Observational studyBMC psychiatry2024
Quality of cognitive-behavioural therapy in routine psychiatric care: therapist adherence and competence, and patient outcomes for depression and anxiety disorders.
Observational study in BMC psychiatry, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03625024 (Quality Assurance of Cognitive-behavioral Therapy), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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.
Quality Assurance of Cognitive-behavioral Therapy: Adherence and Competence in Therapists and Treatment Outcome in Patients With Depression and Anxiety
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Psychiatric Association of Türkiye Mood Disorders Section Depression Treatment Guideline - III: Treatment Approach for Depression Subtypes and Special Groups, Psychotherapies, and Psychosocial Interventions.Turk psikiyatri dergisi = Turkish journal of psychiatry · 2026Guideline
- Transdiagnostic Internet-delivered intervention for children and adolescents with anxiety and depressive disorders: a randomized controlled trial.NPJ digital medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundQuality of care is essential for the dissemination of evidence-based practices, yet therapist adherence and competence are seldom assessed. We examined the quality of delivery of cognitive-behavioural therapy (CBT) in routine psychiatric care for depression and anxiety disorders, considering therapist adherence and competence, and therapy effectiveness, as well as their associations.
methodsTwenty-nine therapists recruited 85 patients with a principal diagnosis of depression or anxiety disorder from two routine psychiatric outpatient clinics in Stockholm, Sweden. Therapist adherence was assessed mid-CBT by observers and post-CBT by patients and therapists, respectively, using an instrument developed as part of the present study. Therapist competence was assessed using role-plays with a standardised patient. Patients rated symptoms, functional impairment, and global health pre- and post-CBT. Linear mixed models were used to analyse associations.
resultsTherapist adherence was high according to patients, moderate to high according to therapists, and moderate according to observers. Most therapists demonstrated competence in CBT, as assessed using the Cognitive Therapy Scale-Revised (M = 40.5, SD = 6.5; 76% passed the ≥ 36 points competence threshold). Patients improved significantly from pre- to post-CBT across outcome measures (Cohen's ds = 0.80 - 1.36). Neither therapist adherence nor competence was associated with patient outcomes.
conclusionsIn routine psychiatric care, therapists delivered CBT with adherence, competence, and improvements for patients with depression and anxiety disorders, on par with previous research results in controlled settings. The implications for quality assessment and improvement are discussed.
trial registrationClinicalTrials.gov NCT03625024 10/08/2018.
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