Validating the Simplified Therapist Demand and Support Code

The didactic nature of current postgraduate training may be limited in its effectiveness for improving therapist performance. A promising training alternative may be process coding, or training in the recognition and appropriate responsiveness to empirically supported psychotherapy process markers. Using Westra et al.s (2016) RCT of cognitive behavioural therapy with and without integrated motivational interviewing for 60 individuals with severe GAD, this study tested the validity of a novel coding system that could be incorporated into training, the Therapist Demand and Support Code. All TDSC indices were highly correlated with a current gold-standard coding measure. All TDSC indices differentiated the more directive CBT-alone group from the more supportive MI-CBT group. Only therapist responsivity errors significantly predicted outcome. These findings provide support for the TDSCs validity. Further, this study lends support for training therapists in process detection and responsivity to manage the health of the therapeutic interaction in real time.