Innovative Methods to Assess Psychotherapy Practices in CBT and CPT: The imAPP Study

The Purpose:

The goal of the study is to develop and evaluate methods to efficiently understand what occurs in CBT interventions, using materials that are generated during routine clinical care. Once we have more efficient, scalable and acceptable tools, we can use them for purposes such as training and supporting the delivery of cognitive behavioral therapies in routine care settings. We seek to identify good alternatives to "gold standard" of reviewing and coding recordings of therapy sessions, which can be time- and labor-intensive, and not always acceptable to clinicians and their clients. We are asking therapists and their clients to help us evaluate and compare different strategies, and will be asking for their feedback on these strategies.

Who Can Participate?

We welcome participation of any treatment provider (clinicians, including interns, postdocs, and practicum students) who uses cognitive behavioral strategies and who use CBT/CPT worksheets as a part of their practice. It could be a good opportunity for trainees to receive feedback based on session recordings and work samples. Decisions about whether, how, and when to use CBT or CPT strategies are entirely up to the clinicians and their patients—we are simply observing what occurs in session. Both patients and therapists will be consented to participate.

Clients will be compensated for the time spent participating in the study, and clinicians will receive supportive feedback and continuing education credits, and, depending on their employers' regulations, compensation for their participation. 

Information about recording clients:

Our study team has conducted research and training that has involved recording CBT protocols with hundreds of therapists. We have noticed that some therapists are hesitant to record their sessions, and some have expressed concerns about whether or not their clients would agree to have their sessions recorded. While some clients do decline to be recorded, over the years, hundreds of clients who have received flyers about the study opportunities from their therapists have been interested and willing to participate—even when they are discussing very sensitive information about past trauma or other sensitive topics. Many clients see it as an opportunity to contribute to knowledge that can help other clients struggling with similar issues.

We are happy to talk with clients who are considering participation to address any concerns or questions. All the therapist needs to do is provide the client with the flyer (and/or put it in the waiting room) and either refer the client to contact our team, or provide our team with a consent to contact form so that we can discuss the study with potentially interested clients. That way the therapist can focus on their therapeutic work with their clients and we can keep study recruitment separate.

We take a number of steps to preserve the clients’ confidentiality and we allow the therapist or client to stop the recording at any time that they are uncomfortable having sensitive information recorded. They can stop recording for part or all of the session. We just ask that as much of the treatment as possible is recorded to allow us to understand what occurs in the sessions.

We have interviewed many therapists in previous studies about their experiences and using a recorder during session. Many therapists expressed that although it takes some time getting used to being recorded, they have found it beneficial because it reminds them to stay on track and, and they can listen back to parts of their sessions to reflect on their work.

We understand that it can be burdensome to record and upload recordings. We will work with therapists who decide to participate to make sure that there is a system for providing us with the data that we need in a way that is as low burden as possible.