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Effects of competence feedback on therapist competence and patient outcome
- 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) andObjective: 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.…
Author details: | Florian WeckORCiDGND, Yvonne Marie JungaORCiDGND, Reinhold KlieglORCiDGND, Daniela Hahn, Katharina Brucker, Michael Witthöft |
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DOI: | https://doi.org/10.1037/ccp0000686 |
ISSN: | 0022-006X |
ISSN: | 1939-2117 |
Pubmed ID: | https://pubmed.ncbi.nlm.nih.gov/34881909 |
Title of parent work (English): | Journal of consulting and clinical psychology |
Subtitle (English): | a randomized controlled trial |
Publisher: | American Psychological Association |
Place of publishing: | Washington |
Publication type: | Article |
Language: | English |
Date of first publication: | 2021/11/01 |
Publication year: | 2021 |
Release date: | 2023/10/02 |
Tag: | competencies; feedback; major depression; outcome; therapeutic; therapeutic alliance |
Volume: | 89 |
Issue: | 11 |
Number of pages: | 13 |
First page: | 885 |
Last Page: | 897 |
Funding institution: | German Research FoundationGerman Research Foundation (DFG) [WE 4654/7] |
Organizational units: | Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Sport- und Gesundheitswissenschaften |
Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Psychologie | |
DDC classification: | 1 Philosophie und Psychologie / 15 Psychologie / 150 Psychologie |
Peer review: | Referiert |