Treatment specific competence predicts outcome in cognitive therapy for social anxiety disorder.
Several studies have demonstrated a positive relationship between competence and outcome in CBT for depression but studies of CBT for anxiety disorders are lacking. The present study explores the relationship between competence and outcome in cognitive therapy (CT) for social anxiety disorder, using hierarchical linear modeling analyses (HLM). Data were drawn from a multicenter randomized controlled trial. Five trained raters evaluated videotapes of two therapy sessions per patient using the Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP). Overall adherence to the treatment manual and patient difficulty were also assessed. Patient outcome was rated by other assessors using the Clinical Global Impression Improvement Scale (CGI-I) and the Liebowitz Social Anxiety Scale (LSAS). Results indicated that competence significantly predicted patient outcome on the CGI-I (β = .79) and LSAS (β = .59). Patient difficulty and adherence did not further improve prediction. The findings support the view that competence influences outcome and should be a focus of training programs. Further research is needed to compare different ways of assessing competence and to understand the complex relationships between competence and other therapy factors that are likely to influence outcome.
Department of Clinical Psychology and Psychotherapy, University of Frankfurt, Frankfurt, Germany. ginzburg@psych.uni-frankfurt.de
Denise M
DM
Ginzburg
Christiane
C
Bohn
Volkmar
V
Höfling
Florian
F
Weck
David M
DM
Clark
Ulrich
U
Stangier
D000328:Adult; D000553:Ambulatory Care; D002983:Clinical Competence / Q000592:standards*; D015928:Cognitive Behavioral Therapy / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010698:Phobic Disorders / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D014743:Videotape Recording; D055815:Young Adult