COGNITIVE BEHAVIOUR THERAPY 1 (CBT 1)

Transcription

1 UEA Doctorate in Clinical Psychology COGNITIVE BEHAVIOUR THERAPY 1 (CBT 1) Module co-ordinator: Dr Ella Beeson 2016 Cohort 2016/17

2 Module: COGNITIVE BEHAVIOUR THERAPY 1 Module co-ordinator: Dr Ella Beeson Learning Objectives This module will focus on fundamental clinical competencies of CBT. The aims of the module are for trainees to develop an understanding of the theoretical basis for CBT, skills in conducting CBT assessments, constructing CBT formulations and applying CBT techniques and interventions. They will understand the application of CBT to specific psychological disorders/problems. They will develop the ability to evaluate outcome of CBT work. Assessment: To achieve this, the objectives of the module are to provide teaching on: o Appropriate assessment methods and techniques within CBT. o Understanding theory and evidence base relating to these CBT assessment techniques. Formulation To achieve this, the objectives of the module are to provide teaching on: o Understanding the theory and evidence base for CBT models of formulation. o Skills in collaboratively developing CBT formulations using the outcomes of assessment, drawing on theory, research, and specific CBT models. o Skills in using knowledge of biology, development, social, cultural, and neuropsychological processes across the lifespan to facilitate o o adaptation of specific CBT formulations to individuals, groups, families, organisations, and communities. Skills in collaboratively using CBT formulations to guide specific and appropriate management plans including the setting of timescales within the CBT model. Skills in developing a formulation through a shared understanding in a way that is accessible and helps the client better understand their experience. Intervention The objectives of the module are to provide teaching on: o Understanding specific CBT techniques and processes as applied when working with a range of individuals in distress. o Understanding the theory, professional guidelines, and evidence base in relation to CBT techniques. o Understanding how to select CBT techniques collaboratively to meet the needs of an individual, groups or communities o Conducting CBT in a way that promotes recovery of personal and social functioning as informed by service user values and goals. Evaluation and Outcome Monitoring The objectives of the module are to provide teaching on: o Reviewing the ongoing effectiveness of CBT through monitoring of processes and outcomes, across multiple dimensions of functioning, in relation to recovery, values and goals and as informed by service user feedback as well as clinical indicators so that formulations and Page 1 of 10

3 o o intervention can be modified/revised accordingly (Professional Responsibility) Building critical evaluation skills in relation to the evidence base and practice in CBT (Reflective Practice). Recognising when (further) intervention is inappropriate, or unlikely to be helpful, and communicating this sensitively to the clients and carers. Page 2 of 10

4 YEAR: TERM SESSION NUMBER TIME ALLOCATED TEACHING SESSION TITLE 1:1 2 6 Basics of CBT: Beckian Approach for Depression LEARNING OBJECTIVES Formulation & Evaluation Trainees will learn about the theoretical concepts, evidence base, and evaluation of behaviour therapy through: o Introduction to the theoretical principles & practices of Beckian CBT o Key characteristics of CBT levels of Cognition o Introduction to the evidence base for CBT o CBT Formulation (case conceptualisation) for Major Depressive Disorder 1:1 1 3 Fundamentals of CBT Trainees will learn about the theoretical concepts, fundamental model and fundamental intervention techniques of CBT through teaching on key CBT techniques. 1:1 3 6 Behavioural Activation as applied to depression 1:1 4 6 CBT for Anxiety, Panic: Theory, presentation, assessment and intervention Trainees will learn about the theoretical concepts and BA approach to depression through teaching on : o BA protocol for Depression o Evidence base for BA o BA competencies Trainees will learn about the theoretical concepts and CBT approach to anxiety through teaching on: o Vicious Flower Formulation (case conceptualisation) o Safety Behaviours o Cognitive Interventions identifying and re-evaluating unhelpful thoughts, strategies for working with unhelpful thoughts Page 3 of 10

5 YEAR: TERM SESSION NUMBER TIME ALLOCATED TEACHING SESSION TITLE LEARNING OBJECTIVES o Thought Diaries, Evidence recording sheets o Skills practice: identifying NATS and looking for evidence o The diagnostic features of panic disorder o Assessment and Measures (including panic diaries and mood diaries) o CBT model of panic disorder (Clark, 1986) o In Vivo exposure and behavioural experiments o Cognitive interventions for Panic Disorder o Skills practice: formulating using a specific CBT model (Clark panic model). 1:1 5 6 CBT with Older People Late life depression and anxiety can be treated effectively with evidence-based psychological interventions. However, older people can face barriers in accessing services for a range of reasons, including their own beliefs and assumptions of ageing and values as well as those of the service and clinician. CBT is particularly appropriate as an intervention for older people as it is skills enhancing, present-oriented, problem-focused, straightforward to use and effective. While depression in later life is often misunderstood as a natural consequence of challenges and losses faced by older people, this unhelpful belief in therapists negates efficacious therapeutic outcomes as therapy becomes unfocused, passive and less effective. In this workshop, CBT is augmented with applied gerontological theories in order to enhance outcome 1:1 6 1 BABCP Evaluation Trainees will learn about the how the Course meets the minimum training standards (MTS) as detailed by the British Association for Behavioural and Cognitive Psychotherapies (BABCP). Page 4 of 10

6 YEAR: TERM SESSION NUMBER TIME ALLOCATED TEACHING SESSION TITLE 1:2 7 6 CBT for Generalised Anxiety Disorder 1:2 8 6 CBT for Obsessive Compulsive Disorder Part 1&2 1: Introduction to Mindfulness LEARNING OBJECTIVES Trainees will learn about the theoretical concepts and CBT approach to GAD through teaching on : o The diagnostic features of GAD o Assessment & Measures (including worry records and mood diaries) o CBT model of GAD (Wells, 1995) o Intervention strategies for GAD (including advantages-disadvantages analysis, behavioural experiments, modifying beliefs about worry) Skills practice: behavioural experiments Trainees will learn about the theoretical concepts and CBT approach to OCD through teaching on : o The diagnostic features of OCD o Assessment & Measures o CBT models of OCD (including Salkovskis model) o Intervention strategies for OCD Skills practice: identifying thoughts and distinguishing these from meaning attributed to thoughts Intervention and Evaluation Trainees will learn about the Mindfulness techniques within CBT through teaching on: o The concept of mindfulness and how it can be applied in our clinical work. o The obstacles to using mindfulness with clients (and to practising it ourselves). o Mindfulness approaches and techniques may be indicated (and contraindicated). Broader uses of Mindfulness with health and education Page 5 of 10

7 YEAR: TERM SESSION NUMBER TIME ALLOCATED TEACHING SESSION TITLE 1:2 8 6 CBT for Social Anxiety Disorder 1:2 9 6 CBT for Post-Traumatic Stress Disorder 1: DBT using Self-Harm as an application LEARNING OBJECTIVES Trainees will learn about the theoretical concepts and CBT approach to social anxiety through teaching on : o Assessment and Measures o Psychological models and theories o Clarke & Wells models of Social Phobia Overview of treatment Skills practice Trainees will learn about the theoretical concepts and CBT approach to PTSD through teaching on : o The diagnostic features of PTSD o Assessment & Measures o CBT models of trauma (including Ehlers & Clark s model) o Intervention strategies for PTSD (including reliving and updating hotspots) Skills practice: explaining rationale for reliving using metaphors Assessment, Formulation, Intervention Trainees will learn about the theoretical concepts and DBT approach to self-harm through teaching on: o DBT Interventions available to help clients o Evidence base 1: CBT for Eating Disorders o To present the key characteristics and symptoms associated with a range of eating disorder presentations o To introduce assessment tools and NICE guidelines o To consider theoretical approaches and evidence based practice to work with this presentation o To look at eating disorders across the lifespan Page 6 of 10

8 YEAR: TERM SESSION NUMBER TIME ALLOCATED TEACHING SESSION TITLE 1:2 3 Working at Core Belief level LEARNING OBJECTIVES Intervention and Evaluation Trainees will develop and advance CBT techniques through teaching and practice on working at Core Belief level in CBT interventions. 1:2 3 CBT for Bi-Polar Trainees will learn about the theoretical concepts and CBT approach to Bi-Polar through teaching on assessment, formulation, intervention, and outcome evaluation. Page 7 of 10

9 References: General Texts Beck J. (2005) Cognitive Therapy for Challenging Problems: what to do when the basics don t work. New York. NY: Guilford Press Beck, J. (2011). Cognitive Therapy: The Basics and Beyond (2 nd Ed). New York, NY: Guildford Press. Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, B. (1979). Cognitive therapy of depression. New York, NY: Guildford Press. Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M., & Westbrook, D. (2004). Oxford guide to behavioural experiments in cognitive therapy. Oxford, UK: Oxford University Press. Blackburn, I. M, James, I. A., Milne, D. L. & Reichelt, F. K. (2001) Cognitive Therapy Scale Revised (CTS-R). Newcastle upon Tyne, UK: Tyne & Wear NHS Trust. Bruch, M (Ed.) (2015). Beyond Diagnosis: Case Formulation in Cognitive Behavioural Therapy (2 nd Ed.) London, UK: Wiley-Blackwell. Butler, G., Fennell, M.J., Hackmann, M. (2010) Cognitive-Behavioural Therapy for Anxiety Disorders: Mastering Clinical Challenges. : London, UK: Guilford Press. Gilbert, P. & Leahy, R.L. (2009) The Therapeutic relationship in the cognitive behavioural psychotherapies. New York, NY: Routledge. Greenberger, D. & Padesky, C. A. (1995) Mind Over Mood: Change How you Feel by Changing the Way you think. London, UK: Guildford Press. Hawton, K. & Salkovskis, P. (1989). Cognitive Behaviour Therapy for Psychiatric Problems: A Practical Guide. Oxford, UK: Oxford University Press Mueller, M., Kennerley, H., McManus, F., Westbrook. D (2010). Oxford Guide to Surviving as a CBT Therapist. Oxford, UK: Oxford University Press. Padesky,C. & Greenberger,D. (1995). Clinician s guide to Mind over Mood. New York, NY: Guilford Press. Roth, A. & Pilling, S. (2007). The competences required to deliver effective cognitive and behavioural therapy with people with depression and with anxiety disorders. Department of Health. Retrieved from: Shafran, R., Brosan, L., Cooper, P. (2013). The Complete CBT Guide for Anxiety. London, UK: Constable & Robinson Ltd. Stott, R., Mansell, W., Salkovskis, P. M., Lavender, A. & Cartwright-Hatton, S. (2010). Oxford Guide to Metaphors in CBT: Building Cognitive Bridges. Oxford, UK: Oxford University Press. Wells A. (1997). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. Chichester, England: Wiley. Page 8 of 10

10 Wells,A. (2000) Emotional Disorders and Meta Cognitions. Chichester, England: Wiley Westbrook, D., Kennerley, H. & Kirk, J. (2007) An Introduction to Cognitive Behaviour Therapy: skills and application. London: Sage CBT for Children & Young People Friedberg, R.D. & McClure, J.M. (2002). Clinical Practice of Cognitive Therapy with Children and Adolescents: The Nuts and Bolts. New York, NY: Guildford Press Fuggle, P, Dunsmuir, S., & Curry, V. (2012). CBT with Children, Young People and Families. London, UK: Sage Kendall, P (2000). Child and Adolescent Therapy: Cognitive Behavioural Procedures. New York, NY: Guildford Press Stallard, P. (2002). Think Good-Feel Good: A Cognitive Behaviour Therapy Workbook for Children and Young People. Chichester, England: John Wiley & Sons Stallard, P. (2005). A Clinician's Guide to Think Good-Feel Good: Using CBT with children and young people. Chichester, England: John Wiley & Sons CBT for Older Adults Laidlaw, K., Thompson, L.W., Siskin-Dick, L., & Gallagher-Thompson, D. (2003). Cognitive Behavioural Therapy with Older People. Chichester, England: John Wiley & Sons, Ltd. Pachana, N., Laidlaw, K., Knight, B.(Eds) (2010). Casebook of Clinical Geropsychology: International Perspectives on Practice. Oxford, UK: Oxford University Press CBT for Learning Disabilities Stenfert Kroese, B., Dagnan, D. & Loumidis, K. (Eds.) (1997). Cognitive- Behaviour Therapy for People with Learning Disabilities. London, UK: Routledge. Taylor, J. L., Lindsay, W. R., Hastings, R. P., Hatton, C. (Eds.) (2013). Psychological therapies for adults with intellectual disabilities. Chichester, England: John Wiley & Sons. Service User and Carer Perspective Clarke, H., Rees, A., & Hardy, G. (2004). The big idea: Clients perspectives of change processes in cognitive therapy. Psychology and Psychotherapy: Theory, Research and Practice, 77, DOI: / Morberg Pain, C., Chadwick, P., Abba, N. (2008) Client experience of case formulation in cognitive behaviour therapy for psychosis. British Journal of Clinical Psychology, 47, DOI: / X Westra, H. A., Aviram, A., Barnes, M., & Angus, L. (2010) Therapy was not what I expected: A preliminary qualitative analysis of concordance between client expectations and experience of cognitive behavioural therapy, Psychotherapy Research, 20, , DOI: / Page 9 of 10

11 The teaching on this module will contribute to trainees learning the following standards of proficiency in line with the HCPC (2015) standards: 2. Be able to practice within the legal and ethical boundaries of their profession 3. Be able to maintain fitness to practice 4. Be able to practise as an autonomous professional, exercising their own professional judgement 5. Be aware of the impact of culture, equality and diversity on practice 9. Be able to work appropriately with others 13. Understand the key concepts of the knowledge base relevant to their profession 14. Be able to draw on appropriate knowledge and skills to inform practice Page 10 of 10