TY - JOUR A1 - Kühne, Franziska A1 - Lacki, Fiona Janina A1 - Muse, Kate A1 - Weck, Florian T1 - Strengthening competence of therapists-in-training in the treatment of health anxiety (hypochondriasis) BT - validation of the assessment of Core CBT Skills (ACCS) JF - Clinical psychology & psychotherapy : an international journal of theory and practice N2 - Although the observation and assessment of psychotherapeutic competences are central to training, supervision, patient care, quality control, and life-long practice, structured instruments are used only occasionally. In the current study, an observation-based tool for the Assessment of Core CBT Skills (ACCS) was translated into German and adapted, and its psychometric properties were pilot evaluated. Competence of therapists-in-training was assessed in a random sample of n = 30 videos on cognitive behavioural therapy including patients diagnosed with hypochondriasis. Two of three raters independently assessed the competences demonstrated in the entire, active treatment sessions (n = 60). In our sample, internal consistency was excellent, and interrater reliability was good. Convergent validity (Cognitive Therapy Scale) and discriminant validity (Helping Alliance Questionnaire) were within the expected ranges. The ACCS total score did not significantly predict the reduction of symptoms of hypochondriasis, and a one-factorial structure of the instrument was found. By providing multiple opportunities for feedback, self-reflection, and supervision, the ACCS may complement current tools for the assessment of psychotherapeutic competences and importantly support competence-based training and supervision. KW - adherence KW - assessment KW - process research KW - psychotherapy KW - skill Y1 - 2019 U6 - https://doi.org/10.1002/cpp.2353 SN - 1063-3995 SN - 1099-0879 VL - 26 IS - 3 SP - 319 EP - 327 PB - Wiley CY - Hoboken ER - TY - JOUR A1 - Kühne, Franziska A1 - Meister, Ramona A1 - Maass, Ulrike A1 - Paunov, Tatjana A1 - Weck, Florian T1 - How reliable are therapeutic competence ratings? BT - results of a systematic review and meta-analysis JF - Cognitive therapy and research N2 - Assessments of psychotherapeutic competencies play a crucial role in research and training. However, research on the reliability and validity of such assessments is sparse. This study aimed to provide an overview of the current evidence and to provide an average interrater reliability (IRR) of psychotherapeutic competence ratings. A systematic review was conducted, and 20 studies reported in 32 publications were collected. These 20 studies were included in a narrative synthesis, and 20 coefficients were entered into the meta-analysis. Most primary studies referred to cognitive-behavioral therapies and the treatment of depression, used the Cognitive Therapy Scale, based ratings on videos, and trained the raters. Our meta-analysis revealed a pooled ICC of 0.82, but at the same time severe heterogeneity. The evidence map highlighted a variety of variables related to competence assessments. Further aspects influencing the reliability of competence ratings and regarding the considerable heterogeneity are discussed in detail throughout the manuscript. KW - competency KW - therapist competence KW - adherence KW - psychotherapy KW - assessment Y1 - 2019 U6 - https://doi.org/10.1007/s10608-019-10056-5 SN - 0147-5916 SN - 1573-2819 VL - 44 IS - 2 SP - 241 EP - 257 PB - Springer CY - New York ER - TY - JOUR A1 - Bohlken, Jens A1 - Weber, Simon A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Continuous treatment with antidementia drugs in Germany 2003-2013: a retrospective database analysis JF - International psychogeriatrics N2 - Background: Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics. Methods: Data from 12,910 outpatients with dementia (mean age 79.2 years; SD = 7.6 years) treated between January 2003 and December 2013 in Germany were included. Continuous treatment was analysed using Kaplan-Meier curves and log-rank tests. In addition, multivariate Cox regression models were fitted with continuous treatment as dependent variable and the predictors antidementia agent, age, gender, medical comorbidities, physician specialty, and health insurance status. Results: After one year of follow-up, nearly 60% of patients continued drug treatment. Donezepil (HR: 0.88; 95% CI: 0.82-0.95) and memantine (HR: 0.85; 0.79-0.91) patients were less likely to be discontinued treatment as compared to rivastigmine users. Patients were less likely to be discontinued if they were treated by specialist physicians as compared to general practitioners (HR: 0.44; 0.41-0.48). Younger male patients and patients who had private health insurance had a lower discontinuation risk. Regarding comorbidity, patients were more likely to be continuously treated with the index substance if a diagnosis of heart failure or hypertension had been diagnosed at baseline. Conclusions: Our results imply that besides type of antidementia agent, involvement of a specialist in the complex process of prescribing antidementia drugs can provide meaningful benefits to patients, in terms of more disease-specific and continuous treatment. KW - adherence KW - cholinesterase inhibitors KW - memantine Y1 - 2015 U6 - https://doi.org/10.1017/S1041610215000654 SN - 1041-6102 SN - 1741-203X VL - 27 IS - 8 SP - 1335 EP - 1342 PB - Cambridge Univ. Press CY - New York ER -