The dissemination and implementation of cognitive behavioral therapy (CBT) is stalled by the lack of empirical data to guide the content and evaluation of training programs. To address the questions of "What should be taught?" and "What do clinicians learn?" reliable and valid measures of therapist behaviors and practice elements are needed. The objective of this report is to identify existing CBT measures and to assess their ability to address these critical questions. We conducted a comprehensive literature review to identify measures of CBT declarative and procedural knowledge. We identified two measures of therapist declarative knowledge, one measure of client declarative knowledge, 22 measures of therapist procedural knowledge, and four measures of client procedural knowledge. Domain coverage, psychometrics, correlations among measures, and relationship to clinical outcomes varied considerably. Measures were evaluated in terms of whether, and to what degree, they might help address key CBT dissemination and implementation questions. Although some of the current set of CBT measures are well suited to the purposes for which they were originally developed, they do not provide the needed technology for advancing CBT dissemination and implementation. Recommendations for measure development are offered.

Men's drive for muscularity refers to the degree to which men wish to increase their muscularity. Men who are more extreme in their drive for muscularity face dangerous consequences, such as increased levels of eating pathology and use of performance-enhancing substances. The aim of this study was to predict men's drive for muscularity, and to test whether hypothesized predictive factors vary across age groups. Participants were 226 men ages 18-67. It was hypothesized that body dissatisfaction would predict men's drive for muscularity. More substantively, however, it was hypothesized that having a strong tendency to compare oneself with others would exacerbate the relationship between men's body dissatisfaction and their drive for muscularity. Results of a hierarchical multiple regression analysis supported these hypotheses. Furthermore, this exacerbating effect was present regardless of men's age. Implications for assessment, clinical practice, research, and prevention efforts are discussed.

Raters differed in competency ratings. Implications for potential use and adaptation of CBT competency measurement methods to enhance training and implementation are discussed.

Context Previous literature has demonstrated the prevalence and socioeconomic impact of postoperative pain in surgery patients. Somatic dysfunction has been demonstrated as a cause, but literature documenting osteopathic manipulative treatment (OMT) in surgery patients is lacking. Objective To describe typical patterns of and common treatments for somatic dysfunction in patients following laparoscopic cholecystectomy. Methods The authors retrospectively reviewed the billing records of all patients over 18 years of age who underwent laparoscopic cholecystectomy by a single surgeon and had postoperative outpatient OMT for right-side pain linked to somatic dysfunction between 2006 and 2018 at a community hospital in Grand Rapids, Michigan. Patients who underwent open cholecystectomy, who did not have documented somatic dysfunction, or had somatic dysfunction unrelated to their biliary disease were excluded. Results Nine patients were selected for inclusion in this retrospective case series. All patients in the study demonstrated anterior right lower rib pain corresponding to posterior lower rib dysfunctions and rotated right and side-bent left thoracic spine dysfunctions between T5 and T11. Pain was successfully managed with muscle energy, high-velocity, low-amplitude, or soft tissue OMT. Conclusion Postoperative pain following laparoscopic cholecystectomy can be related to right-sided thoracic and rib dysfunctions. This is important for early diagnosis of surgical patients with somatic dysfunction and initiation of appropriate OMT to decrease morbidity related to pain, functional status, and quality of life.

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