Assessing treatment integrity in personalized CBT: the inventory of therapeutic interventions and skills

The third wave of cognitive behavioral therapy (CBT) has increased the heterogeneity of today's CBT practice, while developments in patient-focused research are paving the road to the empirical personalization of CBT. This paper presents the development and psychometric properties of a therapy...

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Bibliographic Details
Published in:Cognitive behaviour therapy 2020-05, Vol.49 (3), p.210-227
Main Authors: Boyle, Kaitlyn, Deisenhofer, Anne-Katharina, Rubel, Julian A., Bennemann, Björn, Weinmann-Lutz, Birgit, Lutz, Wolfgang
Format: Article
Language:English
Subjects:
adherence
Adult
Clinical Competence - statistics & numerical data
cognitive behavioral therapy
Cognitive Behavioral Therapy - standards
Cognitive therapy
competence
Female
Guideline Adherence - statistics & numerical data
Humans
Male
Practice Guidelines as Topic
Precision Medicine - standards
Psychometrics - statistics & numerical data
Treatment integrity
video ratings
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Summary:The third wave of cognitive behavioral therapy (CBT) has increased the heterogeneity of today's CBT practice, while developments in patient-focused research are paving the road to the empirical personalization of CBT. This paper presents the development and psychometric properties of a therapy video rating instrument, which was designed to adequately assess the treatment integrity (adherence and competence) of modern, personalized CBT. The Inventory of Therapeutic Interventions and Skills (ITIS) was developed based on two existing CBT adherence and competence scales and augmented with third wave content and overarching therapeutic strategies. The instrument was then applied by graduate students and post-graduate clinicians to rate N = 185 therapy videos from N = 70 patients treated at a university outpatient clinic. Descriptive results, inter-rater reliability, item structure, and associations with session outcome and alliance were examined. Average inter-rater reliability was excellent for Interventions items and good for Skills items. Intercorrelations were low between Interventions items, but higher and significant between Skills items, which loaded on a single factor. Several ITIS items were shown to be predictive of session outcome and alliance, even after controlling for the nested data structure. Implications of these results for future research and clinical training are discussed.
ISSN:1650-6073
1651-2316
DOI:10.1080/16506073.2019.1625945