Category: Child / Adolescent - Anxiety
The measurement of competence, characterized by a therapist’s responsiveness and skillfulness in delivering an intervention, is an important component of treatment integrity research. The Cognitive-Behavioral Treatment for Anxiety in Youth Competence Scale (CBAY-C) is an observational instrument developed to assess competence of the delivery of individual cognitive-behavioral therapy (ICBT) for youth anxiety. The original CBAY-C items showed promising score reliability and validity. Recently, there has been a shift toward modularized approaches to treatment wherein practice elements are used to treat youth problems, such as anxiety, depression, and disruptive behavior problems. The CBAY-C was thus adapted to capture therapist competence for practice elements for anxiety, depression, and disruptive behavior problems. This study aims to replicate previous reliability and validity findings of the CBAY-C with the 10 new items that cover depression and disruptive behavior problems. Specifically, the adapted CBAY-C was used to assess therapist competence in a trial that investigated the effectiveness of Standard Modularized Treatment (SMT), Modular MATCH Treatment (MMT), and usual care (UC) in community settings.
This study was conducted with a sample of 796 recordings from 38 youth with anxiety disorders who were treated by 26 therapists. Recordings were independently scored by coders using observational instruments designed to assess therapist competence, treatment adherence, and alliance. The 12 original CBAY-C items for anxiety demonstrated a mean ICC of .77 (SD = .08, range .59 to .86) whereas the 10 new items demonstrated a mean ICC of .62 (SD = .32, range -.01 to .91). Overall, the new items were not observed very often; seven items exhibited a restricted range and three items were not observed. The correlations between competence and corresponding adherence items were small to moderate in magnitude, and correlations between competence and alliance scores were mostly small to moderate in magnitude. Overall, the findings replicate previous findings regarding the score reliability and validity of the 12 competence items; however, the new competence items were not coded with enough frequency to adequately assess score reliability and validity.
Diane Keister– Research Assistant, Virginia Commonwealth University, Richmond, Virginia
Ashely Bacalso– Virginia Commonwealth University
Stephanie Violante– Graduate Student, Virginia Commonwealth University, Richmond, Virginia
Bryce McLeod– Associate Professor of Psychology, Virginia Commonwealth University, Richmond, Virginia
Michael Southam-Gerow– Professor, Virginia Commonwealth University, Richmond, Virginia
Associate Professor of Psychology
Virginia Commonwealth University