Development of a Standardized Behavioral Assessment of Therapist Competence in Cognitive Therapy for Depression

The assessment of therapist competence in providing cognitive therapy (CT) is vital to both research and clinical work. In studies examining CT, being able to characterize the competence of therapists is important for placing research findings in context. In clinical settings, therapist competence evaluations can be used for credentialing or selecting therapists to provide clinical services. Currently, the most widely used method of assessing therapist competence is the Cognitive Therapy Scale (CTS; Young & Beck, 1980), an observer-rated measure completed on the basis of CT session recordings. While studies have shown utility of the CTS, a standardized assessment may have important advantages. In this study, I used data from a clinical trial (DeRubeis et al., 2005) to analyze the relationship between a number of patient variables assessed prior to treatment (i.e., history of illness, demographics and life circumstances, family history of mental illness, cognitive dysfunction, functioning, depressive symptoms, and personality disorder status) and CTS scores. While these patient variables failed to predict CTS scores, there was a non-significant trend suggesting observer ratings of another patient characteristic (i.e., patient difficulty) may be related to lower CTS scores. Two patient variables emerged as predictors of patient difficulty ratings: dysthymic disorder and personality disorder. In addition, I developed a standardized behavioral measure of therapist competence in CT for depression. The new assessment uses a series of hypothetical scenarios for which the respondent is asked to role play the cognitive therapist with the assessor acting as the patient, according to a manual detailing how the patient will respond in each scenario. Role plays are being recorded and evaluated using an observer-rated competence scale. Ultimately, I plan to evaluate the reliability and validity of this standardized measure and compare it to the CTS ratings.Social and Behavioral Sciences Research GrantNo embargoAcademic Major: PhilosophyAcademic Major: Psycholog