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An investigation into the factor structure of the Cognitive Therapy Scale – Revised (CTS-R) in a CBT training sample

Published online by Cambridge University Press:  18 January 2021

Sarah Beale ,
Silia Vitoratou  and
Sheena Liness
Sarah Beale*
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King’s College London, LondonSE5 8AF, UK
Silia Vitoratou
Affiliation:
Psychometrics & Measurement Lab, Department of Biostatistics and Health Informatics, King’s College London, London, UK
Sheena Liness
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King’s College London, LondonSE5 8AF, UK
*
*Corresponding author. Email: sarah.beale@kcl.ac.uk
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Abstract

Background:

Effective monitoring of cognitive behaviour therapy (CBT) competence depends on psychometrically robust assessment methods. While the UK Cognitive Therapy Scale – Revised (CTS-R; Blackburn et al., 2001) has become a widely used competence measure in CBT training, practice and research, its underlying factor structure has never been investigated.

Aims:

This study aimed to present the first investigation into the factor structure of the CTS-R based on a large sample of postgraduate CBT trainee recordings.

Method:

Trainees (n = 382) provided 746 mid-treatment audio recordings for depression (n = 373) and anxiety (n = 373) cases scored on the CTS-R by expert markers. Tapes were split into two equal samples counterbalanced by diagnosis and with one tape per trainee. Exploratory factor analysis was conducted. The suggested factor structure and a widely used theoretical two-factor model were tested with confirmatory factor analysis. Measurement invariance was assessed by diagnostic group (depression versus anxiety).

Results:

Exploratory factor analysis suggested a single-factor solution (98.68% explained variance), which was supported by confirmatory factor analysis. All 12 CTS-R items were found to contribute to this single factor. The univariate model demonstrated full metric invariance and partial scalar invariance by diagnosis, with one item (item 10 – Conceptual Integration) demonstrating scalar non-invariance.

Conclusions:

Findings indicate that the CTS-R is a robust homogenous measure and do not support division into the widely used theoretical generic versus CBT-specific competency subscales. Investigation into the CTS-R factor structure in other populations is warranted.

Keywords

anxietycognitive behaviour therapy (CBT)competencedepressionfactor structuretraining
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 6 , November 2021 , pp. 721 - 731
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2021

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