ArticleBehavior therapy2020
The Structure of Competence: Evaluating the Factor Structure of the Cognitive Therapy Rating Scale.
Article in Behavior therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed.
- A cognitive layer architecture to support large-language model performance in psychotherapy interactions.Nature medicine · 2026Trial
- A culturally adapted manual-assisted problem-solving intervention (CMAP) for adults with a history of self-harm: a multi-centre randomised controlled trial.BMC medicine · 2023Trial
- Cognitive behavioural therapy for older adults with depressive symptoms living in residential aged care: A pilot study of a systemic treatment model.Psychology and psychotherapy · 2026Article
- Cognitive behavioral therapy for bipolar disorder: patient-level participation barriers and ketogenic metabolic therapy as a candidate adjunct.Frontiers in psychology · 2026Review
- Predictors of skill trajectories in the implementation of cognitive behavioral therapy.Implementation science communications · 2025Article
- Behavioral Nudges to Enhance Fidelity in Telehealth Sessions (BENEFITS): Protocol for Developing and Pilot Testing a Telehealth Tool to Improve Cognitive Behavioral Therapy Implementation.JMIR research protocols · 2025Article
- Automating the assessment of multicultural orientation through machine learning and natural language processing.Psychotherapy (Chicago, Ill.) · 2025Article
- A comparison of scalable routine clinical materials and observer ratings to assess CBT fidelity.Behaviour research and therapy · 2025Observational
- Mental Health Counseling From Conversational Content With Transformer-Based Machine Learning.JAMA network open · 2024Article
- Enhancing the quality of cognitive behavioral therapy in community mental health through artificial intelligence generated fidelity feedback (Project AFFECT): a study protocol.BMC health services research · 2022Article
- Linking organizational climate for evidence-based practice implementation to observed clinician behavior in patient encounters: a lagged analysis.Implementation science communications · 2022Article
- Knowledge and Attitudes Toward an Artificial Intelligence-Based Fidelity Measurement in Community Cognitive Behavioral Therapy Supervision.Administration and policy in mental health · 2022Article
- A new short version of the Cognitive Therapy Scale Revised (CTSR-4): preliminary psychometric evaluation.BMC psychology · 2022Article
- The concise measurement of clinical communication skills: Validation of a short scale.Frontiers in psychiatry · 2022Article
- Assessing Causal Pathways and Targets of Implementation Variability for EBP use (Project ACTIVE): a study protocol.Implementation science communications · 2021Article
- Changes in Community Clinicians' Attitudes and Competence following a Transdiagnostic Cognitive Behavioral Therapy Training.Implementation research and practice · 2021Article
- Psychometric Properties of the Norwegian Version of the Cognitive Therapy Adherence and Competence Scale (CTACS) and Its Associations With Outcomes Following Treatment in IAPT Norway.Frontiers in psychology · 2021Article
- Machine learning and natural language processing in psychotherapy research: Alliance as example use case.Journal of counseling psychology · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
The Cognitive Therapy Rating Scale (CTRS) is an observer-rated measure of cognitive behavioral therapy (CBT) treatment fidelity. Although widely used, the factor structure and psychometric properties of the CTRS are not well established. Evaluating the factorial validity of the CTRS may increase its utility for training and fidelity monitoring in clinical practice and research. The current study used multilevel exploratory factor analysis to examine the factor structure of the CTRS in a large sample of therapists (n = 413) and observations (n = 1,264) from community-based CBT training. Examination of model fit and factor loadings suggested that three within-therapist factors and one between-therapist factor provided adequate fit and the most parsimonious and interpretable factor structure. The three within-therapist factors included items related to (a) session structure, (b) CBT-specific skills and techniques, and (c) therapeutic relationship skills, although three items showed some evidence of cross-loading. All items showed moderate to high loadings on the single between-therapist factor. Results support continued use of the CTRS and suggest factors that may be a relevant focus for therapists, trainers, and researchers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.