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Journal Article

Citation

Hildebrand-Burke C, Davey C, Gwini SM, Catania L, Kazantzis N. Psychother. Res. 2024; 34(1): 41-53.

Copyright

(Copyright © 2024, Society for Psychotherapy Research, Publisher Informa - Taylor and Francis Group)

DOI

10.1080/10503307.2023.2267166

PMID

37963351

Abstract

OBJECTIVE: Prior studies of Cognitive Behavioral Therapy (CBT) have focused on the quantity and quality of clients' homework completion and only rarely have considered the role of therapist competence.
METHODS: The present study examined (a) therapist competence across the entire process of integrating homework into CBT, including the review, design, and planning of tasks; (b) homework engagement, including client appraisals of the difficulty and obstacles encountered in task completion using the Homework Rating Scale - Revised (HRS-II); (c) pre-post symptom reduction as the index of outcome; and (d) considered client factors such as suicide risk in a community-based trial for adolescent depression. Trained independent observers assessed therapist competence and engagement with homework at two consecutive sessions of CBT for N = 80 young people (Mage = 19.61, SD = 2.60).
RESULTS: Significant complementary mediation effects were obtained; there was an indirect mediation effect of HRS-II Beliefs (b = 1.03, SE B = 0.42, 95% BCa CI [0.35, 2.03]) and HRS-II Perceived Consequences on the Competence-Engagement relationship (b = 0.85, SE B = 0.31, 95% BCa CI [0.39, 1.61]). High levels of suicidal ideation were also shown to moderate this relationship.
CONCLUSIONS: The present findings contribute to the growing body of CBT process research designed to examine the complex interrelationships of client and therapist variables, in a manner that reflects the actual process of therapy, and advances beyond studies of isolated predictors of symptom change.


Language: en

Keywords

Adolescent; Adult; Cognitive Behavioral Therapy; Depression; homework; Humans; Suicidal Ideation; therapist competence; Treatment Outcome; Young Adult

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