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Randomized Controlled Trial
. 2021 May;24(2):70-76.
doi: 10.1136/ebmental-2020-300217. Epub 2021 Jan 5.

Development and validation of the Cognitive Behavioural Therapy Skills Scale among college students

Masatsugu Sakata  1 , Rie Toyomoto  2 , Kazufumi Yoshida  2 , Yan Luo  2 , Yukako Nakagami  3 , Shuntaro Aoki  4 , Tomonari Irie  5 , Yuji Sakano  6 , Hidemichi Suga  7 , Michihisa Sumi  8 , Takashi Muto  9 , Nao Shiraishi  10 , Ethan Sahker  2   11 , Teruhisa Uwatoko  12 , Toshi A Furukawa  2
Affiliations
Randomized Controlled Trial

Development and validation of the Cognitive Behavioural Therapy Skills Scale among college students

Masatsugu Sakata et al. Evid Based Ment Health. 2021 May.

Abstract

Background: There are many different skill components used in cognitive behavioural therapy (CBT). However, there is currently no comprehensive way of measuring these skills in patients.

Objective: To develop a comprehensive and brief measure of five main CBT skills: self-monitoring, behavioural activation, cognitive restructuring, assertiveness training and problem-solving.

Methods: University students (N=847) who participated in a fully factorial randomised controlled trial of smartphone CBT were assessed with the CBT Skills Scale, the Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder-7 (GAD-7) and the short form of the Japanese Big Five Scale. Structural validity was estimated with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency evaluated with Cronbach's α coefficients. Construct validity was evaluated with the correlations between each factor of the CBT Skills Scale, the PHQ-9, the GAD-7 and the Big Five Scale.

Findings: The EFA supported a five-factor solution based on the original instruments assessing each CBT skill component. The CFA showed sufficient goodness-of-fit indices for the five-factor structure. The Cronbach's α of each factor was 0.75-0.81. Each CBT skills factor was specifically correlated to the PHQ-9, GAD-7, and the Big Five Scale.

Conclusions: The CBT Skills Scale has a stable structural validity and internal consistency with a five-factor solution and appropriate content validity concerning the relationship with depression, anxiety and personality.

Clinical implications: The CBT Skills Scale will be potential predictor and effect modifier in studying the optimisation of CBT interventions.

Trial registration: CTR-000031307.

Keywords: depression & mood disorders.

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Conflict of interest statement

Competing interests: TAF reports personal fees from Mitsubishi-Tanabe, MSD and Shionogi, a grant from Mitsubishi-Tanabe, and, outside the submitted work; TAF has a patent 2018-177688 pending and intellectual properties for Kokoro-app licensed. NS received lecture fees from Dainippon-Sumitomo and Meiji-seika Pharma for work that was not associated with this article.

Figures

Figure 1
Figure 1
Confirmatory factor analysis of a five-factor model of the Cognitive Behavioural Therapy Skills Scale. AT, assertiveness training; BA, behavioural activation; CR, cognitive restructuring; PS, problem-solving; SM, self-monitoring.
See this image and copyright information in PMC

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