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

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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 (nthinspace=thinspace33) and end of training (nthinspace=thinspace45), and at least 12 months post-training (nthinspace=thinspace45). Pre-to-posttreatment clinical outcome for trainees' patients during the course (nthinspace=thinspace360) and post-training (nthinspace=thinspace360) was evaluated using standardised self-report measures. The relationship between therapist competence and patient outcomes was explored. Trainees achieved competence during training (100%, nthinspace=thinspace45) and largely maintained competence post-training (84%, nthinspace=thinspace38). 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.
Original languageEnglish
Pages (from-to)631-641
Number of pages11
JournalCognitive Therapy and Research
Issue number3
Early online date12 Dec 2018
Publication statusPublished - 15 Jun 2019


  • Cognitive behavioural therapy (CBT)
  • Competence
  • Follow-up
  • IAPT
  • Patient outcomes
  • Supervision


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