Treatment-Relevant Assessment in Cognitive-Behavioral Therapy

Despite advances in the research and dissemination of cognitive behavioral therapy (CBT), evidence-based cognitive behavioral assessment remains relatively neglected in both research and practice. We discuss empirically supported assessment in the context of CBT and demonstrate how assessment can be effectively used to enhance outcomes across all phases of treatment, including intake and case formulation, treatment monitoring, relapse prevention, and termination of treatment. The importance of the mutual influence of evidence-based practice and practice-based evidence is emphasized. Strategies for the selection, use, interpretation, and evaluation of assessment measures for diagnostic/symptom-, behavioral-, and cognitive-based (including cognitive products, processes, and structures) assessment are highlighted. Future directions for the science and practice of cognitive behavioral assessment are also discussed—directions that will inform clinical practice and help clinicians better align practice with evidence. The need to select and develop measures with demonstrated reliability and precision, expand beyond self-report instruments and data, use and development of normative data, incorporate priming techniques in both research and practice, and examine the temporal stability of various cognitive constructs are highlighted. By conducting research with a practice-based focus, and assessing patients using an empirically based scientific approach, researchers and clinicians can better advance the field of cognitive behavioral assessment and, in turn, enhance treatment outcomes.