Wanted: Reliable and valid measures for the science of cognitive behavioral therapy dissemination and implementation.

Abstract

The dissemination and implementation of cognitive behavioral therapy (CBT) is stalled by the lack of empirical data to guide the content and evaluation of training programs. To address the questions of “What should be taught?” and “What do clinicians learn?” reliable and valid measures of therapist behaviors and practice elements are needed. The objective of this report is to identify existing CBT measures and to assess their ability to address these critical questions. We conducted a comprehensive literature review to identify measures of CBT declarative and procedural knowledge. We identified two measures of therapist declarative knowledge, one measure of client declarative knowledge, 22 measures of therapist procedural knowledge, and four measures of client procedural knowledge. Domain coverage, psychometrics, correlations among measures, and relationship to clinical outcomes varied considerably. Measures were evaluated in terms of whether, and to what degree, they might help address key CBT dissemination and implementation questions. Although some of the current set of CBT measures are well suited to the purposes for which they were originally developed, they do not provide the needed technology for advancing CBT dissemination and implementation. Recommendations for measure development are offered.