The Sustained Effects of CBT Training on Therapist Competence and Patient Outcomes

Abstract

The continued effectiveness of in-service psychological therapy training requires evaluation. This study assessed therapist competence and patient clinical outcome during cognitive behaviour therapy training and 12+ months post-training. Trainee competence was assessed using audio-recorded sessions rated on the Cognitive Therapy Scale Revised at the beginning (n = 33) and end of training (n = 45), and at least 12 months post-training (n = 45). Pre-to-posttreatment clinical outcome for trainees’ patients during the course (n = 360) and post-training (n = 360) was evaluated using standardised self-report measures. The relationship between therapist competence and patient outcomes was explored. Trainees achieved competence during training (100%, n = 45) and largely maintained competence post-training (84%, n = 38). Patients demonstrated pre-to-posttreatment effect sizes between 1.38 and 1.89 and reliable improvement exceeding 80% during and after training. Competence was not significantly associated with patient outcome. Trainees predominantly maintained competence and achieved good clinical outcomes post-training. Structured training and continued use of regular supervision possibly supported retention of competence.