Beck Institute Blog

The role of therapist competence in cognitive behavioral therapy (CBT) outcomes was the subject of a naturalistic process-outcome study conducted at the Center for Cognitive Therapy, an outpatient clinic at the University of Pennsylvania. Sixty-nine clients presenting with depression, some with comorbid presenting problems, were treated by one of eighteen CBT therapists at the Center. Therapist competence was measured by clients and experts. The findings, published in Psychotherapy and Psychosomatics, were that more competent therapists achieved better outcomes with depression patients, regardless of degree of morbidity. The clinical implication of this finding is that “initial selection of therapists will enhance treatment outcomes,” and this contradicts the idea that more competent therapists should focus on more complex cases. 

Study authors: W. Kuyken, D. Tsivrikos

A journalist from the Boston Globe spoke with Dr. Aaron Beck about his 2008 article in the American Journal of Psychiatry, in which he reflects on the evolution of the cognitive model of depression and its neurobiological correlates. In the Globe article, Dr. Beck discusses how researchers are now able to identify genes that make the brain hyperreactive to negative experiences, which in turn affects serotonin levels and makes the amygdala hyperactive—all of which can contribute to the development of depression. Recent genetics and brain science studies have pointed to “the potential interaction of genetic, neurochemical, and cognitive factors.” Dr. Beck notes that even in light of a biological vulnerability, depressed patients can be helped by cognitive therapy, alone or in conjunction with medication.