@article{ref1,
title="Therapist competence, homework engagement, and client characteristics in CBT for youth depression: a study of mediation and moderation in a community-based trial",
journal="Psychotherapy research",
year="2024",
author="Hildebrand-Burke, Craig and Davey, Christopher and Gwini, StellaMay and Catania, Lisa and Kazantzis, Nikolaos",
volume="34",
number="1",
pages="41-53",
abstract="OBJECTIVE: Prior studies of Cognitive Behavioral Therapy (CBT) have focused on the quantity and quality of clients' homework completion and only rarely have considered the role of therapist competence.  METHODS: The present study examined (a) therapist competence across the entire process of integrating homework into CBT, including the review, design, and planning of tasks; (b) homework engagement, including client appraisals of the difficulty and obstacles encountered in task completion using the Homework Rating Scale - Revised (HRS-II); (c) pre-post symptom reduction as the index of outcome; and (d) considered client factors such as suicide risk in a community-based trial for adolescent depression. Trained independent observers assessed therapist competence and engagement with homework at two consecutive sessions of CBT for N = 80 young people (Mage = 19.61, SD = 2.60).  RESULTS: Significant complementary mediation effects were obtained; there was an indirect mediation effect of HRS-II Beliefs (b = 1.03, SE B = 0.42, 95% BCa CI [0.35, 2.03]) and HRS-II Perceived Consequences on the Competence-Engagement relationship (b = 0.85, SE B = 0.31, 95% BCa CI [0.39, 1.61]). High levels of suicidal ideation were also shown to moderate this relationship.  CONCLUSIONS: The present findings contribute to the growing body of CBT process research designed to examine the complex interrelationships of client and therapist variables, in a manner that reflects the actual process of therapy, and advances beyond studies of isolated predictors of symptom change.<p /> <p>Language: en</p>",
language="en",
issn="1050-3307",
doi="10.1080/10503307.2023.2267166",
url="http://dx.doi.org/10.1080/10503307.2023.2267166"
}