title: Development and Initial Psychometrics for a Therapist Competence Instrument for CBT for Youth Anxiety.
abstract: Therapist competence is an important component of treatment integrity. This article reports on the development and initial psychometric assessment of the Cognitive-Behavioral Treatment for Anxiety in Youth Competence Scale (CBAY-C), an observational instrument designed to capture therapist limited-domain competence (i.e., competence in the delivery of core interventions and delivery methods found in a specific psychosocial treatment program) in the delivery of the core practice elements in individual cognitive-behavioral treatment (ICBT) for youth anxiety. Treatment sessions (N = 744) from 68 youth participants (M age = 10.60 years, SD = 2.03; 82.3% Caucasian; 52.9% male) of the same ICBT program for youth anxiety from (a) an efficacy study and (b) an effectiveness study were independently scored by 4 coders using observational instruments designed to assess therapist competence, treatment adherence, treatment differentiation, alliance, and client involvement. Interrater reliability-intraclass correlation coefficients (2,2)-for the item scores averaged 0.69 (SD = 0.11). The CBAY-C item, scale, and subscale (Skills, Exposure) scores showed evidence of validity via associations with observational instruments of treatment adherence to ICBT for youth anxiety, theory-based domains (cognitive-behavioral treatment, psychodynamic, family, client centered), alliance, and client involvement. Important to note, although the CBAY-C scale, subscale, and item scores did overlap with a corresponding observational treatment adherence instrument independently rated by coders, the degree of overlap was moderate, indicating that the CBAY-C assesses a distinct component of treatment integrity. Applications of the instrument and future research directions discussed include the measurement of treatment integrity and testing integrity-outcome relations.
authors.affiliation: a Department of Psychology , Virginia Commonwealth University.
authors.forename: Bryce D
authors.initials: BD
authors.lastname: McLeod
authors.affiliation: a Department of Psychology , Virginia Commonwealth University.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Southam-Gerow
authors.affiliation: a Department of Psychology , Virginia Commonwealth University.
authors.forename: Adriana
authors.initials: A
authors.lastname: Rodríguez
authors.affiliation: a Department of Psychology , Virginia Commonwealth University.
authors.forename: Alexis M
authors.initials: AM
authors.lastname: Quinoy
authors.affiliation: a Department of Psychology , Virginia Commonwealth University.
authors.forename: Cassidy C
authors.initials: CC
authors.lastname: Arnold
authors.affiliation: b Department of Psychology , Temple University.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Kendall
authors.affiliation: c Department of Psychology , Harvard University.
authors.forename: John R
authors.initials: JR
authors.lastname: Weisz
mesh_terms: D001008:Anxiety Disorders / Q000523:psychology*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results