Cognitive Behavioural Therapy Competency: Pilot Data from a Comparison of Multiple Perspectives

Abstract

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

Trainee self-assessment of cognitive behaviour therapy competence during and after training

“…These findings have important implications regarding the use of self-evaluation as a resourceefficient CBT competence assessment methodparticularly in training. The changing proportion of agreement across training supports previous assertions that self-evaluation is not an appropriate stand-alone competence assessment for trainees (Rozek et al, 2018). Rather, selfassessment appears to be more appropriate as a self-reflective learning tool (Waltman et al, 2016), with trainees' understanding of their own skill becoming more accurate with repeated comparison to expert ratings and with increasing experience.…”

“…Comparison of trainees' self-ratings and expert ratings of competence for a single session during training (Rozek et al, 2018) and towards the beginning and end of training (Mathieson et al, 2009) indicated trends towards agreement, with varying significance. Limited longitudinal evidence indicates that while there is considerable variability in the strength of the relationship between self and expert ratings, agreement tends to improve across training (Loades and Myles, 2016;McManus et al, 2012).…”

“…Limited longitudinal evidence indicates that while there is considerable variability in the strength of the relationship between self and expert ratings, agreement tends to improve across training (Loades and Myles, 2016;McManus et al, 2012). A small study found evidence of trainee over-estimation compared with objective markers (Rozek et al, 2018), while larger studies indicated under-estimationparticularly by more-competent trainees (McManus et al, 2012), or switching over time (Loades and Myles, 2016). Methodological issues, including relatively small sample sizes (n = 5-64) and the use of different measures for self and expert ratings and/or of unvalidated competency rating scales may have contributed to inconsistency in findings.…”

“…To meet these ambitious goals and support the expansion of CBT training and provision, effective methods to assess therapists' competence, or skilfulness at delivering CBT, are required. Expert objective ratings of therapy recordings are the gold-standard competence assessment, but are resource-intensive (Rozek et al, 2018). Interest in varied assessment methods, including therapist self-assessment of competence, has consequently grown (Rozek et al, 2018;Singla et al, 2014).…”

“…Expert objective ratings of therapy recordings are the gold-standard competence assessment, but are resource-intensive (Rozek et al, 2018). Interest in varied assessment methods, including therapist self-assessment of competence, has consequently grown (Rozek et al, 2018;Singla et al, 2014). Valid and feasible methods to assess treatment integrity and therapy qualityincluding competenceare integral for the large-scale implementation of evidence-based therapies such as CBT (Shoenwald et al, 2011).…”