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Trainee Self-Assessment of Cognitive Behaviour Therapy Competence During and After Training

Research output: Contribution to journalArticle

Original languageEnglish
JournalThe Cognitive Behaviour Therapist
Accepted/In press7 Oct 2019


King's Authors


Large-scale CBT training and implementation programmes, such as the pioneering UK IAPT initiative, aim to develop a workforce of competent therapists who can deliver evidence-based interventions skilfully. Self-awareness of competence enables CBT therapists to accurately evaluate their clinical practice and determine professional development needs. The accuracy of self-assessed competence, however, remains unclear when compared to assessments conducted by markers with expertise in CBT practice and evaluation. This study investigated the relationship between self- and expert-rated competence – assessed via therapy recordings rated on the Cognitive Therapy Scale Revised (CTS-R) – for a large sample of IAPT CBT trainees during training and, for the first time, at post-training follow-up. CBT trainees (n=150) submitted therapy recordings at baseline, mid-training and end-of-training. At 12+ month follow-up, a sub-set of former trainees (n=30) submitted recordings from clinical practice. There were positive relationships (r=.27-.56) between self and expert CTS-R scores at all time points. The proportion of tapes demonstrating significant agreement between self and expert ratings (CTS-R difference <5 points) increased significantly across training and remained stable at follow-up. Findings indicate that accurate self-awareness of competence can be developed during structured CBT training and retained in the workplace. These outcomes are encouraging given the importance of self-awareness to CBT practice and accreditation. Future investigation into the development and maintenance of accurate self-awareness of competence is warranted.

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