The Identification of Metacompetence in Cognitive Behavioural Therapists

Literature Review This literature review sought to explore how CBT therapists develop their practice with experience. A narrative synthesis of relevant journal articles indicated a weight towards adherence to disorder-specific protocols, with the suggestion that drift results in poor treatment outcomes. However, in practice most practitioners do not follow disorder-specific protocols, as they do not address the complexities of the clients they work with. The findings suggest that as therapists become more experienced, they tend to take a more formulation-based approach. Service Evaluation This study evaluated participants views on the impact of a five-day CBT course on their current working practice. Measures were taken at pre, post and follow-up. The feedback was generally positive with significant increases reported in knowledge and understanding. Ongoing supervision and support were highlighted as important in embedding learning. Research Report Metacompetencies are vaguely defined in the literature thus making them difficult to measure. This study attempted to investigate and specify what metacompetence looks like and how it develops in recently qualified and experienced CBT therapists. Template Analysis was used to explore the therapists justifications for a formulation and treatment plan for a complex client outlined in a vignette. Both groups reported a departure from disorder-specific protocols despite references to evidence-based practice. Differences in confidence impacting working with complexity was also highlighted. Results were discussed with regards to implications for training and supervision.</p

Correlation between cardiac T2* and serum ferritin(SF) values in Chinese TM patients.

<p>Cardiac T2* was negatively associated with SF (r = −0.319, p = 0.000). The dotted line represents reference range for cardiac T2* of 20 ms, and the solid line represents SF of 2500 ng/ml.</p

Correlation between cardiac T2* and total units of blood transfused in Chinese TM patients.

<p>Cardiac T2* was negatively associated with units of transfused blood(r = −0.360, p = 0.000).</p

Correlation between cardiac T2* and age in Chinese TM patients.

<p>The dotted line represents cardiac T2* of 20 ms. The solid line represents age of 6 years old. Cardiac T2* was negatively associated with age (r = −0.328, p = 0.000) in these patients.</p

The main characteristics of Chinese TM patients along with the main results of the study.

<p><b>DFO</b>,deferoxamine; <b>DFP</b>, deferiprone; <b>DFX</b>, deferasirox; <b>SD</b>, standard deviation; <b>SF</b>, serum ferritin; <b>LVEF</b>, left ventricular ejection fraction.</p><p><b>^a:</b> patients received both DFO and DFP as prior chelation therapies, but these may not have been in combination.</p><p><b>^b:</b> patients received both DFO and deferasirox as prior chelation therapies, but these may not have been in combination.</p

Correlation between cardiac T2* and left ventricular ejection fraction (LVEF) in Chinese TM patients.

<p>No correlation was found between cardiac T2* and LVEF (r = −0.147, p = 0.052). The solid line presents reference range (56%) for LVEF. The dotted line represents reference range for cardiac T2* of 20 ms.</p

Additional file 6: of Longitudinal expression profiling of CD4+ and CD8+ cells in patients with active to quiescent giant cell arteritis

Figure S3. Expression levels of the top 500 most variable transcripts in CD4 and CD8 cells, shown for each of 135 samples. Sample groups are indicated by the orange (CD4) and blue (CD8) bars at the top of the heatmap. (DOCX 555 kb

Additional file 5: of Longitudinal expression profiling of CD4+ and CD8+ cells in patients with active to quiescent giant cell arteritis

Table S3. General disease outcome and prognostic measures. (DOCX 38 kb

Additional file 10: of Longitudinal expression profiling of CD4+ and CD8+ cells in patients with active to quiescent giant cell arteritis

Table S7. Significant CD4 genes shared by phenotypes at T1. (CSV 4 kb

Additional file 7: of Longitudinal expression profiling of CD4+ and CD8+ cells in patients with active to quiescent giant cell arteritis

Table S4. Differential expression results CD4. (XLSX 272 kb