002: T = Testing — A Boring Topic with Exciting Implications

In this podcast, Dr. David Burns describes the “Testing” part of the T.E.A.M. model. Topics include:

  • The shocking results of a study of therapist accuracy at Stanford
  • Why therapists who don’t test usually get it wrong
  • How session-by-session testing can revolutionize your practice

(Repost for submission to iTunes)

9 thoughts on “002: T = Testing — A Boring Topic with Exciting Implications

  1. Another great talk on a topic not always fully appreciated by therapists.
    A question: do most therapists really get such low empathy scores when they first start using the empathy questionnaire? Such scores could be quite deflating, and possibly lead to discouraging negative cognitions for a therapist, especially if he or she has been practicing for years thinking that he or she has good empathy skills! This being said, if he or she gets over the initial shock and persists in this practice, one can hope that empathy scores will improve over time…

    • Thanks so much Chris! Yes, most therapists will get failing grades initially when they first start using the empathy questionnaire, and it can be very upsetting, especially if your ego is involved. This is a case were therapists need to work on their own negative thoughts on their own Daily Mood Log, in addition to working to improve their empathy skills. If the therapist persists with the tools, and get some training, then you can get superb scores from the vast majority of patients within a few weeks. One way to do that is to join of the weekly online TEAM-CBT training groups. A list of times and contact persons can be found on my website. But it is shocking and deflating for therapists to learn that they cannot acknowledge patients’ feelings in an accurate or skillful way. But this is reality, this is how it actually is! And if the therapist has courage and a huge determination to improve, then great things can be done! Please keep listening and posting your terrific comments and questions, Chris! All the best, david

  2. Dr. Burns, I am curious about the reliability and validity percentage for Beck Inventory. Articles state it is within 80s%, but you said 65% and below.

    • Thanks, sadly I do not get many statistical questions, but that’s an area I really enjoy. The “reliability” of a scale is defined as the correlation of the total scale score with the “factor” or concept that drives the scale. In other words, if you are looking at the reliability of any depression scale, like the Beck Depression Inventory (BDI), you would look at the correlation between the total score, and the concept of “pure depression” which has no errors of measurement, the Platonic “pure concept,” so to speak. You can actually make this calculation using something called “structural equation modeling,” a fairly advanced statistical method.

      The correlation between the scores on the BDI and the Depression Factor is generally reported around .78, which is close to .8. The shared variance, or “accuracy,” is the square of the correlation, or around 64% or less. This means that roughly one third of the points on the test do not reflect depression, but other variables, along with errors of measurement. To me, that’s not very good, and that’s why I created the three Burns depression tests, plus many other tests for anxiety, anger, relationship problems, therapeutic empathy, and many more variables of interest to therapists.

      The reliability on the scales I have created are typically between .90 and .98, much higher than the Beck test. In addition, I try to create scales that are short and user friendly. These scales have revolutionized the practice of psychotherapy and are a cornerstone of what we call TEAM-CBT. Hope this helps. Thanks!


      • Thank you for your reply, Dr. Burns!
        Once i am in my internship, i will certainly give it a try to your scales! They are available on your website, correct?

    • They are not free, but if you purchase a Therapist’s Toolkit your are licensed to use them free of charge for your entire career. You can find order forms for the Toolkit on my website. All the best, David

  3. Thanks so much for your great work.
    I have just one question : could you please give the reference of the article you mention where you found a very low correlation between patient and clinicians rating?

    • Thanks, Remy, I did not publish it, was just curious as I had the data for analysis. I did publish the original study on Willingness and recovery from depression, and this is the reference, along with a similar study on poor congruence between patient and therapist perceptions of the therapeutic alliance, with I think the exact findings I observed, and similar methodology. David
      Burns, D., Westra, H., Trockel, M., & Fisher, A. (2012) Motivation and Changes in Depression. Cognitive Therapy and Research DOI 10.1007/s10608-012-9458-3 Published online 22 April 2012
      Hatcher, R. L., Barends, A., Hansell, J. & Gutfreund, M.J. (1995). Patients’ and therapists’ shared and unique views of the therapeutic alliance: An investigation using confirmatory factory analysis in a nested design. Journal of Consulting and Clinical Psychology, 63(4), 636 – 643.

  4. HI David, I’m going back to listen to some podcasts. I love your books as you know and I also loved Change Your Brain Change Your Life by DR. Daniel Amen. Are you familiar with his work? He says he treats people by doing PET (?) Scans and seeing where the brain is under/over active or damaged. It’s confusing that so many mental health professionals have such different views of how to treat mental health.

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