Therapist competence ratings in relation to clinical outcome in cognitive therapy of depression

This study reports on the relationship of therapist competence to the outco me of cognitive-behavioral treatment in the National Institute of Mental He alth Treatment of Depression Collaborative Research Program. Outpatients su ffering from major depressive disorder were treated by cognitive-behavioral therapists at each of 3 U.S. sites using a format of 20 sessions in 16 wee ks. Findings provide some support for the relationship of therapist compete nce (as measured by the Cognitive Therapy Scale) to reduction of depressive symptomatology when controlling for therapist adherence and facilitative c onditions. The results are, however, not as strong or consistent as expecte d. The component of competence that was most highly related to outcome is a factor that reflects the therapist's ability to structure the treatment.