TY  - JOUR
A1  - Weck, Florian
A1  - Junga, Yvonne Marie
A1  - Kliegl, Reinhold
A1  - Hahn, Daniela
A1  - Brucker, Katharina
A1  - Witthöft, Michael
T1  - Effects of competence feedback on therapist competence and patient outcome
BT  - a randomized controlled trial
JF  - Journal of consulting and clinical psychology
N2  - 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.
KW  - feedback
KW  - outcome
KW  - major depression
KW  - therapeutic alliance
KW  - therapeutic
KW  - competencies
Y1  - 2021
U6  - https://doi.org/10.1037/ccp0000686
SN  - 0022-006X
SN  - 1939-2117
VL  - 89
IS  - 11
SP  - 885
EP  - 897
PB  - American Psychological Association
CY  - Washington
ER  - 
TY  - JOUR
A1  - Maiwald, Lisa Marie
A1  - Junga, Yvonne Marie
A1  - Lang, Thomas
A1  - Montini, Romina
A1  - Witthöft, Michael
A1  - Heider, Jens
A1  - Schröder, Annette
A1  - Weck, Florian
T1  - The role of therapist and patient in-session behavior for treatment outcome in exposure-based cognitive behavioral therapy for panic disorder with agoraphobia
JF  - Journal of clinical psychology
N2  - 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.
KW  - interpersonal behavior
KW  - panic disorder with agoraphobia
KW  - therapeutic alliance
KW  - therapist competence
KW  - treatment outcome
Y1  - 2018
U6  - https://doi.org/10.1002/jclp.22738
SN  - 0021-9762
SN  - 1097-4679
VL  - 75
IS  - 4
SP  - 614
EP  - 626
PB  - Wiley
CY  - Hoboken
ER  -