Module Catalogue 2024/25

Pre Requisite Comment

N/A

Co Requisite Comment

N/A

Aims

1. To develop core knowledge of the theoretical and research literature of CBT.

2. To develop practical competency in the fundamentals of CBT with an emphasis on clinical assessment

3. To increase reflective capacity for new learning and promote self-awareness as a CBT therapist

This module will help trainees identify and consolidate pre-existing CBT knowledge, skills and attitudes at the start of the programme. It will provide a framework for identifying specific learning needs and supporting trainee goal setting. It will encourage on-going reflection of the learning process and will encourage attention to both internal and external sources of feedback. It will maximise the opportunity for trainees to use self-knowledge as they learn the fundamental principles of CBT. Trainees will be encouraged to develop a critical understanding of the theoretical and research evidence for CBT models and the ability to evaluate that evidence. The module will enable trainees to have an understanding of how scientific principles inform their clinical practice, specifically the core clinical competencies (skills) necessary to undertake CBT, including cognitive models, maintenance and developmental conceptualisations of cases and the core aspects of the cognitive and behavioural process of therapy. The module will have a particular emphasis on the assessment process at the outset of a course of treatment. Overall, the module will support reflection at the end of the programme on the knowledge, skills and attitudes that have been gained and what needs to be done to consolidate future progress.

Outline Of Syllabus

The Fundamentals module is supported by a series of workshops concentrated in the first six weeks of the programme. Within this module trainees are initiated in keeping a Reflective Log which serves two main functions: first, it encourages trainees to notice, record, remember and reflect on a range of learning experiences from diverse activities such as supervision, study, providing therapy, etc. Second, it allows their Tutor to monitor the trainee’s progress on the programme and in their workplace. The module will cover:

Classifying common mental health problems
• Phenomenology, diagnostic classification and epidemiological characteristics of common mental health disorders
• Risk assessment, mental state examination, personal & medical history
• Knowledge of relevant pharmacological interventions

CBT theory and evidence
• Fundamental principles of CBT e.g. collaborative empiricism : clinical process – formulation, rationale giving, measurement, active treatment, relapse prevention: structuring sessions – agenda setting, summarising, setting homework
• Assessment methodology: clinical and research: clinical trials; outcome studies
• Theories and experimental studies of process.
• Application of theory and method to the individual case

CBT assessment and formulation
• Application and suitability for CBT: guidelines, case applications and contra-indications (to include assessment of alcohol/substance misuse)
• Use of standard and idiosyncratic clinical measurement to monitor CBT process and outcome
•The role of the therapeutic relationship in CBT
• Application of CBT with more complex presentations, deriving CBT-driven formulations in cases of co-morbidity

Reflective practice, supervision & service awareness
• Developing self-awareness as a CBT practitioner and using this to become a responsive and flexible therapist
• Experiential learning illustrating how CBT methods can be applied to the trainees’ own lives.
• The role of supervision (how to make best use of supervision on the course and after training)
• Effective use of supervision to help trainees identify own values and beliefs in working with CBT to enhance and regulate good practice
• Respectful attitudes within therapy and ethical practice
• Values, culture and diversity (access, ethical, professional and cultural considerations)
• Reflective-practitioner orientation to treatment
• An overview of the principles of stepped care and the role of psychological therapies within that framework.

Intended Knowledge Outcomes

Trainees will be able to:

1. Identify key characteristics of common mental health disorders and their diagnostic classification (e.g. the status of psychiatric diagnostic concepts, the major diagnostic manuals)

2. Explain and discuss the fundamental principles of CBT including evidence supporting and questioning those principles; specifically, building therapeutic alliances, eliciting patient problems, goal setting, collaborative empiricism, formulation building, key change processes, outcome evaluation and relapse prevention

3. Review the evidence base for cognitive and behavioural processes within CBT theories and models of affective disorders, including the evidence base for the outcome of CBT treatments

4. Reflect on the factors that influence the development of professional and personal attitudes in CBT, including respect for diverse patients’ cultures and values; inquisitiveness and scientific curiosity about highly individual or unusual clinical presentations; openness to working collaboratively with patients from a broad range of socio-economic backgrounds, including how CBT principles are relevant to their own personal experience

Intended Skill Outcomes

Trainees will be able to:

1.       Conduct clinical assessments for CB therapy, which will include
• assessing patients for suitability for short-term CBT
• delivering a clear CBT treatment rationale
• setting agreed goals for treatment which are specific, achievable and measurable
• developing CBT treatment plans
• making judgements about the appropriate source/s of treatment for patients under assessment
•taking into account the cultural norms and sensitivities of patients and their significant others

2.       Foster therapeutic relationships with sensitive and flexible dialogue, which will include
• using guided discovery, adopting an open and inquisitive style
• ability to form trusting therapeutic relationships with evidence of teamwork, collaboration
• skilful use of empathy
• eliciting and identifying verbal and written cognitive-behavioural content & processes associated with distressing emotions

3.       Help patients to conceptualise and change unhelpful patterns of thinking and behaviour, which will include
• using clinical information to construct maintenance and developmental CBT conceptualisations
• using CBT conceptualisation to inform the treatment plan.
• employing a range of change techniques such as pie charts, advantages and disadvantages, continua, positive data logs to enable patients to therapeutically re-evaluate thoughts, assumptions and beliefs.
•       constructing, carrying out and evaluating behavioural experiments

4.       Structure a course of CB therapy, which will include
• agenda setting, pacing and structuring of CBT sessions
• agreeing and reviewing appropriate homework tasks with patients
• acquiring evidence of treatment outcomes using standardised and personalised measures
• ability to deal with ending therapy and planning for long term maintenance of gains through a relapse prevention plan
• use of supervision to inform assessment, treatment plan, and own behaviour in therapy sessions

Teaching Rationale And Relationship

Skills workshops in the first two-week of the programme provide an opportunity to re-fresh and extend fundamental CBT skills, knowledge and attitudes. These workshops provide a focus and orientation towards a process of reflective practice across the remainder of the programme. The reflective process is supported by a Reflective Log in which trainees make regular preparatory and reflective notes concerning their learning from their experiences. The log provides the material from which trainees can raise specific issues, questions or problems with their clinical supervisors and personal tutors.

Specific subject knowledge and understanding will be developed through:
• Small group work, to provide opportunities for interaction, discussion and clarification of the fundamental principles of CBT
• Guided self-study, supported by the provision of targets to expand knowledge of common mental health disorders and the evidence base for cognitive and behavioural processes
• Individual tutorials, to develop a deeper understanding of CBT and develop appropriate professional and personal attitudes
• Independent small reflective groups using the principles of SP/SR
•Two seminars to aid development of key principles, deepen understanding of research methods and provide opportunities for critical evaluation of peer review papers.

Practical skills are developed through skill workshops that provide:
• A strong foundation in the clinical procedures of CBT with a particular emphasis on clinical assessment
• Video simulations and demonstrations of how to foster therapeutic relationships with sensitive and flexible dialogue
• Feedback on trainee’s conceptualisations of their training cases and guidance on how to use them to create a process of change
• Demonstrations of how to structure therapy sessions and agree a structure for the overall treatment

Personal tutors have a key role in encouraging reflective practice and responding to pastoral needs of trainees during the programme. They will also take the lead in supporting trainees to prepare academically for the essay as one of the main assessments of this module.

Formative Practice
The Reflective Log increases self-awareness of the knowledge, skills and attitudes acquired across the programme. CBT has its effects through promoting patient learning and competent therapists need to be sufficiently aware of their own learning processes and styles.

Assessment Rationale And Relationship

The assessment strategy at the outset of the programme is:
• to emphasise formative rather than summative assessment
• to have a range of assessments that cover the fundamentals of CBT each with relative emphasis on core knowledge (Essay), skills (Clinical Recording) and attitudes (Reflective Log).

The Essay will examine trainees’ grasp of theory & practice of CBT, including reference to its applicability to the trainee’s own experience. At the same time it will promote critical awareness of the assumptions and philosophical basis of the CBT framework.

The video recording of a CBT assessment session provides a baseline assessment of trainees CBT skills early in the programme. In addition to the recording, trainees are required to complete a self-rated CTS-R. The Clinical Recording will capture the trainee’s skills in alliance building, problem elicitation, goal setting and treatment planning to promote competence in assessment skills. These are essential to initiate courses of therapy with a broad range of patients and to use a diverse range of change processes covered in subsequent modules. These are reviewed by the University supervisor.

General Notes

N/A