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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.
While metacognitive interventions are gaining attention in the treatment of various mental disorders, a review of the literature showed that the term is often defined poorly and used for a variety of psychotherapeutic approaches that do not necessarily pursue the same goal. We give a summary of three metacognitive interventions which were developed within a sound theoretical framework-metacognitive therapy, metacognitive training, and metacognitively-oriented integrative psychotherapies-and discuss their similarities and distinctive features. We then offer an integrative operational definition of metacognitive interventions as goal-oriented treatments that target metacognitive content, which is characterized by the awareness and understanding of one's own thoughts and feelings as well as the thoughts and feelings of others. They aim to alleviate disorder-specific and individual symptoms by gaining more flexibility in cognitive processing.