Therapist Self-Efficacy in Delivering Cognitive Processing Therapy in a Randomized Controlled Implementation Trial

Pace, Brian T.; Song, Jiyoung; Suvak, Michael K.; Shields, Norman; Monson, Candice M.; Stirman, Shannon Wiltsey

doi:10.1016/j.cbpra.2020.08.002

Cited by 14 publications

(11 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The RHPs became more confident about the (often new to them) interventional approach and content as they delivered more sessions. These findings support earlier fatigue studies [ 17 ] and literature reporting a positive relationship between health professional self-efficacy and patient outcomes [ 18 ], highlighting the importance that a positive training experience and on-going support might have on health professional self-efficacy and, in turn, patient outcomes.…”

Section: Discussionsupporting

confidence: 89%

Acceptability of a brief fatigue intervention for inflammatory arthritis: a qualitative process evaluation

Berry

Bridgewater

Abbott

et al. 2022

Rheumatology Advances in Practice

View full text Add to dashboard Cite

Objectives We developed a brief cognitive-behavioural, one-to-one intervention to reduce fatigue impact for patients with inflammatory arthritis. This qualitative process evaluation explored intervention acceptability and potential refinements from the perspective of (i) patients who attended sessions and (ii) rheumatology health professionals (RHPs) who delivered the intervention. Methods Interviews were conducted with patients and RHPs from five NHS sites. Data were analysed using inductive thematic analysis. Results Twenty-two patients and eleven RHPs participated. Patient themes Collaborative, non-judgemental consultations: patients valued having space to reflect, where their fatigue was validated. Relevant content, but not ground-breaking: patients appreciated the opportunity to tailor content to individual priorities. Daily diaries were useful to visualise fatigue. Self-awareness: patients reported increased acceptance, sense of control, and confidence to manage fatigue. Degrees of openness to change: sessions prompted patients to engage in behaviour change. For some, complicated lives made it difficult to plan for change. RHP themes Engagement with intervention: RHPs liked training face-to-face, and sessions were more enjoyable with experience of delivery. Research versuss clinical practice: RHPs expressed concern about fitting sessions into NHS clinic appointments. It was difficult to offer follow-up sessions within two-weeks. Collaborating with patients: RHPs reported that patients engaged with the tools and strategies. Some RHPs followed the manual in a linear way, others used it flexibly. Conclusions There is potential for this brief fatigue intervention to benefit patients. Future research will focus on flexibility to fit with local services and creating educational resources to use in a range of contexts. Lay summary What does this mean for patients? This purpose of this study was to find out what patients and health professionals thought about taking part in fatigue management sessions for people with inflammatory arthritis. We discussed the sessions with 22 patients who attended sessions, and eight health professionals who were trained in and delivered the sessions. Patients told us that they liked having an opportunity to talk about their fatigue. Although the information was not always new, they liked the resources, including the daily diaries. Sessions made them think about things in their day-to-day lives that might be making their fatigue worse. For some, it gave them ideas about things to change or do differently. Health professionals liked training with other health professionals and felt more confident about the fatigue sessions with practise. Some were using the fatigue information and resources in their usual consultations. Sometimes it was difficult to make sure everyone had enough time, and to fit in all the appointments within the recommended two-week time frame. The results show that patients value the opportunity to address their fatigue with a health professional, but also the challenges of providing these sessions in clinical practice.

show abstract

Section: Discussionsupporting

confidence: 89%

Acceptability of a brief fatigue intervention for inflammatory arthritis: a qualitative process evaluation

Berry

Bridgewater

Abbott

et al. 2022

Rheumatology Advances in Practice

View full text Add to dashboard Cite

show abstract

“…Client outcome, for instance their overall distress level over the course of their therapy sessions with a therapist, may serve as such an “external” factor. Research indicated that more distressed clients could present a bigger challenge for therapists, especially beginning trainees, making it potentially more difficult to have an effective session (Pace et al, 2021). In addition, client distress level over time can serve as reciprocal feedback information for therapist trainee’s perceived performance (Reese et al, 2009).…”

Section: Counseling Self-efficacy: Definition and Existing Studiesmentioning

confidence: 99%

“…In their literature review, Larson and Daniels (1998) summarized some significant correlates of counseling self-efficacy including counselor traits such as self-concept and self-consciousness, counselor states such as anxiety, other social-cognitive variables including outcome expectancies and self-evaluation, and counselor performance rated by trained raters. More recent research on counseling self-efficacy focused on its measurement (e.g., Lent et al, 2003), its application to specific areas such as career (Heppner et al, 1998) or multicultural counseling (Sheu & Lent, 2007), the effects of various types of training on self-efficacy (e.g., Al-Darmaki, 2004; Mullen et al, 2015), the predictors of self-efficacy (e.g., Easton et al, 2008; Greason & Cashwell, 2009; Morrison & Lent, 2018), the outcome variables of self-efficacy (e.g., session quality in Lent et al, 2006; vocational goal achievement in McCarthy, 2014; symptom improvement in Pace et al, 2021), and the moderating or mediating effect of self-efficacy (e.g., de Jong et al, 2012; Lai et al, 2021). Taken together, these existing studies suggested the important role of counselor self-efficacy in various areas of counseling activities, supported the positive effects of training on self-efficacy, helped unveil potential factors that could increase self-efficacy, provided some preliminary evidence to the positive effects of counseling self-efficacy, and supported the mediating or moderating roles of counseling self-efficacy.…”

Section: Counseling Self-efficacy: Definition and Existing Studiesmentioning

confidence: 99%

The “roller coaster ride”: A longitudinal investigation of the dynamic relationship between Chinese counseling trainees’ self-efficacy and their clients’ outcome and the mediating effects of working alliance and session evaluation.

Xu¹,

Lin

et al. 2022

Journal of Counseling Psychology

View full text Add to dashboard Cite

Based on the social-cognitive theory, this study investigated the dynamic association between counseling trainees' self-efficacy and their clients' outcome (i.e., symptom distress), and the mediating effects of therapist-and client-rated working alliance and session quality. Data set included 1,352 sessions conducted by 87 master's level therapist trainees with their 317 clients in China. Before every session, therapists completed a measure of self-efficacy and clients reported their symptom distress; and after every session, both therapists and clients rated their working alliance and session quality. Results showed that, (a) over the course of therapy, the initial level of therapist self-efficacy did not predict how quickly client symptom declined; (b) the initial level of client distress did not predict how quickly therapist self-efficacy increased; and (c) client distress decline was not related to therapist self-efficacy increase over the course of therapy. However, at the session-to-session level, higher therapist self-efficacy before one session significantly predicted lower client distress before the next session, and higher client distress before one session significantly predicted lower therapist self-efficacy before the subsequent session. Therapist and client perceptions of working alliance were both significant mediators, while their session quality ratings were not. Findings supported the dynamic and reciprocal relationship between therapist self-efficacy and client distress at the immediate session-to-session level rather than the overall trajectory level, and revealed its specific mediating mechanism through the relationship building between therapist and client. Public Significance StatementTherapist trainees' self-efficacy and their clients' distress temporally predict each other from session to session in a reciprocal way. When feeling more confident about their therapy sessions, trainees appear to build better relationships with clients, which leads to client symptom relief; in contrary, when clients are more distressed, it seems hard to have a strong working alliance, which undermines trainees' subsequent confidence.

show abstract

“…Similarly, clinician self-efficacy or confidence in their ability to competently implement CBT may also be an important variable to assess. Clinicians with more positive attitudes towards EBPs may have higher self-efficacy (Pace et al, 2020). Given that previous literature has found that change in knowledge of CBT is associated with improvements in EBP attitudes (Lim et al, 2012), an examination of clinicians' change in knowledge may shed additional light on the relation between attitudes and competence.…”

Section: Future Directionsmentioning

confidence: 99%

Changes in community clinicians’ attitudes and competence following a transdiagnostic Cognitive Behavioral Therapy training

Creed¹,

Crane

Calloway³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Objective: Although data suggest that knowledge of evidence-based practices (EBPs) and attitudes towards EBPs may be related, the relation between attitudes and competence in delivering EBPs has not been examined. This study examined how initial attitudes and competence relate to improvements in attitudes and competence following EBP training. Methods: Community clinicians (N=891) received intensive training in cognitive behavioral therapy skills followed by six months of consultation. Clinician attitudes were assessed using the Evidence Based Practice Attitude Scale, and competence was assessed using the Cognitive Therapy Rating Scale. Data was analyzed by fitting three latent change score models to examine the relationship between changes in attitudes and competence across the training and within its two phases (workshop phase, consultation phase).Results: Latent change models identified significant improvement in attitudes (Mslatent change≥1.07, SEs≤ 0.19, zs≥6.85, ps< .001) and competence (Mslatent change≥13.13, SEs≤3.53, zs≥2.30, ps<.001) across the full training and in each phase. Higher pre-workshop attitudes predicted significantly greater change in competence in the workshop phase and across the full training (bs≥1.58, SEs≤1.13, z≥1.89, p<.048, β≥0.09); however, contrary to our hypothesis, post-workshop attitudes did not significantly predict change in competence in the consultation phase (b=1.40, SE=1.07, z=1.31, p=.19, β=0.08). Change in attitudes and change in competence in the training period, the workshop phase, and the consultation phase were not significantly correlated. Conclusions: Results indicate that pre-training attitudes about EBPs present a target for implementation interventions, given their relation to changes in both attitudes and competence throughout training.

show abstract

Therapist Self-Efficacy in Delivering Cognitive Processing Therapy in a Randomized Controlled Implementation Trial

Cited by 14 publications

References 39 publications

Acceptability of a brief fatigue intervention for inflammatory arthritis: a qualitative process evaluation

Acceptability of a brief fatigue intervention for inflammatory arthritis: a qualitative process evaluation

The “roller coaster ride”: A longitudinal investigation of the dynamic relationship between Chinese counseling trainees’ self-efficacy and their clients’ outcome and the mediating effects of working alliance and session evaluation.

Changes in community clinicians’ attitudes and competence following a transdiagnostic Cognitive Behavioral Therapy training

Contact Info

Product

Resources

About