The why, what, when, who and how of assessing CBT competence to support lifelong learning

Abstract

Assessment of cognitive behaviour therapy (CBT) competence is a critical component in ensuring optimal clinical care, supporting therapists’ skill acquisition, and facilitating continuing professional development. This article provides a framework to support trainers, assessors, supervisors and therapists when making decisions about selecting and implementing effective strategies for assessing CBT competence. The framework draws on the existing evidence base to address five central questions: Why assess CBT competence?; What is CBT competence?; When should CBT competence be assessed?; Who is best placed to assess CBT competence?; and How should CBT competence be assessed? Various methods of assessing CBT competence are explored and the potential benefits and challenges are outlined. Recommendations are made about which approach to use across different contexts and how to use these effectively to facilitate the acquisition, enhancement and evaluation of CBT knowledge and skills. Key learning aims After reading this article you will be able to: (1) Identify key issues about why, what, when, who and how to assess CBT competence and use this framework to guide decisions about the best strategy to use. (2) Be aware of the range of methods for assessing CBT competence and consider the main benefits and potential challenges of these. (3) Consider the most effective ways to implement CBT competence assessment strategies as a tool for evaluation and learning.

The relation between knowledge and skills assessments in psychotherapy training: Secondary analysis of a randomized controlled trial.

“…Therefore, the associations found in our study are probably higher than expected due to common methodology effects such as response bias or recognition effects. Future studies could therefore develop more realistic case scenarios, such as video vignettes, with an open response format (Muse et al, 2022).…”

“…Despite several authors identifying components of effective training such as modeling (Hill & Lent, 2006), feedback (Weck et al, 2021), or instructions (Hill & Lent, 2006), most psychotherapy training aims at the improvement of higher level competence rather than at basic knowledge and skills (Beidas & Kendall, 2010). Furthermore, multicomponent assessments, as implemented in the present study, may be used not only to ensure that novice therapists acquire the necessary knowledge and skills, but also for broad formative feedback in self-reflective or supervisory practice (Muse et al, 2022).…”

“…Second, improvable item difficulty and item discrimination indices suggested that the items were either rather easy to solve, or could not discriminate sufficiently between participants with different levels of knowledge. Therefore, in future studies, we recommend using pretested and validated questionnaires (Jungmann & Witthöft, 2022; Muse et al, 2022). Furthermore, the MCQs and CVs shared some commonalities such as the same response format (five options with distractors).…”

Higher-order CBT skills: are there differences in meta-competence between trainee and experienced therapists?

“…The structure of competence scales emphasises the presence or absence of a particular feature, potentially at the expense of adaptations to individual clients. Muse et al (2022) explored the potential benefits and challenges of competence assessment and highlighted the difficulty in researchers agreeing on a clear working definition of competence. Although a broad range of CBT treatment approaches is helpful when treating patient problems, the ever-evolving nature of CBT means there is a recurrent challenge establishing a consensus about what constitutes effective and competent CBT practice.…”

CBT 50 years on: a celebration of empirically grounded and evidence-based psychological therapy

“…This included how to be an anti-racist clinician (Williams et al ., 2022) and an examination of the various frameworks to date for the cultural adaption of CBT (Naeem et al ., 2023). In line with the remit of tCBT in publishing all kinds of practice-based papers including those on training, supervision and practice-based research, it also published a summary paper on the key task of assessing CBT competence (Muse et al ., 2022) and an examination of the concept of reliable change, and reliable change index (Blampied, 2022).…”