Towards competence-based CBT workshops
ERNST H.W. KOSTER
GHENT 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
Type of cost
Amount
Trainer investment
500 euro
Expenses (travel)
100 euro

Positive balance of 2400 euro

Project extension
ACKNOWLEDGEMENT:
Ghent University:
-
Kristof Hoorelbeke
EABCT!!
Psychopathology and
Affective Neuroscience
Lab
www.pan.ugent.be
Peter van den Bilcke &
VVGT
Contact:
[email protected]