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Practitioner competence and clinical outcomes during cognitive behavioural and cognitive-analytic guided self-help for anxiety

Part of: Low Intensity CBT

Published online by Cambridge University Press:  04 December 2024

Niall Power Open the ORCID record for Niall Power [Opens in a new window] ,
Melanie Simmonds-Buckley ,
Jaime Delgadillo ,
Jessica Smithies ,
Charlotte Bee  and
Stephen Kellett
Niall Power*
Affiliation:
Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK South West Yorkshire Partnership NHS Foundation Trust, UK
Melanie Simmonds-Buckley
Affiliation:
Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK Rotherham Doncaster and South Humber NHS Foundation Trust, UK
Jaime Delgadillo
Affiliation:
Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK Rotherham Doncaster and South Humber NHS Foundation Trust, UK
Jessica Smithies
Affiliation:
Pennine Care NHS Foundation Trust, UK
Charlotte Bee
Affiliation:
Pennine Care NHS Foundation Trust, UK
Stephen Kellett
Affiliation:
Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK Rotherham Doncaster and South Humber NHS Foundation Trust, UK
*
Corresponding author: Niall Power; Email: [email protected]
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Abstract

Despite the ubiquity of guided self-help (GSH) interventions in Primary Care psychological services, there have been no previous studies of the relationship between the competence of qualified practitioners and treatment outcomes. This study compared competence-outcome associations in two types of GSH. Competence and clinical outcome measures were drawn from a clinical trial comparing the efficacy of two types of GSH for anxiety disorders, based on cognitive behaviour therapy (CBT-GSH) or cognitive analytic therapy (CAT-GSH). These interventions were delivered over the telephone by qualified and supervised practitioners. Audio-recordings of GSH sessions (n=94) were rated using a validated competence measure. Clinical outcomes were anxiety, depression and functioning. Secondary outcomes were attendance and need for further intervention after GSH. Competence ratings were highly reliable. No significant associations were found between competence and clinical outcomes, treatment engagement or need for further intervention. In this clinical trial, GSH competence ratings were not associated with clinical outcomes. Directions for future competence-outcome research are provided for GSH interventions.

    Key learning aims

  1. (1) Become familiar with the current empirical literature on therapist competence and associations with clinical outcome.

  2. (2) Raise awareness of a recently developed alternative form of guided self-help based on the theory and principles of cognitive analytic therapy.

  3. (3) Enhance understanding of the relationship between practitioner competence and clinical outcome in guided self-help for anxiety disorders.

Keywords

adherencecompetenceguided self-helpprocess-outcome
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 17 , 2024 , e40
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Kellett, S., Bee, C., Smithies, J., Aadahl, V., Simmonds-Buckley, M., Power, N., … & Delgadillo, J. (2023). Cognitive-behavioural versus cognitive-analytic guided self-help for mild-to-moderate anxiety: a pragmatic, randomised patient preference trial. British Journal of Psychiatry, 1–8. https://doi.org/10.1192/bjp.2023.78 Google ScholarPubMed

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