Concordance between clinician, supervisor and observer ratings of therapeutic competence in CBT and treatment as usual: does clinician competence or supervisor session observation improve agreement?
Lowering the cost of assessing clinicians' competence could promote the scalability of evidence-based treatments such as cognitive behavioral therapy (CBT). This study examined the concordance between clinicians', supervisors' and independent observers' session-specific ratings o...
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| Veröffentlicht in: | Behavioural and cognitive psychotherapy 2020-05, Vol.48 (3), p.350-363 |
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| container_title | Behavioural and cognitive psychotherapy |
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| creator | Caron, E B Muggeo, Michela A Souer, Heather R Pella, Jeffrey E Ginsburg, Golda S |
| description | Lowering the cost of assessing clinicians' competence could promote the scalability of evidence-based treatments such as cognitive behavioral therapy (CBT).
This study examined the concordance between clinicians', supervisors' and independent observers' session-specific ratings of clinician competence in school-based CBT and treatment as usual (TAU). It also investigated the association between clinician competence and supervisory session observation and rater agreement.
Fifty-nine school-based clinicians (90% female, 73% Caucasian) were randomly assigned to implement TAU or modular CBT for youth anxiety. Clinicians rated their confidence after each therapy session (n = 1898), and supervisors rated clinicians' competence after each supervision session (n = 613). Independent observers rated clinicians' competence from audio recordings (n = 395).
Patterns of rater discrepancies differed between the TAU and CBT groups. Correlations with independent raters were low across groups. Clinician competence and session observation were associated with higher agreement among TAU, but not CBT, supervisors and clinicians.
These results support the gold standard practice of obtaining independent ratings of adherence and competence in implementation contexts. Further development of measures and/or rater training methods for clinicians and supervisors is needed. |
| doi_str_mv | 10.1017/S1352465819000699 |
| format | Article |
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This study examined the concordance between clinicians', supervisors' and independent observers' session-specific ratings of clinician competence in school-based CBT and treatment as usual (TAU). It also investigated the association between clinician competence and supervisory session observation and rater agreement.
Fifty-nine school-based clinicians (90% female, 73% Caucasian) were randomly assigned to implement TAU or modular CBT for youth anxiety. Clinicians rated their confidence after each therapy session (n = 1898), and supervisors rated clinicians' competence after each supervision session (n = 613). Independent observers rated clinicians' competence from audio recordings (n = 395).
Patterns of rater discrepancies differed between the TAU and CBT groups. Correlations with independent raters were low across groups. Clinician competence and session observation were associated with higher agreement among TAU, but not CBT, supervisors and clinicians.
These results support the gold standard practice of obtaining independent ratings of adherence and competence in implementation contexts. Further development of measures and/or rater training methods for clinicians and supervisors is needed.</description><identifier>ISSN: 1352-4658</identifier><identifier>EISSN: 1469-1833</identifier><identifier>DOI: 10.1017/S1352465819000699</identifier><identifier>PMID: 31806076</identifier><language>eng</language><publisher>United States: Cambridge University Press</publisher><subject>Accuracy ; Adolescent ; African Americans ; Agreements ; Anxiety Disorders ; Clinical Competence ; Cognitive ability ; Cognitive Behavioral Therapy ; Cognitive therapy ; Demographics ; Female ; Females ; Humans ; Hypotheses ; Male ; Mental disorders ; Observer Variation ; Pediatrics ; Psychologists ; Psychotherapy ; Ratings & rankings ; Students ; Studies ; Supervision ; Supervisors</subject><ispartof>Behavioural and cognitive psychotherapy, 2020-05, Vol.48 (3), p.350-363</ispartof><rights>British Association for Behavioural and Cognitive Psychotherapies 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-bd6df8690263b1c3933eb3eb53d7742de404c8ee2432ccc2b4ca33530e2228763</citedby><cites>FETCH-LOGICAL-c329t-bd6df8690263b1c3933eb3eb53d7742de404c8ee2432ccc2b4ca33530e2228763</cites><orcidid>0000-0002-3717-2979</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31806076$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Caron, E B</creatorcontrib><creatorcontrib>Muggeo, Michela A</creatorcontrib><creatorcontrib>Souer, Heather R</creatorcontrib><creatorcontrib>Pella, Jeffrey E</creatorcontrib><creatorcontrib>Ginsburg, Golda S</creatorcontrib><title>Concordance between clinician, supervisor and observer ratings of therapeutic competence in CBT and treatment as usual: does clinician competence or supervisor session observation improve agreement?</title><title>Behavioural and cognitive psychotherapy</title><addtitle>Behav Cogn Psychother</addtitle><description>Lowering the cost of assessing clinicians' competence could promote the scalability of evidence-based treatments such as cognitive behavioral therapy (CBT).
This study examined the concordance between clinicians', supervisors' and independent observers' session-specific ratings of clinician competence in school-based CBT and treatment as usual (TAU). It also investigated the association between clinician competence and supervisory session observation and rater agreement.
Fifty-nine school-based clinicians (90% female, 73% Caucasian) were randomly assigned to implement TAU or modular CBT for youth anxiety. Clinicians rated their confidence after each therapy session (n = 1898), and supervisors rated clinicians' competence after each supervision session (n = 613). Independent observers rated clinicians' competence from audio recordings (n = 395).
Patterns of rater discrepancies differed between the TAU and CBT groups. Correlations with independent raters were low across groups. Clinician competence and session observation were associated with higher agreement among TAU, but not CBT, supervisors and clinicians.
These results support the gold standard practice of obtaining independent ratings of adherence and competence in implementation contexts. Further development of measures and/or rater training methods for clinicians and supervisors is needed.</description><subject>Accuracy</subject><subject>Adolescent</subject><subject>African Americans</subject><subject>Agreements</subject><subject>Anxiety Disorders</subject><subject>Clinical Competence</subject><subject>Cognitive ability</subject><subject>Cognitive Behavioral Therapy</subject><subject>Cognitive therapy</subject><subject>Demographics</subject><subject>Female</subject><subject>Females</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Male</subject><subject>Mental disorders</subject><subject>Observer Variation</subject><subject>Pediatrics</subject><subject>Psychologists</subject><subject>Psychotherapy</subject><subject>Ratings & rankings</subject><subject>Students</subject><subject>Studies</subject><subject>Supervision</subject><subject>Supervisors</subject><issn>1352-4658</issn><issn>1469-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNplkd2K1jAQhoMo7o9egCcS8MQDq0kmTVtPRD_WH1jwwPW4pOl8a5Y2qZl0xRv0ukzdT10UAplhnvd9B4axR1I8l0I2Lz5JqJU2dSs7IYTpujvsWGrTVbIFuFvqMq62-RE7IboSQkKh7rMjkK0wojHH7McuBhfTaINDPmD-hhi4m3zwztvwjNO6YLr2FBO3YeRxoNJi4slmHy6Jxz3PXzDZBdfsHXdxXjDjZuYD3725-KXKCW2eMWRuia-02uklHyPS36DbwhJ1K5WQyMdwSC6ppfbzkuI1cnuZEDffVw_Yvb2dCB8e_lP2-e3Zxe59df7x3Yfd6_PKgepyNYxm3LemE8rAIB10ADiUV8PYNFqNqIV2LaLSoJxzatDOAtQgUCnVNgZO2dMb37LA1xUp97Mnh9NkA8aVegVKNVq2ui3ok3_Qq7imULYrVAe1qetmo-QN5VIkSrjvl-Rnm773UvTbkfv_jlw0jw_O6zDj-Efx-6rwE1brppY</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Caron, E B</creator><creator>Muggeo, Michela A</creator><creator>Souer, Heather R</creator><creator>Pella, Jeffrey E</creator><creator>Ginsburg, Golda S</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3717-2979</orcidid></search><sort><creationdate>20200501</creationdate><title>Concordance between clinician, supervisor and observer ratings of therapeutic competence in CBT and treatment as usual: does clinician competence or supervisor session observation improve agreement?</title><author>Caron, E B ; Muggeo, Michela A ; Souer, Heather R ; Pella, Jeffrey E ; Ginsburg, Golda S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-bd6df8690263b1c3933eb3eb53d7742de404c8ee2432ccc2b4ca33530e2228763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Accuracy</topic><topic>Adolescent</topic><topic>African Americans</topic><topic>Agreements</topic><topic>Anxiety Disorders</topic><topic>Clinical Competence</topic><topic>Cognitive ability</topic><topic>Cognitive Behavioral Therapy</topic><topic>Cognitive therapy</topic><topic>Demographics</topic><topic>Female</topic><topic>Females</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Male</topic><topic>Mental disorders</topic><topic>Observer Variation</topic><topic>Pediatrics</topic><topic>Psychologists</topic><topic>Psychotherapy</topic><topic>Ratings & rankings</topic><topic>Students</topic><topic>Studies</topic><topic>Supervision</topic><topic>Supervisors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Caron, E B</creatorcontrib><creatorcontrib>Muggeo, Michela A</creatorcontrib><creatorcontrib>Souer, Heather R</creatorcontrib><creatorcontrib>Pella, Jeffrey E</creatorcontrib><creatorcontrib>Ginsburg, Golda S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Behavioural and cognitive psychotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Caron, E B</au><au>Muggeo, Michela A</au><au>Souer, Heather R</au><au>Pella, Jeffrey E</au><au>Ginsburg, Golda S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Concordance between clinician, supervisor and observer ratings of therapeutic competence in CBT and treatment as usual: does clinician competence or supervisor session observation improve agreement?</atitle><jtitle>Behavioural and cognitive psychotherapy</jtitle><addtitle>Behav Cogn Psychother</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>48</volume><issue>3</issue><spage>350</spage><epage>363</epage><pages>350-363</pages><issn>1352-4658</issn><eissn>1469-1833</eissn><abstract>Lowering the cost of assessing clinicians' competence could promote the scalability of evidence-based treatments such as cognitive behavioral therapy (CBT).
This study examined the concordance between clinicians', supervisors' and independent observers' session-specific ratings of clinician competence in school-based CBT and treatment as usual (TAU). It also investigated the association between clinician competence and supervisory session observation and rater agreement.
Fifty-nine school-based clinicians (90% female, 73% Caucasian) were randomly assigned to implement TAU or modular CBT for youth anxiety. Clinicians rated their confidence after each therapy session (n = 1898), and supervisors rated clinicians' competence after each supervision session (n = 613). Independent observers rated clinicians' competence from audio recordings (n = 395).
Patterns of rater discrepancies differed between the TAU and CBT groups. Correlations with independent raters were low across groups. Clinician competence and session observation were associated with higher agreement among TAU, but not CBT, supervisors and clinicians.
These results support the gold standard practice of obtaining independent ratings of adherence and competence in implementation contexts. Further development of measures and/or rater training methods for clinicians and supervisors is needed.</abstract><cop>United States</cop><pub>Cambridge University Press</pub><pmid>31806076</pmid><doi>10.1017/S1352465819000699</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-3717-2979</orcidid></addata></record> |
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| ispartof | Behavioural and cognitive psychotherapy, 2020-05, Vol.48 (3), p.350-363 |
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| source | MEDLINE; Cambridge Journals |
| subjects | Accuracy Adolescent African Americans Agreements Anxiety Disorders Clinical Competence Cognitive ability Cognitive Behavioral Therapy Cognitive therapy Demographics Female Females Humans Hypotheses Male Mental disorders Observer Variation Pediatrics Psychologists Psychotherapy Ratings & rankings Students Studies Supervision Supervisors |
| title | Concordance between clinician, supervisor and observer ratings of therapeutic competence in CBT and treatment as usual: does clinician competence or supervisor session observation improve agreement? |
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