Assessing intervention competence and its relation to therapy outcome: A selected review derived from the outcome literature.

Abstract

The assessment of intervention competence possesses an obvious relevance for practitioners and clinical scientists alike. It is often assessed as part of the evaluation of treatment integrity in clinical research in general, and in randomized clinical trials (RCTs) in particular. The authors first attempt to add clarity to the concept and better differentiate intervention competence from closely related constructs. Next, the authors review and evaluate the main measures of therapist competence used in RCTs, relying on this conceptual foundation to provide suggestions for future measures. The empirical literature on the relation between therapist competence and clinical outcome is then reviewed. The relation, while positive, is weaker than expected, and factors having a potential bearing on this are discussed. The authors then recommend that new measures be created and that the assessment of limited-domain competence be supplemented by explorations of global competence. Due to the potential ramifications for the field, the authors also recommend that caution be exercised in the task of operationally defining competence.

Development and Validation of the Mindfulness-Based Interventions – Teaching Assessment Criteria (MBI:TAC)

“…However, experienced mindfulnessbased teachers will vary in their views regarding which specific teaching strategy represents the best option in the moment. There are no data in this, or related fields, to suggest which moment-to-moment intervention is associated with participant outcome (Barber et al, 2007). The MBI:TAC does, however, aim to allow for a range of teaching styles because there is no empirical evidence to favor one style over another.…”

Implementation Integrity of Practice-Based Coaching: Preliminary Results from the BEST in CLASS Efficacy Trial

“…Data from the current study suggest that teacher competence of delivery of BEST in CLASS practices did improve in BEST in CLASS classrooms at posttest, representing an important aspect of integrity which appears to be amenable to improvement through methods such as coaching. Whereas treatment adherence focuses on whether, and how much, a teacher delivers specific practices, competence assesses whether a teacher knows when and how to deliver an intervention for maximum impact (Barber, Sharpless, Klostermann, & McCarthy, 2007). Therefore, the competent delivery of BEST in CLASS practices requires a teacher to adapt specific components to meet the unique characteristics of the classroom and the individual child.…”

Expert Insight into the Assessment of Competence in Cognitive–Behavioural Therapy: A Qualitative Exploration of Experts' Experiences, Opinions and Recommendations

“…In line with the concept of 'limited-domain intervention competence' (Barber et al, 2007;Kaslow, 2004), participants focused on therapists' ability to appropriately, effectively and skilfully deliver evidence-based CBT treatments. Hence, broader aspects of CBT competence (e.g., use of supervision and ethical practice) were typically not assessed.…”

“…Cognitive-behavioural therapy (CBT) intervention competence can be defined as the degree to which a therapist demonstrates the general therapeutic and treatmentspecific knowledge and skills required to appropriately deliver CBT interventions that reflect the current evidence base for treatment of the patient's presenting problem (Barber, Sharpless, Klostermann & McCarthy, 2007;Kaslow, 2004). Roth and Pilling (2007) provide a comprehensive framework outlining the key competences required to deliver effective CBT.…”