While it might seem obvious, researchers have now proved that a therapist’s competence—particularly those practicing cognitive behavioral therapy (CBT)—affects the degree to which a person with depression will have a reduction in symptoms, according to a study published in the June issue of the Journal of Consulting and Clinical Psychology.

Numerous studies have shown that CBT is an effective treatment for depression. CBT focuses on changing negative thinking and behavior patterns in order to improve a person’s mood and other symptoms of depression. However, recovery rates with CBT are not perfect. No studies thus far have fully explored how a therapist’s competence affects a depressed client’s recovery.

To test therapist competence, Daniel Strunk, PhD, and his colleagues videotaped (with the participants’ permission) four therapy sessions with 60 adult participants who were diagnosed with depression. Other therapists viewed the videotapes and rated how well the therapists adhered to CBT principles.

Strunk found that a therapist’s competence did substantially influence recovery from depression in participants with more complex depression.

“People with depression who don’t have complicating issues like anxiety are fairly likely to show benefit even if they don’t see the most highly rated therapists,” Strunk said. “But people who have substantial anxiety or a history of depression that began at an early age really do best if they have the most highly rated treatment.”

While Strunk said the results of his study should be validated and explored more deeply in future studies, he did add that the findings could influence how clinics treat their patients. Clinic directors, for example, might want to steer people with more severe or complex depression to therapists who have been rated as more competent.