Psychotherapeutic interventions in the SPIRR-CAD trial are characterized by (1) a stepwise combination of individual and group treatment, (2) integration of behavioural skills and education into a psychodynamic group framework focusing on negative affect and social inhibition. In order to assure a high quality of comparable interventions at the 10 sites of the multicenter trial, systematic analyses of adherence and competence of therapists are performed on videotape recordings of all treatments. Based on rating manuals for psychodynamic and behavioral intervention, specific rating manuals were devised and raters were trained. Moderate to good interrater reliabilities were obtained between raters based on 18 randomly selected individual sessions (0.48 -0.69). Therapists are trained according to manual, undergo regular supervision and obtain written feedback on their performance. One out of two individual sessions is evaluated. Out of 25 group sessions, 3 are randomly selected from early, middle and termination phase.