An exploration of the relationships between patient application of CBT skills and therapeutic outcomes during a two-week CBT treatment

ABSTRACT

The application of Cognitive Behavioural Therapy (CBT) skills are believed to be a mechanism of therapeutic change in treatment. Research has shown that the application of CBT skills affects outcomes, however, the way these relationships may change during treatment has not been explored. In this study, a naturalistic observational approach is used to examine the relationships between patients’ wellbeing, symptoms, and the application of CBT skills throughout treatment. It is hypothesized that the application of CBT skills would lead to an increase in patients reported wellbeing, and a decrease in symptoms. Additionally, it was hypothesized that the application of CBT skills affects wellbeing and symptoms at different points in therapy. A sample of 584 patients in a two-week CBT treatment completed session-to-session measures of wellbeing, symptoms, and their application of CBT skills. Results of an autoregressive cross-lagged path analysis indicated that in the early stages of treatment the application of CBT skills predicted patient wellbeing but not symptoms. At the later stages of therapy, the application of CBT skills predicted both patient wellbeing and symptoms. At no point in treatment did patient wellbeing or symptoms predict the later application of CBT skills. Implications and future directions for research are discussed.

Keywords:

• Cognitive behaviour therapy
• depression
• anxiety

Acknowledgements

The authors acknowledge that the research was carried out while an author was in receipt of an Australian Government Research Training Program Scholarship at The University of Western Australia.

Supplemental Data

Supplemental data for this article can be accessed here at https://doi.org/10.1080/10503307.2020.1845414.

Additional information

Funding

This research was supported in part by an Australian Government Research Training Program Scholarship