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Published on: June 12, 2020
Variability in clinician intentions to implement specific cognitive-behavioral therapy components
Courtney Benjamin Wolk1,2, Emily M Becker-Haimes3,4, Jessica Fishman3,5,6
1Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA. cbenja@upenn.edu.
Background:
CBT comprises many discrete components that vary in complexity, but implementation and training efforts often approach CBT as a single entity. We examined variability in clinician intentions to use different structural and interventional components of CBT for three different clinical groups: clients receiving CBT, clients with depression, and clients with anxiety.
Methods:
Clinicians (n = 107) trained in CBT completed a one-time electronic survey. Clinicians' intentions were measured using established item stems from social psychology adapted to examine intentions to use six specific CBT components: exposure therapy, cognitive restructuring, behavioral activation, planning homework, reviewing homework, and agenda-setting.
Results:
Intentions were weakest, on average, for exposure. They were strongest, on average, for reviewing homework. A series of ANOVAs with Tukey's post-hoc tests revealed that participants intended to use exposure with clients receiving CBT (p = .015) and clients with anxiety (p < .001) significantly more than for clients with depression. Participants intended to use behavioral activation with clients with depression (p = .01) significantly more than for clients with anxiety. No other intentions to use CBT components differed among these three clinical populations.
Conclusions:
When studying determinants of CBT use and designing interventions to increase use, implementers should consider that different CBT components may require different implementation strategies.
Trial Registration:
Not applicable.
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