Therapist competence, homework engagement, and client characteristics in CBT for youth depression: A study of mediation and moderation in a community-based trial

References

• Alfonsson, S., Parling, T., Spännargård, Å, Andersson, G., & Lundgren, T. (2018). The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: A systematic review. Cognitive Behaviour Therapy, 47(3), 206–228. https://doi.org/10.1080/16506073.2017.1369559
   PubMed Web of Science ®Google Scholar
• Barber, J. P., Liese, B. S., & Abrams, M. J. (2003). Development of the cognitive therapy adherence and competence scale. Psychotherapy Research, 13, 205–221.
   Web of Science ®Google Scholar
• Beck, A. T., Rush, J., Shaw, B., & Emery, G. (1979). Cognitive therapy of depression. Guildford Press.
   Google Scholar
• Beck, J. S. (1995). Cognitive therapy: Basics and beyond. Guildford Press.
   Google Scholar
• Beck, J. S., & Tompkins, M. A. (2007). Cognitive therapy. In N. Kazantzis, & L. L’Abate (Eds.), Handbook of homework assignments in psychotherapy: Research, practice, prevention (pp. 51–63). Springer Science + Business Media. https://doi.org/10.1007/978-0-387-29681-4_4
   Google Scholar
• Bryant, M., Simons, A., & Thase, M. (1999). Therapist skill and patient variables in homework compliance: Controlling an uncontrolled variable in cognitive therapy outcome research. Cognitive Therapy and Research, 23(4), 381–399. https://doi.org/10.1023/A:1018703901116
   Web of Science ®Google Scholar
• Callan, J. A., Kazantzis, N., Park, S. Y., Moore, C. G., Thase, M. E., Minhajuddin, A., Kornblith, S., & Siegle, G. J. (2019). A propensity score analysis of homework-adherence outcome relations in cognitive behavioural therapy for depression. Behavior Therapy, 50(2), 285–299. https://doi.org/10.1016/j.beth.2018.05.010
   PubMed Web of Science ®Google Scholar
• Collyer, H., Eisler, I., & Woolgar, M. (2020). Systematic literature review and meta-analysis of the relationship between adherence, competence and outcome in psychotherapy for children and adolescents. European Child and Adolescent Psychiatry, 29(4), 417–431. https://doi.org/10.1007/s00787-018-1265-2
   PubMed Web of Science ®Google Scholar
• Conklin, L., Strunk, D., & Cooper, A. (2018). Therapist behaviors as predictors of immediate homework engagement in cognitive therapy for depression. Cognitive Therapy and Research, 42(1), 16–23. https://doi.org/10.1007/s10608-017-9873-6
   PubMed Web of Science ®Google Scholar
• Constantino, M. J., Boswell, J. F., & Coyne, A. E. (2021). Patient, therapist, and relational factors. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change: 50th anniversary edition (pp. 225–262). John Wiley & Sons, Inc.
   Google Scholar
• Crawford, E., Frank, H., Palitz, S., Davis, J., & Kendall, P. (2017). Process factors associated with improved outcomes in CBT for anxious youth: Therapeutic content, alliance, and therapist actions. Cognitive Therapy and Research, 42(2), 172–183. https://doi.org/10.1007/s10608-017-9864-7
   Web of Science ®Google Scholar
• Davey, C. G., Chanen, A. M., Hetrick, S. E., Cotton, S. M., Ratheesh, A., Amminger, G. P., Koutsogiannis, J., Phelan, M., Mullen, E., Harrison, B. J., Rice, S., Parker, A. G., Dean, O. M., Weller, A., Kerr, M., Quinn, A. L., Catania, L., Kazantzis, N., McGorry, P. D., & Berk., M. (2019). The addition of fluoxetine to cognitive behavioural therapy for youth depression (YoDA-C): A randomised, double-blind, placebo-controlled, multicentre clinical trial. The Lancet. Psychiatry, 6(9), 735–744. https://doi.org/10.1016/S2215-0366(19)30215-9
   PubMed Web of Science ®Google Scholar
• Dobson, K. (2022). Therapeutic relationship. Cognitive and Behavioral Practice, 29(3), 541–544. https://doi.org/10.1016/j.cbpra.2022.02.006
   Web of Science ®Google Scholar
• Dobson, K., & Kazantzis, N. (2003). The therapist in cognitive-behavioral therapy: Introduction to a special section. Psychotherapy Research, 13(2), 131–134. https://doi.org/10.1080/713869635
   Web of Science ®Google Scholar
• Dobson, K., & Kazantzis, N. (2023). Therapeutic relationships in cognitive-behavioral therapy: Tailoring the therapeutic alliance. Psychotherapy Research, 33(1), 1–2. https://doi.org/10.1080/10503307.2023.2177942
   PubMed Web of Science ®Google Scholar
• Dozois, D. J. A. (2010). Understanding and enhancing the effects of homework in cognitive-behavioral therapy. Clinical Psychology: Science and Practice, 17(2), 157–161. https://doi.org/10.1111/j.1468-2850.2010.01205.x
   Web of Science ®Google Scholar
• Dunn, H., Morrison, A., & Bentall, R. (2002). Patients’ experiences of homework tasks in cognitive behavioural therapy for psychosis: A qualitative analysis. Clinical Psychology and Psychotherapy, 9(5), 361–369. https://doi.org/10.1002/cpp.344
   Web of Science ®Google Scholar
• Falkenström, F. (2022). Data analytic advances that bridge the scientist-practitioner gap. Cognitive and Behavioral Practice, 29(3), 585–590.
   Web of Science ®Google Scholar
• Falkenström, F., Solomonov, N., & Rubel, J. A. (2022). How to model and interpret cross-lagged effects in psychotherapy mechanisms of change research: A comparison of multilevel and structural equation models. Journal of Consulting and Clinical Psychology, 90(5), 446–458. https://doi.org/10.1037/ccp0000727
   PubMed Web of Science ®Google Scholar
• Farrer, L., Griffiths, K., Christensen, H., Mackinnon, A., & Batterham, P. (2014). Predictors of adherence and outcome in internet-based cognitive behavior therapy delivered in a telephone counseling setting. Cognitive Therapy and Research, 38(3), 358–367. https://doi.org/10.1007/s10608-013-9589-1
   Web of Science ®Google Scholar
• First, M., Spitzer, R., Gibbon, M., & Williams, J. (1996). Structured clinical interview for Axis I disorders -patient edition. Biometrics Research, New York State Psychiatric Institute.
   Google Scholar
• Helbig, S., & Fehm, L. (2004). Problems with homework in CBT: Rare exception or rather frequent? Behavioural and Cognitive Psychotherapy, 32(3), 291–301. https://doi.org/10.1017/S1352465804001365
   Web of Science ®Google Scholar
• Hetrick, S., Parker, A., & Bailey, A. (2015). Cognitive–behavioural therapy for depression in young people: A treatment manual. https://www.orygen.org.au/Education-Training/Resources-Training/Resources/Free/Manuals/CBT-youth-depression (accessed January 20, 2019).
   Google Scholar
• Holdsworth, E., Bowen, E., Brown, S., & Howat, D. (2014). Client engagement in psychotherapeutic treatment and associations with client characteristics, therapist characteristics, and treatment factors. Clinical Psychology Review, 34(5), 428–450. https://doi.org/10.1016/j.cpr.2014.06.004
   PubMed Web of Science ®Google Scholar
• Hudson, J. L., & Kendall, P. C. (2005). Children. In N. Kazantzis, F. Deane, K. Ronan, & L. L’Abate (Eds.), Using homework assignments in cognitive behavior therapy (pp. 75–94). Routledge.
   Google Scholar
• Impala, T., Dobson, K. S., & Kazantzis, N. (2022). Does the working alliance mediate the therapist competence-outcome relationship in cognitive behavior therapy for depression? Psychotherapy Research, 32(1), 16–28. https://doi.org/10.1080/10503307.2021.1946195
   PubMed Web of Science ®Google Scholar
• Jain, S., Carmody, T. J., Trivedi, M. H., Hughes, C., Bernstein, I. H., Morris, D. W.,  Emslie, G. J. & Rush, A. J. (2007). A psychometric evaluation of the CDRS and MADRS in assessing depressive symptoms in children. Journal of the American Academy of Child and Adolescent Psychiatry, 46(9), 1204–1212. https://doi.org/10.1097/chi.0b013e3180cc2575
   PubMed Web of Science ®Google Scholar
• Johns, R. G., Barkham, M., Kellett, S., & Saxon, D. (2019). A systematic review of therapist effects: A critical narrative update and refinement to review. Clinical Psychology Review, 67, 78–93. https://doi.org/10.1016/j.cpr.2018.08.004
   PubMed Web of Science ®Google Scholar
• Jungbluth, N. J., & Shirk, S. R. (2013). romoting homework adherence in cognitive-behavioral therapy for adolescent depression. Journal of Clinical Child & Adolescent Psychology, 42(4), 545–553. https://doi.org/10.1080/15374416.2012.743105
   PubMed Web of Science ®Google Scholar
• Kazantzis, N. (2000). Power to detect homework effects in psychotherapy outcome research. Journal of Consulting and Clinical Psychology, 68(1), 166–170. https://doi.org/10.1037/0022-006X.68.1.166
   PubMed Web of Science ®Google Scholar
• Kazantzis, N., Brownfield, N., Mosely, L., Usatoff, A., & Flighty, A. (2017). Homework in CBT: A systematic review of adherence assessment in anxiety and depression treatment (2011-2016). Psychiatric Clinics of North America, 40(4), 625–639. https://doi.org/10.1016/j.psc.2017.08.001
   PubMed Web of Science ®Google Scholar
• Kazantzis, N., Clayton, X. C., Cronin, T. J., Farchione, D., Limburg, K., & Dobson, K. S. (2018). The Cognitive Therapy Scale and Cognitive Therapy Scale-Revised as measures of therapist competence in cognitive behavior therapy for depression: Relations with short and long term outcome. Cognitive Therapy and Research, 42(4), 385–397. https://doi.org/10.1007/s10608-018-9919-4
   Web of Science ®Google Scholar
• Kazantzis, N., Dattilio, F. M., Shinkfield, G., & Petrik, A. M. (2022). Clinician experiences of homework in couples and family therapy: A survey of perceived impact on the working alliance. Scandinavian Journal of Psychology, 64(1), 1–9. http://doi.org/10.1111/sjop.12861
   PubMed Web of Science ®Google Scholar
• Kazantzis, N., Deane, F., & Ronan, K. (2000). Homework assignments in cognitive behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice, 7(2), 189–202. https://doi.org/10.1093/clipsy.7.2.189
   Web of Science ®Google Scholar
• Kazantzis, N., Deane, F., & Ronan, K. (2005). Homework Rating Scale – Revised (HRS-II). Unpublished scale, Cognitive Behavior Therapy Research Unit, Melbourne, Victoria, Australia.
   Google Scholar
• Kazantzis, N., & Dobson, K. (2022). Therapeutic relationships in cognitive behavioural therapy: Theory and recent research. Psychotherapy Research, 32(8), 969–971. https://doi.org/10.1080/10503307.2022.2124047
   PubMed Web of Science ®Google Scholar
• Kazantzis, N., & L’Abate, L. (2005). Theoretical foundations. In N. Kazantzis, F. Deane, K. Ronan, & L. L’Abate (Eds.), Using homework assignments in cognitive behavior therapy (pp. 9–34). Routledge.
   Google Scholar
• Kazantzis, N., Luong, H., Usatoff, A., Impala, T., Yew, R., & Hofmann, S. (2018). The processes of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 42(4), 349–357. https://doi.org/10.1007/s10608-018-9920-y
   Web of Science ®Google Scholar
• Kazantzis, N., MacEwan, J., & Dattilio, F. (2005). A guiding model for practice. In N. Kazantzis, F. Deane, K. Ronan, & L. L’Abate (Eds.), Using homework assignments in cognitive behavior therapy (pp. 293–336). Routledge.
   Google Scholar
• Kazantzis, N., & Miller, A. R. (2022). A comprehensive model of homework in cognitive behavior therapy. Cognitive Therapy and Research, 46(1), 247–257. https://doi.org/10.1007/s10608-021-10247-z
   Web of Science ®Google Scholar
• Kazantzis, N., Wedge, P., & Dobson, K. (2005). Homework Adherence and Competence Scale (HAACS). Unpublished scale, Cognitive Behavior Therapy Research Unit, Melbourne, Victoria, Australia.
   Google Scholar
• Kazantzis, N., Whittington, C., & Dattilio, F. (2010). Meta-analysis of homework effects in cognitive and behavioral therapy: A replication and extension. Clinical Psychology: Science and Practice, 17(2), 144–156. https://doi.org/10.1111/j.1468-2850.2010.01204.x
   Web of Science ®Google Scholar
• Kazantzis, N., Whittington, C., Zelencich, L., Kyrios, M., Norton, P. J., & Hofmann, S. G. (2016). Quantity and quality of homework compliance: A meta-analysis of relations with outcome in cognitive behavior therapy. Behavior Therapy, 47(5), 755–772. https://doi.org/10.1016/j.beth.2016.05.002
   PubMed Web of Science ®Google Scholar
• Kazdin, A. E. (2014). Moderators, mediators and mechanisms of change in psychotherapy. In W. Lutz, & S. Knox (Eds.), Quantitative and qualitative methods in psychotherapy research (pp. 87–101). Routledge/Taylor & Francis Group.
   Google Scholar
• Kendall, P. C., Peterman, J., Villabø, M., Mychailyszyn, M., & O’Neil, K. (2016). Treating children and adolescents. In A. Nezu, & C. Nezu (Eds.), The Oxford handbook of cognitive and behavioral therapies (pp. 363–382). Oxford University Press.
   Google Scholar
• Kühne, F., Maas, J., Wiesenthal, S., & Weck, F. (2019). Empirical research in clinical supervision: A systematic review and suggestions for future studies. BMC Psychology, 7(1), https://doi.org/10.1186/s40359-019-0327-7
   PubMedGoogle Scholar
• Kuyken, W., & Tsivrikos, D. (2009). Therapist competence, comorbidity and cognitive-behavioral therapy for depression. Psychotherapy and Psychosomatics, 78(1), 42–48. https://doi.org/10.1159/000172619
   PubMed Web of Science ®Google Scholar
• Laudet, A. (2003). Attitudes and beliefs about 12-step groups among addiction treatment clients and clinicians: Toward identifying obstacles to participation. Substance Use & Misuse, 38(14), 2017–2047. https://doi.org/10.1081/ja-120025124
   PubMed Web of Science ®Google Scholar
• Mausbach, B. T., Moore, R., Roesch, S., Cardenas, V., & Patterson, T. L. (2010). The relationship between homework compliance and therapy outcomes: An updated meta-analysis. Cognitive Therapy and Research, 34(5), 429–438. https://doi.org/10.1007/s10608-010-9297-z
   PubMed Web of Science ®Google Scholar
• McDonald, B., & Morgan, R. (2013). Enhancing homework compliance in correctional psychotherapy. Criminal Justice and Behavior, 40(7), 814–828. https://doi.org/10.1177/0093854813480781
   Web of Science ®Google Scholar
• McEvoy, P. M., Bendlin, M., Johnson, A. R., Kazantzis, N., Campbell, B. N. C., Bank, S. R., & Egan, S. J. (2023). The relationships among working alliance, group cohesion and homework engagement in group cognitive behavior therapy for social anxiety disorder. Psychotherapy Research, https://doi.org/10.1080/10503307.2022.2161966
   PubMed Web of Science ®Google Scholar
• Montgomery, S., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. The British Journal of Psychiatry, 134(4), 382–389. https://doi.org/10.1192/bjp.134.4.382
   PubMed Web of Science ®Google Scholar
• O’Connor, R., Fraser, L., Whyte, M., MacHale, S., & Masterton, G. (2009). Self-regulation of unattainable goals in suicide attempters: The relationship between goal disengagement, goal reengagement and suicidal ideation. Behaviour Research and Therapy, 47(2), 164–169. https://doi.org/10.1016/j.brat.2008.11.001
   PubMed Web of Science ®Google Scholar
• Podell, J. L., Kendall, P. C., Gosch, E. A., Compton, S. N., March, J. S., Albano, A.-M., Rynn, M. A., Walkup, J. T., Sherrill, J. T., Ginsburg, G. S., Keeton, C. P., Birmaher, B., & Piacentini, J. C. (2013). Therapist factors and outcomes in CBT for anxiety in youth. Professional Psychology: Research and Practice, 44(2), 89–98. https://doi.org/10.1037/a0031700
   PubMed Web of Science ®Google Scholar
• Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., & Mann, J. J. (2011). The Columbia–Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168(12), 1266–1277. https://doi.org/10.1176/appi.ajp.2011.10111704
   PubMed Web of Science ®Google Scholar
• Preacher, K., & Hayes, A. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Insturuments and Computers, 36(4), 717–731. https://doi.org/10.3758/BF03206553
   PubMedGoogle Scholar
• Preacher, K., & Kelley, K. (2011). Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods, 16(2), 93–115. https://doi.org/10.1037/a0022658
   PubMed Web of Science ®Google Scholar
• Reise, S., Bonifay, W., & Haviland, M. (2018). Bifactor modelling and the evaluation of scale scores. In P. Irwing, T. Booth, & D. Hughes (Eds.), The wiley handbook of psychometric testing: A multidisciplinary reference on survey, scale and test development (pp. 677–707). John Wiley & Sons Ltd.
   Google Scholar
• Rogers, M., Ringer, F., & Joiner, T. (2018). The association between suicidal ideation and lifetime suicide attempts is strongest at low levels of depression. Psychiatry Research, 270, 324–328. https://doi.org/10.1016/j.psychres.2018.09.061
   PubMed Web of Science ®Google Scholar
• Rungtusanatham, M., Miller, J., & Boyer, K. (2014). Theorizing, testing and concluding for mediation in SCM research: Tutorial and procedural recommendations. Journal of Operations Management, 32(3), 99–113. https://doi.org/10.1016/j.jom.2014.01.002
   Web of Science ®Google Scholar
• Ryum, T., Bennion, M., & Kazantzis, N. (2023). Integrating between-session homework in psychotherapy: A systematic review of immediate in-session and intermediate outcomes. Psychotherapy, 60(3), 306–319. https://doi.org/10.1037/pst0000488
   PubMed Web of Science ®Google Scholar
• Ryum, T., Stiles, T. C., Svartberg, M., & McCullough, L. (2010). The effects of therapist competence in assigning homework in cognitive therapy with cluster C personality disorders: Results from a randomized controlled trial. Cognitive and Behavioral Practice, 17(3), 283–289. https://doi.org/10.1016/j.cbpra.2009.10.005
   Web of Science ®Google Scholar
• Sachsenweger, M., Fletcher, R., & Clarke, D. (2015). Pessimism and homework in CBT for depression. Journal of Clinical Psychology, 71(12), 1153–1172. https://doi.org/10.1002/jclp.22227
   PubMed Web of Science ®Google Scholar
• Shaw, B. F., Elkin, I., Yamaguchi, J., Olmsted, M., Vallis, T. M., Dobson, K. S., Lowery, A., Sotsky, S. M., Watkins, J. T., & Imber, S. D. (1999). Therapist competence ratings in relation to clinical outcome in cognitive therapy of depression. Journal of Consulting and Clinical Psychology, 67(6), 837–846. https://doi.org/10.1037/0022-006X.67.6.837
   PubMed Web of Science ®Google Scholar
• StataCorp. (2019). Stata statistical software: Release 16. StataCorp LLC.
   Google Scholar
• Stirman, S., Gutner, C., Suvak, M., Adler, A., Calloway, A., & Resick, P. (2018). Homework completion, patient characteristics, and symptom change in cognitive processing therapy for PTSD. Behavior Therapy, 49(5), 741–755. https://doi.org/10.1016/j.beth.2017.12.001
   PubMed Web of Science ®Google Scholar
• Strunk, D. J. (2022). Homework. Cognitive and Behavioral Practice, 29(3), 560–563. https://doi.org/10.1016/j.cbpra.2022.02.009
   Web of Science ®Google Scholar
• Strunk, D. J., Brotman, M., DeRubeis, R., & Hollon, S. (2010). Therapist competence in cognitive therapy for depression: Predicting subsequent symptom change. Journal of Consulting and Clinical Psychology, 78(3), 429–437. https://doi.org/10.1037/a0019631
   PubMed Web of Science ®Google Scholar
• Tinsley, H. E. A., & Weiss, D. J (2000). Interrater reliability and agreement. In H. E. A. Tinsley & S. D. Brown (Eds.), Handbook of applied multivariate statistics and mathematical modeling (pp. 95–124). Academic Press. https://doi.org/10.1016/B978-012691360-6/50005-7
   Google Scholar
• Trepka, C., Rees, A., Shapiro, D., Hardy, G., & Barkham, M. (2004). Therapist competence and outcome of cognitive therapy for depression. Cognitive Therapy and Research, 28(2), 143–157. https://doi.org/10.1023/B:COTR.0000021536.39173.66
   Web of Science ®Google Scholar
• Walters, G. (2018). PM effect size estimation for mediation analysis: A cautionary note, alternate strategy, and real data illustration. International Journal of Social Research Methodology, 21(1), 25–33. https://doi.org/10.1080/13645579.2017.1305710
   Web of Science ®Google Scholar
• Wampold, B. E., & Owen, J. (2021). Therapist effects: History, methods, magnitude, and characteristics of effective therapists. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change: 50th anniversary edition (pp. 297–326). John Wiley & Sons, Inc.
   Google Scholar
• Webb, C. A., DeRubeis, R. J., & Barber, J. P. (2010). Therapist adherence/competence and treatment outcome: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78(2), 200–211. https://doi.org/10.1037/a0018912
   PubMed Web of Science ®Google Scholar
• Weck, F., Richtberg, S., Esch, S., Hofling, V., & Stangier, U. (2013). The relationship between therapist competence and homework compliance in maintenance cognitive therapy for recurrent depression: Secondary analysis of a randomized trial. Behavior Therapy, 44(1), 162–172. https://doi.org/10.1016/j.beth.2012.09.004
   PubMed Web of Science ®Google Scholar
• Wen, Z., & Fan, X. (2015). Monotonicity of effect sizes: Questioning kappa-squared as mediation effect size measure. Psychological Methods, 20(2), 193–203. https://doi.org/10.1037/met0000029
   PubMed Web of Science ®Google Scholar
• Yew, R. Y., Dobson, K. S., Zyphur, M., & Kazantzis, N. (2021). Mediators and moderators of homework–outcome relations in CBT for depression: A study of engagement, therapist skill, and client factors. Cognitive Therapy and Research, 45(2), 209–223. https://doi.org/10.1007/s10608-019-10059-2
   Web of Science ®Google Scholar
• Young, J., & Beck, A. T. (1980). Cognitive therapy scale: Rating manual. University of Philadelphia.
   Google Scholar
• Zelencich, L., Kazantzis, N., Wong, D., McKenzie, D., Downing, M., & Ponsford, J. (2020). Demographic, injury-related and process factors predict homework engagement in adapted CBT for traumatic brain injury. Cognitive Therapy and Research, 44, 40–51. https://doi.org/10.1007/s10608-019-10036-9
   Web of Science ®Google Scholar
• Zhao, X., Lynch, J., & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of Consumer Research, 37(2), 197–206. https://doi.org/10.1086/651257
   Web of Science ®Google Scholar