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Competence and Adherence Scale for Cognitive Behavioural Therapy (CAS-CBT) for anxiety disorders in youth: reliability and factor structure

Published online by Cambridge University Press:  20 May 2021

Stine Harstad ,
Jon Fauskanger Bjaastad ,
Odin Hjemdal ,
Scott Compton ,
Trine Waaktaar  and
Marianne Aalberg
Stine Harstad*
Affiliation:
Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway Nic Waals Institute, Lovisenberg Diaconal Hospital
Jon Fauskanger Bjaastad
Affiliation:
Division of Psychiatry, Stavanger University Hospital
Odin Hjemdal
Affiliation:
Department of Psychology, Norwegian University of Science and Technology
Scott Compton
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
Trine Waaktaar
Affiliation:
Department of Psychology, University of Oslo
Marianne Aalberg
Affiliation:
Akershus University Hospital
*
*Corresponding author. Email: [email protected]
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Abstract

Background:

There has been increased research interest into the concept of treatment integrity within psychotherapy research. The Competence and Adherence Scale for Cognitive Behavioural Therapy (CAS-CBT) was developed to measure therapists’ competence and adherence in cognitive behavioural therapy (CBT), when delivered to children and youth with anxiety disorders.

Aims:

The aim of this study was to evaluate the psychometric properties of the CAS-CBT in a naturalistic treatment setting.

Method:

Ratings of 212 randomly selected sessions from a clinical effectiveness trial for children with anxiety disorders (n = 165, mean age = 10.46 years, SD = 1.49) were analysed to assess the psychometric properties of CAS-CBT. Therapy format included both individual sessions and group sessions.

Results:

Internal consistency for the CAS-CBT was excellent (Cronbach’s alpha = .88). Factor analysis suggested a two-factor solution for the total sample, where the first factor was related to CBT structure and session goals, and the second factor was associated with process and relational skills. The individual CBT treatment condition (ICBT) and group CBT treatment condition (GCBT) showed the same factor solution.

Conclusion:

The CAS-CBT is a feasible and reliable measure for assessing competence and adherence to CBT in the treatment of anxious children. Future research is needed to further assess the generalizability of this scale, its psychometric properties in different treatment populations and with other treatment approaches, and ideally with larger sample sizes.

Keywords

adherencecognitive behavioural therapycompetenceCompetence and Adherence Scale for Cognitive Behavioural Therapytreatment integrity
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 6 , November 2021 , pp. 745 - 757
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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