (N = 94) from 50 depressed participants (M age = 39.2 years, 76{\%} female, with an average of 5.9 depressive episodes) were evaluated on the CTS and CTS-R by trained independent observers who were blind to treatment outcome, as well as to subject, and session numbers. A comprehensive training program and inter-rater reliability monitoring protocol were employed. Two models were used to compare CTS and CTS-R in relation to change in depression symptoms at termination, 12 and 24 month follow-up while controlling for pre-treatment depression levels and working alliance. Both the CTS and CTS-R demonstrated comparable internal reliability, interrater reliability, and when assessed in early treatment phase, both predicted a statistically significant reduction in depressive symptomatology at termination. No significant competence-outcome relations were detected with late CTS and CTS-R ratings, and the significant positive interaction terms indicated relations with depressive symptomatology were not maintained at follow-up. Given these findings, we encourage future research to examine specific competence domains and “therapist drift” with an increased number of session assessments.",
keywords = "Cognitive Behavior Therapy, Cognitive Therapy Scale, Cognitive Therapy Scale-Revised, Major depressive disorder, Therapist competence",
author = "Nikolaos Kazantzis and Xavier Clayton and Cronin, {Timothy J.} and Davide Farchione and Karina Limburg and Dobson, {K. S.}",
year = "2018",
month = "8",
doi = "10.1007/s10608-018-9919-4",
language = "English",
volume = "42",
pages = "385--397",
journal = "Cognitive Therapy and Research",
issn = "0147-5916",
publisher = "Springer-Verlag London Ltd.",
number = "4",

}

The Cognitive Therapy Scale and Cognitive Therapy Scale-Revised as Measures of Therapist Competence in Cognitive Behavior Therapy for Depression : Relations with Short and Long Term Outcome. / Kazantzis, Nikolaos; Clayton, Xavier; Cronin, Timothy J.; Farchione, Davide; Limburg, Karina; Dobson, K. S.

In: Cognitive Therapy and Research, Vol. 42, No. 4, 08.2018, p. 385-397.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The Cognitive Therapy Scale and Cognitive Therapy Scale-Revised as Measures of Therapist Competence in Cognitive Behavior Therapy for Depression

T2 - Relations with Short and Long Term Outcome

AU - Kazantzis, Nikolaos

AU - Clayton, Xavier

AU - Cronin, Timothy J.

AU - Farchione, Davide

AU - Limburg, Karina

AU - Dobson, K. S.

PY - 2018/8

Y1 - 2018/8

N2 - Therapist competence is an important factor in treatment integrity. This study reports on a direct comparison of the original Cognitive Therapy Scale (CTS) with the revised version, the Cognitive Therapy Scale-Revised (CTS-R), as observational instruments designed to evaluate therapist competence in a completed trial of Cognitive Behavior Therapy (CBT) for depression. Treatment sessions (N = 94) from 50 depressed participants (M age = 39.2 years, 76% female, with an average of 5.9 depressive episodes) were evaluated on the CTS and CTS-R by trained independent observers who were blind to treatment outcome, as well as to subject, and session numbers. A comprehensive training program and inter-rater reliability monitoring protocol were employed. Two models were used to compare CTS and CTS-R in relation to change in depression symptoms at termination, 12 and 24 month follow-up while controlling for pre-treatment depression levels and working alliance. Both the CTS and CTS-R demonstrated comparable internal reliability, interrater reliability, and when assessed in early treatment phase, both predicted a statistically significant reduction in depressive symptomatology at termination. No significant competence-outcome relations were detected with late CTS and CTS-R ratings, and the significant positive interaction terms indicated relations with depressive symptomatology were not maintained at follow-up. Given these findings, we encourage future research to examine specific competence domains and “therapist drift” with an increased number of session assessments.

AB - Therapist competence is an important factor in treatment integrity. This study reports on a direct comparison of the original Cognitive Therapy Scale (CTS) with the revised version, the Cognitive Therapy Scale-Revised (CTS-R), as observational instruments designed to evaluate therapist competence in a completed trial of Cognitive Behavior Therapy (CBT) for depression. Treatment sessions (N = 94) from 50 depressed participants (M age = 39.2 years, 76% female, with an average of 5.9 depressive episodes) were evaluated on the CTS and CTS-R by trained independent observers who were blind to treatment outcome, as well as to subject, and session numbers. A comprehensive training program and inter-rater reliability monitoring protocol were employed. Two models were used to compare CTS and CTS-R in relation to change in depression symptoms at termination, 12 and 24 month follow-up while controlling for pre-treatment depression levels and working alliance. Both the CTS and CTS-R demonstrated comparable internal reliability, interrater reliability, and when assessed in early treatment phase, both predicted a statistically significant reduction in depressive symptomatology at termination. No significant competence-outcome relations were detected with late CTS and CTS-R ratings, and the significant positive interaction terms indicated relations with depressive symptomatology were not maintained at follow-up. Given these findings, we encourage future research to examine specific competence domains and “therapist drift” with an increased number of session assessments.

KW - Cognitive Behavior Therapy

KW - Cognitive Therapy Scale

KW - Cognitive Therapy Scale-Revised

KW - Major depressive disorder

KW - Therapist competence

UR - http://www.scopus.com/inward/record.url?scp=85047163737&partnerID=8YFLogxK

U2 - 10.1007/s10608-018-9919-4

DO - 10.1007/s10608-018-9919-4

M3 - Article

VL - 42

SP - 385

EP - 397

JO - Cognitive Therapy and Research

JF - Cognitive Therapy and Research

SN - 0147-5916

IS - 4

ER -