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Although studies have shown that client feedback can improve treatment outcome, little is known about which factors might possibly moderate the effects of such feedback. The present study investigated potential therapist variables that might influence whether frequent client feedback is effective, including the Big Five personality traits, internal/external feedback propensity and self‐efficacy. Data from two previous studies, a quasi‐experimental study and a randomized controlled trial, were combined. The sample consisted of 38 therapists and 843 clients (55.4% females, mean age = 42.05 years, SD = 11.75) from an outpatient mental health institution. The control condition consisted of cognitive‐behavioural therapies combined with low frequency monitoring of clients' symptoms. In the experimental condition, high‐intensity (i.e., frequent) client feedback as an add‐on to treatment as usual was provided. Outcomes were measured as adjusted post‐treatment symptom severity on the Symptom Checklist‐90 and drop out from treatment. The final model of the multilevel analyses showed that therapists with higher levels of self‐efficacy had poorer treatment outcomes, but when high‐intensity client feedback was provided, their effectiveness improved. Furthermore, higher self‐efficacy was associated with a higher estimation of therapists' own effectiveness, but therapists' self‐assessment of effectiveness was not correlated with their actual effectiveness. The results of this study might indicate that therapists with high levels of self‐efficacy benefit from client feedback because it can correct their biases. However, for therapists with low self‐efficacy, client feedback might be less beneficial, possibly because it can make them more insecure. These hypotheses need to be investigated in future research. [ABSTRACT FROM AUTHOR]

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Childhood anxiety is a problem not only because of its negative consequences on the well-being of children but also because of its adverse effects on society and its role in mental disorders later in life. Adequate prevention might be the key in tackling this problem. The effectiveness of Coping Cat, as an indicated CBT-based prevention program in Dutch primary school children, was assessed by means of a randomized controlled trial. In total, 141 children aged 7-13 with elevated levels of anxiety and their mothers were included and randomly assigned to an intervention group and a waiting list control group. After screening, all participants completed baseline, post-intervention, and 3-month follow-up assessments. The results showed that Coping Cat, as an indicated prevention program, reduces children's self-reported anxiety symptoms, with Cohen's effect size d of 0.66 at the 3-month follow-up. A moderating effect was found for baseline anxiety level; specifically, children with high levels of baseline anxiety who received the Coping Cat program had lower anxiety levels at follow-up compared to children with high levels of anxiety in the control condition. No moderating effects of gender or age were found. An unexpected decline in anxiety levels from screening to pre-assessment was found in both groups, and this decline was stronger in the experimental group. These promising results warrant the implementation of Coping Cat as an indicated prevention program. [ABSTRACT FROM AUTHOR]