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) ItemBaselineFollow-up MSDM Theory / Explanation Hierarchy of fear Collaboration (in terms of structure of exposure and avoidance behavior) Implementation of in vitro and in vivo exposure Resources Transition to client-guided exposure Evaluation Transfer of skills Total score

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  Positive balance of 2400 euro  Project extension Type of costAmount Trainer investment500 euro Expenses (travel)100 euro

A CKNOWLEDGEMENT : Ghent University: - Kristof Hoorelbeke Psychopathology and Affective Neuroscience Lab Contact: Peter van den Bilcke & VVGT EABCT!!