Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Vice Chancellor, University of Hull, Hull, UK.
Behav Cogn Psychother. 2019 Nov;47(6):672-685. doi: 10.1017/S1352465819000201. Epub 2019 Mar 28.
There is international interest in the training of psychological therapists to deliver evidence-based treatment for common mental health problems. The UK Improving Access to Psychological Therapies (IAPT) programme, one of the largest training initiatives, relies on competent therapists to successfully deliver cognitive behaviour therapy (CBT) and promote good patient outcome.
To evaluate an IAPT CBT training course by assessing if trainees' clinical skills improve during training and reach competency standards, and to report patient outcome for submitted training cases. To investigate a possible relationship between trainee competence and patient outcome. To explore professional differences during training.
CBT trainee (n = 252) competence was assessed via audio recordings of therapy sessions at the beginning, middle and end of training. Patient pre- to post-treatment outcomes were extracted from submitted training cases (n = 1927). Differences in professional background were examined across competence, academic final grade and tutorial support.
CBT trainees attained competence by the end of the course with 77% (anxiety recordings) and 72% (depression recordings) improving reliably. Training cases reported pre- to post-treatment effect sizes of 1.08-2.26 across disorders. CBT competence predicted a small variance in clinical outcome for depression cases. Differences in professional background emerged, with clinical psychologists demonstrating greater competence and higher academic grades. Trainees without a core professional background required more additional support to achieve competence.
Part of a new CBT therapist workforce was successfully trained to deliver relatively brief treatment effectively. Trainees without a core profession can be successfully trained to competence, but may need additional support. This has implications for workforce training.
国际上对心理治疗师进行培训以提供常见心理健康问题的循证治疗非常感兴趣。英国改善心理治疗服务（IAPT）计划是最大的培训计划之一，它依赖于有能力的治疗师成功地提供认知行为疗法（CBT）并促进良好的患者结果。
通过评估受训者在培训过程中的临床技能是否提高并达到能力标准，以及报告提交的培训案例的患者结果，来评估 IAPT CBT 培训课程。调查受训者能力与患者结果之间的可能关系。探讨培训过程中的专业差异。
通过在培训开始、中间和结束时对治疗课程的音频记录评估 CBT 培训生的能力。从提交的培训案例中提取患者治疗前后的结果（n = 1927）。在能力、学术最终成绩和辅导支持方面，比较了专业背景的差异。
CBT 培训生在课程结束时达到了能力水平，77%（焦虑录音）和 72%（抑郁录音）的能力可靠地提高。培训案例报告了 1.08-2.26 之间的各种障碍的治疗前后效应大小。CBT 能力预测了抑郁案例临床结果的微小差异。专业背景的差异显现出来，临床心理学家表现出更高的能力和更高的学术成绩。没有核心专业背景的培训生需要更多的额外支持才能达到能力水平。
一部分新的 CBT 治疗师成功地接受了培训，能够有效地提供相对简短的治疗。没有核心专业背景的培训生可以成功地接受培训以达到能力水平，但可能需要额外的支持。这对劳动力培训有影响。
