Role of therapist competence in CBT for Depression

The role of therapist competence in cognitive behavioral therapy (CBT) outcomes was the subject of a naturalistic process-outcome study conducted at the Center for Cognitive Therapy, an outpatient clinic at the University of Pennsylvania. Sixty-nine clients presenting with depression, some with comorbid presenting problems, were treated by one of eighteen CBT therapists at the Center. Therapist competence was measured by clients and experts. The findings, published in Psychotherapy and Psychosomatics, were that more competent therapists achieved better outcomes with depression patients, regardless of degree of morbidity. The clinical implication of this finding is that “initial selection of therapists will enhance treatment outcomes,” and this contradicts the idea that more competent therapists should focus on more complex cases.

Study authors: W. Kuyken, D. Tsivrikos

CBT for Smoking Cessation among Cancer Patients

Smoking, alcohol use and depression often co-exist at high rates among patients with head and neck cancer. Researchers recently designed a randomized, controlled study to see whether patients with head and neck cancer and at least one of the above traits improved with integrated Cognitive Behavior Therapy (CBT) that addressed all of the above factors.

184 patients were randomly assigned to either usual care or 9-11 CBT phone sessions plus optional medications over a period of six months. At the end of the trial, those in the CBT group had significantly improved their smoking cessation rate as compare to those in the usual care group (47% compared to 31%).

The study suggests that an integrated CBT approach, which treats smoking cessation, alcohol and depression simultaneously, may improve smoking cessation rates and provide a more practical means of addressing these co-morbid factors.