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Assessing competence in cognitive–behavioural therapy

Child and Family Mental Health Service, Royal Aberdeen Children’s Hospital, Aberdeen

Mark H. Freeston, PhD

Newcastle Cognitive and Behavioural Therapies Centre, University of Newcastle & University of Durham, UK

Correspondence: Dr Andrew Keen, Child and Family Mental Health Service, Royal Aberdeen Children’s Hospital, Westburn Road, Aberdeen AB25 2ZD. Email: Andrew.Keen{at}ARH.grampian.scot.nhs.uk

Declaration of interest

M.F. is Director of the Diploma in Cognitive Therapy, whose examinations are detailed herein.

Background

Postgraduate courses on cognitive–behavioural therapy (CBT) assess various competencies using essays, case studies and audiotapes or videotapes of clinical work.

Aims

To evaluate how reliably a well-established postgraduate course assesses CBT competencies.

Method

Data were collected on two cohorts of trainees (n=52). Two examiners marked trainees on: (a) two videotapes of clinical practice; (b) two case studies; and (c) three essays.

Results

Essay examinations were more reliable than case studies, which in turn were more reliable than videotaped assessments. The reliability of the latter two assessments was considerably lower than that commonly expected of high-stakes examinations. To assess reliably standard CBT competencies, postgraduate courses would need to examine about 5 essays, 12 case studies and 19 videotapes.

Conclusions

Reliable assessment of standard competencies is complex and resource intensive. There would need to be a marked increase in the number of samples of clinical work assessed to be able to make reliable judgements about proficiency.

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