title: Investigating the relationship between competence and patient outcome with CBT.
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.
authors: School of Psychology and CLS, University of Reading, Earley Gate, Reading, Berkshire RG14 6AL, United Kingdom. Electronic address: a.branson@reading.ac.uk.
authors: Amanda
authors: A
authors: Branson
authors: Child Health Centre, University College London, Gower Street, London, WC1E 6BT, United Kingdom. Electronic address: r.shafran@ucl.ac.uk.
authors: Roz
authors: R
authors: Shafran
authors: School of Psychology and CLS, University of Reading, Earley Gate, Reading, Berkshire RG14 6AL, United Kingdom. Electronic address: pamelamyles@reading.ac.uk.
authors: Pamela
authors: P
authors: Myles
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy; D002983:Clinical Competence; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000592:standards; D005260:Female; D006282:Health Personnel / Q000193:education* / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D011361:Professional Competence; D016896:Treatment Outcome
keywords: Anxiety; CBT; Competence; Depression; IAPT; Outcome; Training