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Judging clinical competence using structured observation tools: A cautionary tale.

Anthony D Roth1, Pamela Myles-Hooton2, Amanda Branson2

  • 1Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.

Behavioural and Cognitive Psychotherapy
|April 16, 2019
PubMed
Summary
This summary is machine-generated.

Assessing therapist competence using rating scales showed low inter-rater reliability for both established and new instruments. These findings question the generalizability of reliability figures and raise concerns for clinical competence judgments.

Keywords:
assessmentclinical supervisiontherapist competencetraining

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Area of Science:

  • Psychology
  • Clinical Psychology
  • Psychotherapy Research

Background:

  • Structured assessment tools evaluate psychological therapy competence by rating therapist performance.
  • These tools are crucial for maintaining standards in therapy delivery.

Purpose of the Study:

  • To examine the inter-rater reliability of the Cognitive Therapy Scale - Revised (CTS-R).
  • To assess the inter-rater reliability of a newly developed scale for evaluating competence in Cognitive Behavioral Therapy (CBT).

Main Methods:

  • Six independent, experienced raters evaluated 25 video recordings of CBT therapists in training.
  • Raters were blinded to each other's assessments.

Main Results:

  • Low inter-rater reliability was observed for both the CTS-R and the new CBT competence scale.
  • The results suggest current reliability metrics may not be universally applicable.

Conclusions:

  • The study highlights potential limitations in the accuracy and generalizability of therapy rating scales.
  • Findings raise concerns regarding the use of these scales for summative assessments of clinical competence in educational and research settings.