The following is a summary of “Quality of cognitive-behavioural therapy in routine psychiatric care: therapist adherence and competence, and patient outcomes for depression and anxiety disorders,” published in the December 2024 issue of Psychiatry by Bergvall et al. 

Quality of care is crucial for implementing evidence-based practices. However, therapist adherence and competence are often overlooked in routine assessments. 

Researchers conducted a retrospective study to examine the quality of cognitive-behavioural therapy (CBT) delivery in routine psychiatric care for depression and anxiety disorders.  

They recruited 29 therapists and 85 patients with depression or anxiety from 2 psychiatric outpatient clinics in Stockholm, Sweden. Therapist adherence was assessed mid-CBT by observers and post-CBT by patients and therapists using a custom instrument. Therapist competence was evaluated through role-plays with a standardized patient. Patients rated symptoms, functional impairment, and global health before and after CBT. Linear mixed models were used to analyze the associations. 

The results showed therapist adherence was high according to patients, moderate to high according to therapists, and moderate according to observers. Most therapists demonstrated competence (M = 40.5, SD = 6.5; 76% passed the ≥36 points threshold). Patients improved significantly from pre- to post-CBT (Cohen’s ds = 0.80–1.36). Neither therapist adherence nor competence was associated with patient outcomes. 

They found that therapists delivered CBT with high adherence and competence, leading to significant patient improvements. The findings aligned with previous research, highlighting the importance of quality assessment and improvement in routine psychiatric care. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-06328-4