@article{WeckJungaKliegletal.2021,
  author    = {Weck, Florian and Junga, Yvonne Marie and Kliegl, Reinhold and Hahn, Daniela and Brucker, Katharina and Witth{\"o}ft, Michael},
  title     = {Effects of competence feedback on therapist competence and patient outcome},
  series = {Journal of consulting and clinical psychology},
  volume    = {89},
  journal   = {Journal of consulting and clinical psychology},
  number    = {11},
  publisher = {American Psychological Association},
  address   = {Washington},
  issn      = {0022-006X},
  doi       = {10.1037/ccp0000686},
  pages     = {885 -- 897},
  year      = {2021},
  abstract  = {Objective: Therapist competence is considered essential for the success of psychotherapy. Feedback is an intervention which has the potential to improve therapist competence. The present study investigated whether competence feedback leads to an improvement of therapist competence and patient outcome. Method: Sixty-seven master-level clinical trainees were randomly assigned to either a competence feedback group (CFG) or a control group (CG). Patients with a diagnosis of major depression (N = 114) were randomly assigned to CFG or CG. Treatment included 20 individual sessions of cognitive behavioral therapy (CBT). In CFG, therapists received, parallel to the treatment, five competence feedbacks, based on videotaped therapy sessions. Independent raters assessed therapist competence with the Cognitive Therapy Scale (CTS) and provided the competence feedback. Patient outcome was evaluated with the Beck Depression Inventory-II (BDI-II) and therapeutic alliance (Helping Alliance Questionnaire [HAQ]) from both therapist's (HAQ-T) and patient's (HAQ-P) perspective were evaluated after each of the 20 sessions. Results: (a) Therapist competence (CTS) increased significantly more for CFG than CG. (b) Depression (BDI-II) decreased significantly across sessions for both groups, but without evidence for a group-differential benefit for the CFG. (c) Therapeutic alliance (HAQ-T/P) increased significantly across sessions for both groups from both perspectives, but without group differences. (d) There is a positive effect of BDI-II on CTS at the beginning and a negative effect of CTS on BDI-II at the end of therapy. Conclusion: Competence feedback improves therapists' independently rated competence, but there is no evidence that competence feedback in CBT leads to better outcome. What is the public health significance of this article? This study suggests the substantial value of systematic competence feedback for improving therapist competence in the psychotherapy of depression. No significant effect of competence feedback on the reduction of reported depressive symptoms was found.},
  language  = {en}
}
@article{MaiwaldJungaLangetal.2019,
  author    = {Maiwald, Lisa Marie and Junga, Yvonne Marie and Lang, Thomas and Montini, Romina and Witth{\"o}ft, Michael and Heider, Jens and Schr{\"o}der, Annette and Weck, Florian},
  title     = {The role of therapist and patient in-session behavior for treatment outcome in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia},
  series = {Journal of clinical psychology},
  volume    = {75},
  journal   = {Journal of clinical psychology},
  number    = {4},
  publisher = {Wiley},
  address   = {Hoboken},
  issn      = {0021-9762},
  doi       = {10.1002/jclp.22738},
  pages     = {614 -- 626},
  year      = {2019},
  abstract  = {Objective There is a very limited amount of research on the relationship between therapist and patient in-session behavior and treatment outcome in cognitive behavioral therapy (CBT) for panic disorder with agoraphobia (PD/AG). Additionally, the findings tend to be inconclusive. This study investigates the association between therapist competence, adherence, patient interpersonal behavior, and therapeutic alliance and outcome in a low-control CBT setting by using comprehensive measures. Methods Twenty-six patients with PD/AG received 12 sessions of exposure-based CBT. With regard to the outcome, treatments were classified either as problematic or nonproblematic by means of distinct criteria. Two raters evaluated the in-session behavior. Results Patient interpersonal behavior was significantly associated with outcome at follow-up (r = 0.49). At posttreatment, the correlation did not reach significance ( r = 0.34). Competence, adherence, and alliance were not outcome associated. Conclusion The findings emphasize the need for therapists to pay particular attention to patients' interpersonal behavior during treatment.},
  language  = {en}
}