Towards competence-based CBT workshops

ERNST H.W. KOSTERGHENT UNIVERSITY

12/09/2014

Recurrent depression

Increasing interest in training competence in CBT

Empirical data suggesting that therapist competence in delivering CBT is associated with the outcome of CBT (e.g., Ginzburg et al., 2012).

Only limited focus on competence is CBT workshops

Little attention to the individual starting knowledge

Workshops focused on information transmission

No assessment of competence after training

The idea and design

Pilot study on Modifying workshops to include:

(1) Competence-based learning objectives

(2) A more specified focus on skill-acquisition during the workshops

(3) A brief assessment of competence after the workshop

Pilot: Workshop on exposure

Key element in many of our treatments

Existing ideas on what constitutes competent exposure (Centre of outcome research and effectiveness)

Two different workshop dates

The idea and design

Together with the trainer the content of the workshop was adjusted based on the different criteria of competence

Participants were administered a questionnaire about their exposure skills pre-workshop in order to be able to adjust the content

8 week follow-up we re-administered the questionnaire on competence online

Offered therapist the possibility to record an exposure session to receive feedback (taking into account confidentiality/ technical issues, etc)

The idea and design

Exposure competence ratings over time (Likert scale 1 – 7; n = 6)

Item Baseline Follow-up

  M SD M SD

Theory / Explanation 5.50 0.84 6.00 0.63

Hierarchy of fear 5.33 0.82 6.17 0.75

Collaboration (in terms of structure of exposure and avoidance behavior)

4.83 1.17 5.67 1.03

Implementation of in vitro and in vivo exposure

4.67 1.51 5.67 0.52

Resources 4.83 1.17 5.67 1.03

Transition to client-guided exposure 4.83 1.47 5.83 1.17

Evaluation 4.83 1.17 6.00 0.89

Transfer of skills 4.67 1.03 5.83 1.17

Total score 39.50 8.69 46.83 6.59

The data

Despite reminders none of the therapist recorded an exposure session!

Why?

Time investment (but…)

Technical difficulties

Doubts and worries

No incentive (well…)

…

Final thoughts

Interesting pilot

Diagnostic value: Readiness to Focus on Competence

Barriers for implementation

Future:

Change current mentality in Therapists (bottom-up)

Try to get Mental Health Centers on board (top-down)

Make competence based assessment compulsory within workshops

Basically:

Costs

Amount awarded: 3000 euro

Positive balance of 2400 euro

Project extension

Type of cost Amount

Trainer investment 500 euro

Expenses (travel) 100 euro

ACKNOWLEDGEMENT:

Ghent University:- Kristof Hoorelbeke

Psychopathology and Affective Neuroscience Labwww.pan.ugent.be

Contact:Ernst.Koster@UGent.be

Peter van den Bilcke & VVGT

EABCT!!