The revised cognitive therapy scale (CTS-R): psychometric properties.
Open accessAbstract
The existing scale for assessing competence in cognitive therapy (CTS) dates from 1988 and only the previous version of 1980 has been validated to any extent. A revised version, the CTS-R, was devised to improve on the CTS by: eliminating overlap between items, improving on the scaling system, and defining items more clearly. Kolb's well-known educational model was used as a guideline. In the new 14-item scale, three new items measure general therapeutic flair, the facilitation of emotional expression, and therapist's non-verbal behaviours (optional). We hypothesized that the CTS-R would prove more user friendly and demonstrate satisfactory reliability and validity. Twenty-one mental health professionals undergoing training in cognitive therapy provided 102 video-tapes of therapy with 34 patients, reflecting three stages of therapy. The tapes were rated by four expert raters, in a balanced design. The CTS-R showed high internal consistency and adequate average inter-rater reliability. Reliability for individual items varied widely among pairs of raters. Validity was demonstrated by improved ratings of competence for trainees who saw patients early and later during the course of training. Although raters found the CTS-R a more useful tool than the CTS and satisfactory reliability and validity were demonstrated, more refinement is needed in item definition. The study has led to modifications in the CTS-R, which are in the process of evaluation.
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Competence in IUT was assessed with the Cognitive Therapy Scale-Revised (CTS-R).
“Competence in IUT was assessed with the Cognitive Therapy Scale-Revised (CTS-R) [38], which includes 12 items and rates competence on a Likert scale that ranges from 0 (absence of feature, or highly inappropriate performance) to 6 (excellent performance, or very good even in the face of patient difficulties).”
From Intolerance-of-uncertainty therapy versus metacognitive therapy for generalized anxiety disorder in primary health care: A randomized controlled pilot trial (2023) · cites this paper as [38]
The Cognitive Therapy Scale-Revised (CTS-R) is a standardised measure of competence within cognitive therapy, consisting of adherence to and skilful application of cognitive therapy methods and the therapeutic alliance.
“This bespoke measure will be supplemented with the Cognitive Therapy Scale-Revised (CTS-R)—a standardised measure of competence within cognitive therapy, consisting of adherence to and skilful application of cognitive therapy methods and the therapeutic alliance.45”
A total of 24 feature categories were defined, informed by the CBT competences framework and the Revised Cognitive Therapy Scale.
“We defined a total of 24 feature categories (Box), informed by the CBT competences framework18 and the Revised Cognitive Therapy Scale.23”
From Quantifying the association between psychotherapy content and clinical outcomes using deep learning (2020) · cites this paper as [23]
The senior supervisor checked the quality of CBT using the cognitive therapy scale-revised.
“The senior supervisor also checked the quality of the CBT delivered by therapists using the cognitive therapy scale-revised [27].”
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“application of cognitive therapy methods and the therapeutic alliance.(45) The CTS-R has 13 items that are”
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“Competence in IUT was assessed with the Cognitive Therapy Scale-Revised (CTS-R) [38], which includes 12 items and rates competence on a Likert scale that ranges from 0 (absence of feature, or highly inappropriate performance) to 6 (excellent performance, or very good even in the face of patient difficulties).”
MethodInfluentialSocial recovery therapy for young people with emerging severe mental illness: the Prodigy RCT
Fowler, D., Berry, C., Hodgekins, J., Banerjee, R., Barton, G., Byrne, R., Clarke, T., Fraser, R., Grant, K., Greenwood, K., et al. (2021) · Health Technology Assessment · doi:10.3310/hta25700 · Cited by 7 · see citing works
The Application of CBT for Adults with Learning Disabilities
Serfaty, M., Broadway-Horner, M., & Hassiotis, A. (2021) · Evidence-Based Treatment for Anxiety Disorders and Depression · doi:10.1017/9781108355605.030 · Cited by 1 · see citing works
- Authors
- Blackburn, I.-M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A., & Reichelt, F. K.
- ORCID
- James, Ian A.
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2001-10
- Volume
- 29
- Issue
- 4
- Pages
- 431-446
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W2125885438
- Cited by
- 568
- References
- 30
- Citations by year
- 2026: 17 · 2025: 34 · 2024: 22 · 2023: 35 · 2022: 29 · 2021: 71 · 2020: 37 · 2019: 34 · 2018: 31 · 2017: 39 · 2016: 29 · 2015: 38 · 2014: 29 · 2013: 23 · 2012: 19
- FWCI
- 3.54
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- inter-rater reliability, scale validation, therapist training
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