How Reliable Are Therapeutic Competence Ratings? Results of a Systematic Review and Meta-Analysis

  • Franziska KühneEmail author
  • Ramona Meister
  • Ulrike Maaß
  • Tatjana Paunov
  • Florian Weck
Original Article


Assessments of psychotherapeutic competencies play a crucial role in research and training. However, research on the reliability and validity of such assessments is sparse. This study aimed to provide an overview of the current evidence and to provide an average interrater reliability (IRR) of psychotherapeutic competence ratings. A systematic review was conducted, and 20 studies reported in 32 publications were collected. These 20 studies were included in a narrative synthesis, and 20 coefficients were entered into the meta-analysis. Most primary studies referred to cognitive-behavioral therapies and the treatment of depression, used the Cognitive Therapy Scale, based ratings on videos, and trained the raters. Our meta-analysis revealed a pooled ICC of 0.82, but at the same time severe heterogeneity. The evidence map highlighted a variety of variables related to competence assessments. Further aspects influencing the reliability of competence ratings and regarding the considerable heterogeneity are discussed in detail throughout the manuscript.


Competency Therapist competence Adherence Psychotherapy Assessment 



We would like to thank, Ricarda Löscher B.Sc. psych., for her assistance with study screening and data extraction.


No external funding.

Compliance with Ethical Standards

Conflict of interest

Florian Weck is an author of six of the publications included in the review. Franziska Kühne, Ramona Meister, Ulrike Maaß and Tatjana Paunov declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies involving human participants.

Research Involving Animal Rights

This article does not contain any studies with animals.

Supplementary material

10608_2019_10056_MOESM1_ESM.pdf (31 kb)
Supplementary material 1 (PDF 30 kb)
10608_2019_10056_MOESM2_ESM.pdf (5 kb)
Supplementary material 2 (PDF 4 kb)


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Authors and Affiliations

  1. 1.Department of Psychology, Clinical Psychology and PsychotherapyUniversity of PotsdamPotsdamGermany
  2. 2.Department of Medical PsychologyUniversity Medical Center Hamburg EppendorfHamburgGermany

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