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      Development and Initial Psychometrics for a Therapist Competence Instrument for CBT for Youth Anxiety

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          Abstract

          Objective:

          Therapistcompetence is an important component of treatment integrity. This paper reports on the development and initial psychometric assessment of the Cognitive-Behavioral Treatment for Anxiety in Youth Competence Scale (CBAY-C), an observational instrumentdesigned to capture therapist limited-domain competence (i.e., competence in the delivery of core interventions and delivery methods found in a specific psychosocialtreatment program) in the delivery of the core practice elements in individual cognitive-behavioral treatment (ICBT) for youth anxiety.

          Method:

          Treatment sessions (N = 744) from 68 youth participants (M age = 10.60 years, SD = 2.03; 82.3% Caucasian; 52.9% male) of the same ICBT program for youth anxiety from (a) an efficacy study and (b) an effectiveness study were independently scored by four coders using observational instruments designed to assess therapist competence, treatment adherence, treatment differentiation, alliance, and client involvement.

          Results:

          Inter-rater reliability (intraclass correlation coefficients, ICC(2,2)) for the item scores averaged 0.69 ( SD = 0.11). The CBAY-C item, scale, and subscale (Skills, Exposure) scores showed evidence of validity via associations with observational instruments of treatment adherence to ICBT for youth anxiety, theory-based domains (CBT, psychodynamic, family, client-centered), alliance, and client involvement. Importantly, although the CBAY-Cscale, subscale, and item scores did overlap with a corresponding observational treatment adherence instrument independently rated by coders,the degree of overlap was moderate, indicating that theCBAY-C assessesa distinct component of treatment integrity.

          Conclusions:

          Applications of the instrument and future research directions discussed include the measurement of treatment integrity and testing integrity-outcome relations.

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          Author and article information

          Contributors
          Journal
          101133858
          29668
          J Clin Child Adolesc Psychol
          J Clin Child Adolesc Psychol
          Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
          1537-4416
          1537-4424
          27 July 2018
          08 December 2016
          Jan-Feb 2018
          28 August 2018
          : 47
          : 1
          : 47-60
          Affiliations
          Virginia Commonwealth University, Department of Psychology, 806 W Franklin St PO Box 842018, Richmond, VA 23284-2018
          Department of Psychology, Temple University, Philadelphia, PA
          Harvard University, Department of Psychology Cambridge, MA 02138
          Author notes
          Correspondence concerning this article should be addressed to Bryce D. McLeod, Department of Psychology, Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, Virginia 23284-2018. Electronic mail may be sent via Internet to bmcleod@ 123456vcu.edu .
          Article
          PMC6112610 PMC6112610 6112610 nihpa1500656
          10.1080/15374416.2016.1253018
          6112610
          27929671
          Categories
          Article

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