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Powell SK, Serafini RA, Frere JJ, De Pins A, Saali A, Sultana SA, Ali M, Dale B, Datta D, Aaronson C, Meah Y, Katz CL, Gluhoski V. Provision of Cognitive Behavior Therapy for Depression and Anxiety Disorders by Medical Student Trainees. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:10-17. [PMID: 37770702 DOI: 10.1007/s40596-023-01873-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE The purpose of the article is to evaluate an innovative education program in which medical students were trained in cognitive behavior therapy (CBT) and provided CBT treatments under supervision to uninsured individuals with depressive, anxiety, adjustment, and trauma-based disorders. METHODS The authors assessed improvements in trainees' CBT knowledge using the Cognitive Therapy Awareness Scale before and after their didactic training. CBT supervisors rated trainees' clinical competencies utilizing standardized checklist evaluations based upon supervision reports. The authors employed mixed effects ANOVA and regression modeling to test the association between the addition of CBT to treatment as usual (TAU) and improvements in patients' depressive and anxious symptom severity. The authors collected feedback and self-assessment of functioning with a Psychotherapy Feedback Questionnaire. RESULTS Medical students showed increases in CBT knowledge that were maintained six months later and demonstrated satisfactory competency in CBT techniques. The addition of CBT to TAU was associated with greater improvements in depressive, but not anxious, symptom severity. However, among the TAU + CBT group, there was an association between the number of CBT sessions received and the magnitude of improvement in anxious symptoms from baseline. Patients gave positive feedback to medical student CBT providers and reported improvements in broad domains of psychosocial functioning. CONCLUSIONS Medical students can provide competent and clinically beneficial CBT treatments for depression and anxiety disorders. These findings have implications for medical training and support the use of medical students to deliver care for individuals with limited access to psychotherapy.
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Affiliation(s)
| | | | - Justin J Frere
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Agathe De Pins
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Muhammad Ali
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brandon Dale
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Debjyoti Datta
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cindy Aaronson
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yasmin Meah
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Craig L Katz
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vicki Gluhoski
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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2
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Nurse K, O'shea M, Ling M, Castle N, Sheen J. The influence of deliberate practice on skill performance in therapeutic practice: A systematic review of early studies. Psychother Res 2024:1-15. [PMID: 38295223 DOI: 10.1080/10503307.2024.2308159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVE Deliberate practice (DP) is recommended as a new approach to facilitate the acquisition of discrete therapeutic skills, however, its implementation and effectiveness in psychotherapy remains unclear. METHOD A systematic search on DP for therapeutic skills among psychotherapy trainees and psychotherapists yielded eleven studies for inclusion. Nine were randomized controlled studies (RCTs), including seven unique RCTs, and two were within-group studies. RESULTS Risk of bias was assessed as "high" for one RCT, "some concerns" for the remaining RCTs, and "serious" for within-group studies. All RCTs found the DP group performed better than the control group. All studies involved efforts to improve performance based on learning objectives and iterative practice but varied in the source of expert guidance and feedback. The included studies provide limited insight into best practice for delivering DP. CONCLUSION The results highlight the paucity of research in this field; however they offer insight into current applications of DP and provide preliminary empirical support DP for as a model for promoting the development of discrete therapeutic skills. Given the rapid dissemination of DP publications and manuals in psychotherapy, future research is strongly encouraged.
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Affiliation(s)
- Karina Nurse
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Melissa O'shea
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Mathew Ling
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Neami National, Melbourne, VIC, Australia
| | | | - Jade Sheen
- School of Psychology, Deakin University, Geelong, VIC, Australia
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3
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Sarfan LD, Zieve G, Gumport NB, Xiong M, Harvey AG. Optimizing outcomes, mechanisms, and recall of Cognitive Therapy for depression: Dose of constructive memory support strategies. Behav Res Ther 2023; 166:104325. [PMID: 37210887 PMCID: PMC10513748 DOI: 10.1016/j.brat.2023.104325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/14/2023] [Accepted: 04/28/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Poor memory for treatment is associated with worse patient outcomes. Therapist use of constructive memory support strategies, which help patients actively engage with treatment content, may improve patient memory for treatment. We sought to identify the dose of constructive memory support needed to optimize treatment outcomes, mechanisms, and patient recall. METHOD Adults with major depressive disorder (N = 178, mean age = 37.9, 63% female, 17% Hispanic or Latino/a) were randomized to Cognitive Therapy plus a Memory Support Intervention or Cognitive Therapy as usual. Because therapists from both groups used constructive memory support, treatment conditions were combined to maximize data. Depression and overall impairment were assessed before treatment, immediately post-treatment (POST), and six (6FU) and 12 months (12FU) after treatment. Patients completed measures of treatment mechanisms - utilization/competency in Cognitive Therapy skills - and treatment recall at POST, 6FU, and 12FU. Patient adherence to treatment was averaged across sessions. RESULTS Using Kaplan-Meier Survival Analyses, the optimal dose of constructive memory support was eight uses per session (sensitivity analysis range: 5-12 uses). Pre-treatment depression symptoms and patient perceptions of treatment may impact the optimal dose. CONCLUSION Eight uses of constructive memory support by therapists per session may optimize treatment outcomes, mechanisms, and recall over the long-term.
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Affiliation(s)
- Laurel D Sarfan
- University of California, 2121 Berkeley Way, Berkeley, CA, 94720, USA.
| | - Garret Zieve
- University of California, 2121 Berkeley Way, Berkeley, CA, 94720, USA.
| | - Nicole B Gumport
- University of California, 2121 Berkeley Way, Berkeley, CA, 94720, USA.
| | - Mo Xiong
- University of California, 2121 Berkeley Way, Berkeley, CA, 94720, USA.
| | - Allison G Harvey
- University of California, 2121 Berkeley Way, Berkeley, CA, 94720, USA.
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Marriott BR, Walker MR, Howard J, Puspitasari A, Scott K, Albright K, Lewis CC. Taking a Magnifying Glass to Measurement-Based Care Consultation Sessions: with What Issues Do Mental Health Clinicians Struggle? ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:366-378. [PMID: 36542316 PMCID: PMC10201798 DOI: 10.1007/s10488-022-01244-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Ongoing consultation following initial training is one of the most commonly deployed implementation strategies to facilitate uptake of evidence-based practices, such as measurement-based care (MBC). Group consultation provides an interactive experience with an expert and colleagues to get feedback on actual issues faced, yet there is little research that unpacks the questions raised in consultation and what types of issues are important to address. METHODS The current study characterized the questions and concerns raised by community mental health clinicians (N = 38 across six clinics) during group consultation sessions completed as part of an MBC implementation trial. We conducted a qualitative content analysis of consultation forms completed by clinicians before each MBC consultation session. RESULTS Clinicians sought MBC consultation for clients across a range of ages and levels of depression severity. Qualitative results revealed five main questions and concerns in consultation sessions: (1) how to administer the PHQ-9, (2) how to review PHQ-9 scores, (3) how to respond to PHQ-9 score, (4) the types of clients for whom MBC would be appropriate, and (5) how MBC could impact a clinician's usual care. CONCLUSION Findings highlight the need for ongoing consultation and limitations of workshop training alone. Practical recommendations for addressing the common questions and concerns identified are presented to support MBC use.
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Affiliation(s)
- Brigid R Marriott
- Department of Psychiatry, Indiana University School of Medicine, 410 W. 10th St, 46202, Indianapolis, IN, USA.
| | - Madison R Walker
- University of North Carolina, 135 Dauer Dr, 27599, Chapel Hill, NC, USA
| | | | - Ajeng Puspitasari
- Rogers Behavioral Health, 576 Bielenberg Dr Ste 180, 55125, Woodbury, MN, USA
| | - Kelli Scott
- Brown University, 121 S. Main Street, 02903, Providence, RI, USA
| | - Karen Albright
- Division of General Internal Medicine, University of Colorado School of Medicine, 12631 East 17th Ave, 80045, Aurora, CO, USA
| | - Cara C Lewis
- MacColl Center for Healthcare Innovation, Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, 98101, Seattle, WA, USA
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Henrich D, Glombiewski JA, Scholten S. Systematic review of training in cognitive-behavioral therapy: Summarizing effects, costs and techniques. Clin Psychol Rev 2023; 101:102266. [PMID: 36963208 DOI: 10.1016/j.cpr.2023.102266] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/09/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
With the steadily growing importance of psychotherapeutic care, there is also an increasing need for high-quality training. We analyze the literature published between 2009 and 2022 on the effectiveness of training in cognitive behavioral therapy. The review addresses current gaps in the literature by focusing on the description of specific training components and their associated costs, as well as examining therapist-level predictors of training effectiveness. Our findings confirm the effect of additional supervision on both therapist competence and patient outcomes. Instructor-led training and self-guided web-based training seem to moderately increase competence, especially when targeting specific and highly structured treatments or skills. The level of prior training and experience of a therapist appears to predict the strength of training-related gains in competence. Few studies analyzed the differential effect of certain elements of training (e.g., the amount of active learning strategies) and training costs were generally not reported. Future studies should replicate or expand the existing evidence on active ingredients and therapist-level predictors of training effectiveness. Costs should be systematically reported to enhance the comparability of different training strategies.
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Affiliation(s)
- Dominik Henrich
- Department of Clinical Psychology and Psychotherapy, RPTU Kaiserslautern-Landau, Germany.
| | - Julia A Glombiewski
- Department of Clinical Psychology and Psychotherapy, RPTU Kaiserslautern-Landau, Germany
| | - Saskia Scholten
- Department of Clinical Psychology and Psychotherapy, RPTU Kaiserslautern-Landau, Germany
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6
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Development of competence in cognitive behavioural therapy and the role of metacognition among clinical psychology and psychotherapy students. Behav Cogn Psychother 2023; 51:200-213. [PMID: 36691810 DOI: 10.1017/s1352465822000686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND There is a paucity of research on therapist competence development following extensive training in cognitive behavioural therapy (CBT). In addition, metacognitive ability (the knowledge and regulation of one's cognitive processes) has been associated with learning in various domains but its role in learning CBT is unknown. AIMS To investigate to what extent psychology and psychotherapy students acquired competence in CBT following extensive training, and the role of metacognition. METHOD CBT competence and metacognitive activity were assessed in 73 psychology and psychotherapy students before and after 1.5 years of CBT training, using role-plays with a standardised patient. RESULTS Using linear mixed modelling, we found large improvements of CBT competence from pre- to post-assessment. At post-assessment, 72% performed above the competence threshold (36 points on the Cognitive Therapy Scale-Revised). Higher competence was correlated with lower accuracy in self-assessment, a measure of metacognitive ability. The more competent therapists tended to under-estimate their performance, while less competent therapists made more accurate self-assessments. Metacognitive activity did not predict CBT competence development. Participant characteristics (e.g. age, clinical experience) did not moderate competence development. CONCLUSIONS Competence improved over time and most students performed over the threshold post-assessment. The more competent therapists tended to under-rate their competence. In contrast to what has been found in other learning domains, metacognitive ability was not associated with competence development in our study. Hence, metacognition and competence may be unrelated in CBT or perhaps other methods are required to measure metacognition.
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Chigwedere C, Fitzmaurice B, Thwaites R. Reliability of the Reflective Essay Marking Scale (REMS): a scale for marking of students’ reflective essays. COGNITIVE BEHAVIOUR THERAPIST 2023. [DOI: 10.1017/s1754470x22000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Abstract
Personal practice (PP) is widely practised and a requirement across major psychology and psychotherapy organizations and modalities. However, one of the challenges for training institutions is how to assess the quality of such PP. The Reflective Essay Marking Scale (REMS) was developed to improve standardization of marking reflective essays in cognitive behavioural psychotherapy (CBT) training. A small sample of 16 expert CBT participants recruited by email used the REMS to rate two mock reflective essays in a within-subjects design. The internal consistency of REMS was acceptable (Cronbach’s α=.73) with excellent inter-rater reliability. Across the raters, it sufficiently differentiated quality (t12=4.91; p<.0001). Although these are the results of a preliminary and very small study with a small sample using mock essays, the REMS may be a useful scale, allowing CBT courses to account for students’ reflective work in a standardized way. A larger validation study is required in the future.
Key learning aims
(1)
To improve the thinking about what raters should focus on when rating the reflective essays of trainee therapists.
(2)
To describe the development of the scale and how its reliability was tested.
(3)
To improve the transparency and objectivity in assessing and rating reflective practice.
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8
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What characterizes helpful personal practice in psychotherapy training? Results of an online survey. Behav Cogn Psychother 2023; 51:74-86. [PMID: 36281883 DOI: 10.1017/s1352465822000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Personal practice (PP) is often considered as a central component in psychotherapy training aiming to promote personal and therapeutic competences. However, its implementation varies considerably in practice. AIMS The purpose of this exploratory study was to examine the current practice of PP regarding the frequency/occurrence and perceived usefulness/impairment of topics, techniques and effects, as well as its helpful characteristics in psychotherapy training. METHOD 407 German psychotherapy trainees (214 cognitive behavioural therapy; 178 psychodynamic therapy) were surveyed online as to their current practice of PP. RESULTS For trainees, personal and therapeutic related topics were discussed. Reflection techniques and self-experiential practice were among the most frequently reported strategies, while the fostering of personal and interpersonal competences was among the effects with the strongest occurrence. However, negative PP effects were recorded as well. Differences in PP practice emerged between therapeutic orientations. CONCLUSIONS As certain techniques which are central to PP (e.g. self-experience) were also rarely or not used, and negative effects reported, its potential might not be fully utilized.
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9
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Doumas DM, Midgett A, Peck M. Gender Differences in Defending Behavior among Elementary School Students Trained in a Bullying Bystander Program: Is Self-Esteem a Moderator? JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2022. [DOI: 10.1080/15377903.2022.2152917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Diana M. Doumas
- Institute for the Study of Behavioral Health and Addiction, Boise State University, Boise, Idaho, USA
| | - Aida Midgett
- Department of Counselor Education, Boise State University, Boise, Idaho, USA
| | - Matt Peck
- Institute for the Study of Behavioral Health and Addiction, Boise State University, Boise, Idaho, USA
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10
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Prasko J, Ociskova M, Vanek J, Burkauskas J, Slepecky M, Bite I, Krone I, Sollar T, Juskiene A. Managing Transference and Countertransference in Cognitive Behavioral Supervision: Theoretical Framework and Clinical Application. Psychol Res Behav Manag 2022; 15:2129-2155. [PMID: 35990755 PMCID: PMC9384966 DOI: 10.2147/prbm.s369294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/10/2022] [Indexed: 11/23/2022] Open
Abstract
Dysfunctional patterns, beliefs, and assumptions that affect a patient’s perception of other people often affect their perceptions and behaviours towards the therapist. This tendency has been traditionally called transference for its psychoanalytical roots and presents an important factor to monitor and process. In supervision, it is important to put the patient’s transference in the context of the conceptualization of the case. Countertransference occurs when the therapist responds complementary to the patient’s transference based on their own dysfunctional beliefs or assumptions. Transference and countertransference provide useful insights into the inner world of the patient, therapist, and supervisor. Guided discovery is one of the most common approaches used by a supervisor and a supervisee to map all types and directions of transference and countertransference. Other options to map transference and countertransference are imagery and role-playing techniques.
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Affiliation(s)
- Jan Prasko
- Department of Psychiatry, Faculty of Medicine, Palacky University, University Hospital Olomouc, Olomouc, Czech Republic.,Department of Psychological Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University, Nitra, Slovak Republic.,Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, Czech Republic.,Rehabilitation Hospital Jessenia Inc, Akeso Holding, Beroun, Czech Republic
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine, Palacky University, University Hospital Olomouc, Olomouc, Czech Republic
| | - Jakub Vanek
- Department of Psychiatry, Faculty of Medicine, Palacky University, University Hospital Olomouc, Olomouc, Czech Republic
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Milos Slepecky
- Department of Psychological Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University, Nitra, Slovak Republic
| | - Ieva Bite
- University of Latvia, Latvian Association of CBT, Riga, Latvia
| | - Ilona Krone
- Riga's Stradins University, Latvian Association of CBT, Riga, Latvia
| | - Tomas Sollar
- Department of Psychological Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University, Nitra, Slovak Republic
| | - Alicja Juskiene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
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11
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Maciag R, Travers‐Hill E, Morrison NR, Kim Y. Paraprofessionals delivering brief psychological interventions: Qualitative accounts of training and supervision. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Rachel Maciag
- Cambridgeshire and Peterborough NHS Foundation Trust Fulbourn Hospital Cambridge UK
| | - Emma Travers‐Hill
- Cambridgeshire and Peterborough NHS Foundation Trust Fulbourn Hospital Cambridge UK
- School of Psychology University of Kent Canterbury UK
| | | | - Youngsuk Kim
- Cambridgeshire and Peterborough NHS Foundation Trust Fulbourn Hospital Cambridge UK
- Harvard Medical School, Home Base, a Red Sox Foundation and Massachusetts General Hospital Program Massachusetts General Hospital Charlestown Massachusetts USA
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12
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‘It was like the unicorn of the therapeutic world’: CBT trainee experiences of acquiring skills in guided discovery. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Training as a cognitive behavioural therapist involves a considerable role transition for mental health professionals where they are expected to demonstrate competence in a range of new skills that emphasise collaboration and Socratic dialogue. This can be in stark contrast to the more didactic style that trainees are familiar with prior to embarking on their training. Guided discovery (GD) is an integral part of formulation and treatment, yet little is known at present about the experiences of cognitive behavioural therapy (CBT) trainees when learning this new skill; specifically, how they assimilate this with existing ways of working and the challenges this might involve. This research is a preliminary attempt to understand factors that help and hinder GD skill acquisition. Eighteen trainee CBT practitioners completed an online questionnaire with the subsequent data analysed using a grounded theory methodology. Three themes were identified: ‘Competing Selves’, ‘Style’ and ‘Active Engagement and Learning’. These themes were used to develop a preliminary model of factors that enable or inhibit skills in GD. The impact of previous professional roles appears to influence the acquisition of confidence and skill in GD. This paper discusses the implications of the findings for CBT trainers, supervisors and trainees.
Key learning aims
As a result of reading this paper, readers should:
(1)
Understand how trainee cognitive behavioural therapists respond to learning how to use guided discovery.
(2)
Identify potential barriers to acquiring and improving skills in guided discovery.
(3)
Recognise training strategies that might assist trainees in becoming more proficient in guided discovery.
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13
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Lewis CC, Scott K, Rodriguez-Quintana N, Hoffacker C, Boys C, Hindman R. Implementation of the Wolverine Mental Health Program, Part 3: Sustainment Phase. COGNITIVE AND BEHAVIORAL PRACTICE 2022; 29:244-255. [PMID: 35310457 PMCID: PMC8932444 DOI: 10.1016/j.cbpra.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Sustaining the implementation of an evidence-based practice (EBP) is the ultimate goal of often years of significant personnel and financial investment. Some conceptualize sustainment as a distinct phase following an active implementation period where the contextual factors, processes, and supports are bolstered to ensure continued EBP delivery. This study provides an overview of the sustainment strategies deployed to embed cognitive-behavioral therapy (CBT) in a Midwestern residential treatment facility serving youth with complex mental health needs. Seven key strategies and their outcomes are described: use of CBT teams, new hire orientation plans, monthly campaigns, change in job descriptions and performance evaluations, development of a behavioral reinforcement system for youth, and a pathway to CBT certification. This study provides a window into how one might sustain an EBP by addressing barriers unique to this phase of work.
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Affiliation(s)
- Cara C Lewis
- Kaiser Permanente Washington Health Research Institute
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14
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Rosenberg BM, Kodish T, Cohen ZD, Gong-Guy E, Craske MG. A Novel Peer-to-Peer Coaching Program to Support Digital Mental Health: Design and Implementation. JMIR Ment Health 2022; 9:e32430. [PMID: 35080504 PMCID: PMC8829693 DOI: 10.2196/32430] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 01/09/2023] Open
Abstract
Many individuals in need of mental health services do not currently receive care. Scalable programs are needed to reduce the burden of mental illness among those without access to existing providers. Digital interventions present an avenue for increasing the reach of mental health services. These interventions often rely on paraprofessionals, or coaches, to support the treatment. Although existing programs hold immense promise, providers must ensure that treatments are delivered with high fidelity and adherence to the treatment model. In this paper, we first highlight the tension between the scalability and fidelity of mental health services. We then describe the design and implementation of a peer-to-peer coach training program to support a digital mental health intervention for undergraduate students within a university setting. We specifically note strategies for emphasizing fidelity within our scalable framework, including principles of learning theory and competency-based supervision. Finally, we discuss future applications of this work, including the potential adaptability of our model for use within other contexts.
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Affiliation(s)
- Benjamin M Rosenberg
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Tamar Kodish
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Zachary D Cohen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Elizabeth Gong-Guy
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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15
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Marshall JM, Dunstan DA, Bartik W. Smartphone Psychological Therapy During COVID-19: A Study on the Effectiveness of Five Popular Mental Health Apps for Anxiety and Depression. Front Psychol 2022; 12:775775. [PMID: 35069357 PMCID: PMC8771308 DOI: 10.3389/fpsyg.2021.775775] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/10/2021] [Indexed: 01/26/2023] Open
Abstract
The aims of this study were to examine the effectiveness of a range of smartphone apps for managing symptoms of anxiety and depression and to assess the utility of a single-case research design for enhancing the evidence base for this mode of treatment delivery. The study was serendipitously impacted by the COVID-19 pandemic, which allowed for effectiveness to be additionally observed in the context of significant community distress. A pilot study was initially conducted using theSuperBetter app to evaluate the proposed methodology, which proved successful with the four finishing participants. In the main study, 39 participants commenced (27 females and 12 males,MAge = 34.04 years,SD = 12.20), with 29 finishing the intervention phase and completing post-intervention measures. At 6-month follow-up, a further three participants could not be contacted. This study used a digitally enhanced, multiple baseline across-individuals single-case research design. Participants were randomly assigned to the following apps:SuperBetter (n = 8),Smiling Mind (n = 7),MoodMission (n = 8),MindShift (n = 8), andDestressify (n = 8). Symptomatology and life functioning were measured at five different time points: pre-baseline/screening, baseline, intervention, 3-week post-intervention, and 6-month follow-up. Detailed individual perceptions and subjective ratings of the apps were also obtained from participants following the study’s completion. Data were analyzed using visual inspection, time-series analysis, and methods of statistical and clinical significance. Positive results were observed for all apps. Overall, more favorable outcomes were achieved by younger participants, those concurrently undertaking psychotherapy and/or psychotropic medication, those with anxiety and mixed anxiety and depression rather than stand-alone depression, and those with a shorter history of mental illness. Outcomes were generally maintained at 6-month follow-up. It was concluded that a diverse range of evidence-based therapies offered via apps can be effective in managing mental health and improving life functioning even during times of significant global unrest and, like all psychotherapies, are influenced by client features. Additionally, this single-case research design is a low-cost/high value means of assessing the effectiveness of mental health apps. Clinical Trial Registration: The study is registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR), which is a primary registry in the World Health Organization Registry Network, registration number ACTRN12619001302145p (http://www.ANZCTR.org.au/ACTRN12619001302145p.aspx).
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Affiliation(s)
- Jamie M Marshall
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Debra A Dunstan
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Warren Bartik
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
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16
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Formulating psychosis: a thematic analysis of CBTp trainees’ experiences. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Abstract
The NICE guidance states that cognitive behavioural therapy (CBT) should now be offered to everyone with psychosis in the UK. This has rightly resulted in an increased demand for adherent therapy from qualified clinicians. Individualised formulation is a key component of CBT for psychosis, yet many trainees struggle to make sense of and apply the theoretical models on which these are based. This study explored trainee and recently qualified therapists’ experience of formulating CBT for psychosis, to help us understand how best to guide training and clinical practice. We ran focus groups with trainees who were completing, or had recently completed, postgraduate training in CBT for psychosis. We then analysed verbatim transcripts of the semi-structured interviews. and completed a thematic analysis of the data using inductive open coding. Three over-arching themes were generated: (1) purpose of formulation, (2) formulation in practice, and (3) (reflection on) learning to formulate. Training programmes and clinical supervisors should focus on fostering trainees’ and newly qualified therapists’ ability to develop simple, targeted formulations. These will draw on maintenance and developmental models of psychosis, depending on the person’s needs and goals. Opportunities for procedural learning are likely to improve skilful formulation, and use as the basis for therapeutic change.
Key learning aims
(1)
CBT for psychosis is best guided by individualised formulation.
(2)
The range and complexity of current theoretical models is challenging.
(3)
A qualitative analysis of trainee and recently qualified therapists’ experiences highlights means of facilitating understanding and application of these models.
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17
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Grover N, Lakhani S, Emran A. Reflective practice in action: an account of psychotherapists’ experiences in group-work training. REFLECTIVE PRACTICE 2021; 22:782-795. [DOI: 10.1080/14623943.2021.1974372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/25/2021] [Indexed: 09/01/2023]
Affiliation(s)
- Naveen Grover
- Department of Clinical Psychology, Institute of Human Behaviour and Allied Sciences, Delhi, India
| | - Sheetal Lakhani
- Department of Clinical Psychology, Institute of Human Behaviour and Allied Sciences, Delhi, India
| | - Ashti Emran
- Department of Clinical Psychology, Institute of Human Behaviour and Allied Sciences, Delhi, India
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18
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O'Sullivan E, Gogan E, Doyle L, Donohue G. Decider Life Skills training as a method of promoting resilience with mental health student nurses on clinical placement. Nurse Educ Pract 2021; 56:103222. [PMID: 34624654 DOI: 10.1016/j.nepr.2021.103222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/08/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
AIM The aim of this study is to explore mental health student nurses' perceptions and application of a CBT-orientated training programme - the Decider Life Skills programme. BACKGROUND The undergraduate nursing degree programme is a challenging one and places high demands both professionally and personally on students. Mental health nursing students are faced with particular stressors including working with people in significant psychological distress, which can result in students feeling overwhelmed and emotionally burdened. There is a requirement for student nurses to be supported to cope with professional and personal difficulties while on practice placement. The Decider Life Skills is a one-day training programme that aims to build resilience and increase effective coping skills. This programme was offered to internship mental health nursing students with the aim of providing them with a toolbox of skills to maintain their wellbeing while on clinical placement. METHODS A qualitative descriptive design was used, and data were collected through two 45-min focus group interviews with mental health students (n = 10) on their internship placement. These students had received a one-day training in Decider Life Skills prior to their clinical placements. Full ethical approval was achieved for this study. RESULTS Participants reported that they found the skills imparted in the training easy to understand and apply in both their professional and their personal lives. CONCLUSIONS The findings from this study that the Decider Life Skills helped students cope in stressful situations and become more mindful of protecting their own mental health is important, as there is a need to safeguard the emotional well-being of mental health nursing students and support them to become resilient practitioners.
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Affiliation(s)
- Eimear O'Sullivan
- HSE Mental Health Services, Dublin South, Kildare & West Wicklow Community Healthcare, Cherry Orchard Hospital, Dublin 10, Ireland.
| | - Eimear Gogan
- HSE Mental Health Services, Dublin South, Kildare & West Wicklow Community Healthcare, Cherry Orchard Hospital, Dublin 10, Ireland.
| | - Louise Doyle
- School of Nursing and Midwifery, Trinity College, University of Dublin, 24 D'Olier Street, Dublin 2, Ireland.
| | - Gráinne Donohue
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College, University of Dublin, 24 D'Olier Street, Dublin 2, Ireland.
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19
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Alpers GW, Hengen KM. Interactions with Standardized Patients to Evaluate Students’ Psychotherapy-Competencies. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2021. [DOI: 10.1026/1616-3443/a000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. The use of standardized patients (SPs) in the training of prospective practitioners is a well-established didactic tool in medical schools. Only recently have simulations of patients in psychotherapy been introduced into the training of psychologists. By integrating psychotherapy training into university-level master’s programs, German law now requires licensing exams for psychotherapists (i. e., Approbationsprüfung) to include an assessment of therapeutic competencies in simulated interactions with SPs. Yet, it has not been examined whether these simulations are useful for a reliable assessment of competencies in psychotherapy trainees. Also, we need to develop standardized instruments to evaluate competencies in entry-level psychotherapists. As part of a university course, we trained master’s-level students from three cohorts in clinical interviewing techniques (course title: Klinisch-psychologische Gesprächsführung). We analyzed videotaped 20-min sequences of N = 104 students while they interviewed one of N = 38 trained SPs. The students’ task was to interview the SP, conduct a brief case history, and use the interviewing skills they had learned in class. Two independent raters evaluated their psychotherapeutic competencies with an adapted version of the German Cognitive Therapy Scale (CTS). Raters evaluated students’ performance on two subscales and the total score with satisfactory interrater agreement (intraclass correlations). In general, students performed well in the interviews: They structured the sessions sufficiently, and their global psychotherapeutic competencies were satisfactory. However, the psychotherapeutic competencies of master’s students fell short of the benchmark derived from experienced psychotherapists. This pilot study provides first evidence that simulated interviews with SPs may be a reliable tool in the assessment of practical competencies in psychotherapy trainees at an early stage of their training. Moreover, we found that the CTS, which has demonstrated validity to quantify competencies of psychotherapists, is applicable and reliable in this training context as well. In sum, this suggests that simulated interviews with SPs may be useful for evaluating psychotherapeutic competencies of psychotherapy trainees.
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Affiliation(s)
- Georg W. Alpers
- School of Social Sciences, Department of Psychology, University of Mannheim, Germany
| | - Kristina M. Hengen
- School of Social Sciences, Department of Psychology, University of Mannheim, Germany
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20
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Hahn D, Weck F, Witthöft M, Maiwald LM, Foral A, Kühne UF. Wie erleben Psychotherapeut_innen in Ausbildung ihre Selbsterfahrung? ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2021. [DOI: 10.1026/1616-3443/a000626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Selbsterfahrung ist zentraler Bestandteil der Psychotherapieausbildung. Gleichzeitig wurde Selbsterfahrung selten empirisch untersucht. Fragestellung: Ziel unserer Studie war es, Bedingungen und Effekte hilfreicher Selbsterfahrung zu explorieren. Methode: Vierzehn verhaltenstherapeutische Ausbildungskandidat_innen wurden anhand halbstrukturierter Leitfadeninterviews befragt. Die Auswertung erfolgte mittels qualitativer Inhaltsanalyse nach Mayring (2015 ). Ergebnisse: Verschiedene Bedingungen wurden mit hilfreich erlebter Selbsterfahrung in Zusammenhang gebracht: Merkmale der Selbsterfahrungsleitung (u. a. Durchführungskompetenz), der Organisation, der Teilnehmer_innen (Lernbereitschaft), die behandelten Themen und die eingesetzten Techniken, sowie eine tragfähige Arbeitsbeziehung. Berichtete positive Effekte waren u. a. die Förderung interpersoneller Kompetenzen. Zudem wurden Nebenwirkungen und negative Effekte formuliert (u. a. Erschöpfung). Schlussfolgerungen: Bedingungen zur Durchführung von als hilfreich erlebter Selbsterfahrung und Effekte von Selbsterfahrung wurden aus Sicht der Teilnehmer_innen extrahiert.
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Affiliation(s)
- Daniela Hahn
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Florian Weck
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Potsdam
| | - Michael Witthöft
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Lisa Marie Maiwald
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Annika Foral
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
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21
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John M. The “existential” in existential psychotherapy: pressing issues of everyday life necessitate intuition informed practice. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1893602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Michael John
- Central Clinical Psychology Practice, Brisbane, Australia
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22
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Heidenreich T, Noyon A, Worrell M, Menzies R. Existential Approaches and Cognitive Behavior Therapy: Challenges and Potential. Int J Cogn Ther 2021; 14:209-234. [PMID: 33425123 PMCID: PMC7781171 DOI: 10.1007/s41811-020-00096-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 11/29/2022]
Abstract
Existential concerns such as death, responsibility, meaninglessness, and isolation not only are the hallmark of existential psychotherapy but also are frequently encountered by CBT therapists-nevertheless, due to epistemological and ideological differences, existential and CBT approaches to psychotherapy had little overlap historically. During recent years, existential issues are increasingly discussed in empirical clinical psychology, e.g., the potential role of the fear of death for a variety of mental disorders by Iverach et al. (Clinical Psychology Review, 34(7), 580-593, 2014), and there is increasing experimental evidence for a causal rather than correlational role of death anxiety discussed by Menzies and Dar-Nimrod (Journal of Abnormal Psychology, 126(4), 367-377, 2017). Further, existential concerns are common themes in CBT discussed by Grober et al. (Psychotherapeut, 61(3), 229-236, 2016) and may play an important role in the training of CBT therapists discussed by Worrell et al. (Journal of Psychotherapy and Counselling Psychology Reflections, 3(1), 9-16, 2018) as well as in personal therapy and supervision.
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Affiliation(s)
- Thomas Heidenreich
- Social Work, Health and Care, University of Applied Sciences Esslingen, Flandernstr. 101, 73728 Esslingen am Neckar, Germany
| | | | - Michael Worrell
- Central and North West London Foundation NHS Trust, London, UK
| | - Ross Menzies
- University of Technology Sydney, Ultimo, Australia
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23
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Midgett A, Doumas DM, Myers VH, Moody S, Doud A. Technology-Based Bullying Intervention for Rural Schools: Perspectives on Needs, Challenges, and Design. ACTA ACUST UNITED AC 2021; 45:14-30. [PMID: 33777286 DOI: 10.1037/rmh0000151] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Bullying is a significant problem in the United States, with 26.7% of middle school students reporting bullying victimization. The majority of bullying programs are comprehensive, school-wide interventions that require significant resources for implementation, creating barriers and challenges for schools in rural and low-income communities. To increase access for these schools, we propose to translate a brief, bystander bullying intervention (STAC) into a technology-based format. Using consensual qualitative research (CQR), we aimed to understand the needs of school personnel and perceived challenges to program implementation to provide information on how to best serve middle schools in rural and low-income communities. We conducted interviews and focus groups with key school personnel at three middle schools in rural, low-income communities (N = 15). Participants indicated a strong interest in a technology-based bullying intervention and reported positive conditions for implementation including administrative support and technology-readiness. Participants identified program efficacy, flexibility of delivery, and parental involvement as important components of bullying prevention and identified implementation challenges, which included time, financial resources, and teacher buy-in. Perceived strengths of the STAC intervention included providing a clear definition of bullying, skills training and practice, and a certificate of completion. Feedback related to translating the intervention to a technology-based format included the use of virtual interaction and a hybrid virtual/in-person program, particularly for booster-sessions. Findings from this study support the need for the proposed technology-based STAC intervention and provide feedback on both the needs and challenges that need to be addressed for successful implementation in middle schools in rural and low-income communities.
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24
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Chigwedere C, Bennett-Levy J, Fitzmaurice B, Donohoe G. Personal practice in counselling and CBT trainees: the self-perceived impact of personal therapy and self-practice/self-reflection on personal and professional development. Cogn Behav Ther 2020; 50:422-438. [PMID: 33325337 DOI: 10.1080/16506073.2020.1846608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
With growing evidence for the potential value of personal practices (PPs) in therapist training, it is important to determine which PPs may be most valuable for which therapists under what conditions. This is the first study to compare the impact of two different PPs selected by accredited therapy training programs as the most appropriate PP for their trainees. Using the same validated outcome measure, the Self-focused Practice Questionnaire, the impact of personal therapy for counselling psychology trainees was compared with the impact of self-practice/self-reflection (SP/SR) training for CBT trainees. The number of PP hours was similar across the two groups. The SP/SR group were older and may have been more experienced professionally. SP/SR was perceived by CBT trainees to be significantly more beneficial for personal and professional development than personal therapy by counselling trainees. Possible reasons are discussed. Although the study does not constitute a direct experimental comparison of personal therapy and SP/SR amongst matched trainees of the same theoretical orientation, it is notable in demonstrating that in training contexts where PP was mandatory, SP/SR was experienced more positively by the CBT trainees than personal therapy by the counselling trainees.
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Affiliation(s)
- Craig Chigwedere
- University Centre for Rural Health, University of Sydney, Lismore, Australia.,Department of Psychiatry, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - James Bennett-Levy
- University Centre for Rural Health, University of Sydney, Lismore, Australia
| | - Brian Fitzmaurice
- Department of Psychiatry, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Gary Donohoe
- School of Psychology, National University of Ireland, Galway, Ireland
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25
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Bennett‐levy J, Wilson S, Nelson J, Rotumah D, Ryan K, Budden W, Stirling J, Beale D. Spontaneous Self‐Practice of Cognitive Behavioural Therapy (CBT) by Aboriginal Counsellors During and Following CBT Training: A Retrospective Analysis of Facilitating Conditions and Impact. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12154] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Shawn Wilson
- University Centre for Rural Health (North Coast), University of Sydney,
| | | | - Darlene Rotumah
- University Centre for Rural Health (North Coast), University of Sydney,
| | - Kelleigh Ryan
- Aboriginal and Torres Strait Islander Healing Foundation,
| | - Wayne Budden
- Mid North Coast Local Health District, NSW Health,
| | - Janelle Stirling
- University Centre for Rural Health (North Coast), University of Sydney,
| | - Dean Beale
- Social and Emotional Well‐being and Mental Health, Galambila Aboriginal Health Service Inc.,
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26
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Bennett‐levy J, Hawkins R, Perry H, Cromarty P, Mills J. Online Cognitive Behavioural Therapy Training for Therapists: Outcomes, Acceptability, and Impact of Support. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2012.00089.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Helen Perry
- University Centre for Rural Health (North Coast), University of Sydney,
| | | | - Jeremy Mills
- University Centre for Rural Health (North Coast), University of Sydney,
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27
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Mcgillivray J, Gurtman C, Boganin C, Sheen J. Self‐Practice and Self‐Reflection in Training of Psychological Interventions and Therapist Skills Development: A Qualitative Meta‐Synthesis Review. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12158] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Jade Sheen
- School of Psychology, Deakin University,
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28
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Baillie AJ, Proudfoot H, Knight R, Peters L, Sweller J, Schwartz S, Pachana NA. Teaching Methods to Complement Competencies in Reducing the “Junkyard” Curriculum in Clinical Psychology. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2011.00036.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Lorna Peters
- Centre for Emotional Health
- Psychology Department
| | - John Sweller
- School of Education, University of New South Wales
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29
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Morris EM, Bilich‐eric L. A Framework to Support Experiential Learning and Psychological Flexibility in Supervision: SHAPE. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Fernández‐álvarez H, Castañeiras C, Wyss G. Commentary on Three Articles on Self‐practice/Self‐reflection in Cognitive‐Behavioural Therapy. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Haarhoff B, Thwaites R, Bennett‐levy J. Engagement With Self‐Practice/Self‐Reflection as a Professional Development Activity: The Role of Therapist Beliefs. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12152] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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Lussier-Valade M, Ngô TL, Leblanc J. www.psychopap.com : améliorer l’accès à la psychothérapie par le transfert des connaissances aux patients et aux futurs thérapeutes. SANTE MENTALE AU QUEBEC 2020. [DOI: 10.7202/1073525ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
La psychothérapie est un traitement efficace pour plusieurs troubles mentaux. Elle est, toutefois, peu accessible pour différentes raisons, dont son coût, la façon de l’offrir et la disponibilité locale des thérapeutes. Par ailleurs, l’accès à la formation en psychothérapie pour les futurs thérapeutes peut être compliqué par différents facteurs incluant le manque de ressources adaptées à différents contextes de pratique et la difficulté à obtenir une supervision. Dans ce contexte, un site web offrant des documents d’autothérapie aux patients, des miniguides de formation dans différents types de psychothérapies basées sur des données probantes, des suggestions d’articles et livres phares, des capsules vidéo expliquant les principes sous-tendant différents modèles théoriques et démontrant des techniques de psychothérapie, pourrait bénéficier autant aux patients qu’aux psychothérapeutes débutants.
L’Hôpital en santé mentale Albert-Prévost (HSMAP), impliqué dès ses origines dans la formation et la pratique de la psychothérapie, conçoit un tel outil pour célébrer son centenaire, le site www.psychopap.com. Le présent article propose de décrire la genèse et le déploiement de ce projet de transmission de connaissances en psychothérapie en décrivant d’abord le contexte et l’implication des membres de l’HSMAP dans l’enseignement de la psychothérapie puis une brève recension des écrits concernant l’autothérapie pour les troubles mentaux, l’utilisation des ordinateurs/Internet pour l’enseignement de la psychothérapie et comment ces données ont été appliquées dans la création de www.psychopap.com.
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Affiliation(s)
| | - Thanh-Lan Ngô
- M.D., M. Sc. FRCPC, psychiatre, CIUSSS du Nord-de-l’Île-de-Montréal - Professeur agrégé de clinique, Département de psychiatrie et d’addictologie, Université de Montréal
| | - Jean Leblanc
- M.D., FRCPC, psychiatre, HSMAP - Professeur agrégé de clinique, Département de psychiatrie et d’addictologie, Université de Montréal
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33
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How does supervision aid cognitive behaviour therapy skill development? Perspectives of CBT trainees: a thematic analysis. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Eleven cognitive behaviour therapy (CBT) trainees in Scotland were interviewed regarding their experiences of clinical supervision and its impact on their skill development. Using thematic analysis, the authors developed four main themes: Linking Theory to Practice, Mirroring CBT in Supervision, The Expert Supervisor, and Trainees’ Reluctance to Give Negative Feedback. Clinical supervision was essential in helping trainees to link theory to practice; particularly through audio recordings, discussing formulations, and modelling and role-play. A CBT-specific approach to supervision and a CBT expert supervisor were also identified as valuable to learning. Trainees were reluctant to give negative feedback to supervisors, fearing negative consequences. The findings inform supervision practice.
Key learning aims
Readers of this paper will be able to:
(1)
Describe trainees’ most valued elements of CBT supervision.
(2)
Determine key learning methods in CBT supervision.
(3)
Explain the value of modality specific CBT supervision.
(4)
Articulate the context of supervision in CBT training and consider mutual feedback as a method to address identified challenges.
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Layton H, Bendo D, Amani B, Bieling PJ, Van Lieshout RJ. Public health nurses' experiences learning and delivering a group cognitive behavioral therapy intervention for postpartum depression. Public Health Nurs 2020; 37:863-870. [PMID: 32924183 DOI: 10.1111/phn.12807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Public Health Nurses (PHNs) often provide support to women with postpartum depression (PPD) in the absence of specialized training. The objective of this study was to explore the experiences of six PHNs who were trained to deliver a group cognitive behavioral therapy (CBT) intervention for PPD in the public health setting, and to describe how learning and delivering this intervention affected their professional roles and personal lives. DESIGN This qualitative study employed a phenomenological approach. SAMPLE Six PHNs who completed the CBT training program and delivered at least one CBT group in their community. MEASUREMENTS Individual in-depth interviews were conducted and transcribed verbatim. Transcripts were analyzed according to thematic derivation procedures. RESULTS The themes that emerged from the interviews with the PHNs included: (a) components of the CBT training program that nurses most valued, (b) benefits of training for their professional role as a PHN, (c) implications for practice, and (d) using CBT skills in their personal lives. CONCLUSIONS The provision of CBT training to PHNs may not only positively impact their work with clients with mental illness, but may also have the potential to provide broader clinical and professional benefits for these skilled professionals and their other clients.
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Affiliation(s)
- Haley Layton
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Daniella Bendo
- Department of Interdisciplinary Programs, Kings University College at Western University, London, Ontario, Canada
| | - Bahar Amani
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Peter J Bieling
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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35
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Frank HE, Becker-Haimes EM, Kendall PC. Therapist training in evidence-based interventions for mental health: A systematic review of training approaches and outcomes. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2020; 27:e12330. [PMID: 34092941 PMCID: PMC8174802 DOI: 10.1111/cpsp.12330] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 01/07/2020] [Indexed: 12/20/2022]
Abstract
A lack of effective therapist training is a major barrier to evidence-based intervention (EBI) delivery in the community. Systematic reviews published nearly a decade ago suggested that traditional EBI training leads to higher knowledge but not more EBI use, indicating that more work is needed to optimize EBI training and implementation. This systematic review synthesizes the training literature published since 2010 to evaluate how different training models (workshop, workshop with consultation, online training, train-the-trainer, and intensive training) affect therapists' knowledge, beliefs, and behaviors. Results and limitations for each approach are discussed. Findings show that training has advanced beyond provision of manuals and brief workshops; more intensive training models show promise for changing therapist behavior. However, methodological issues persist, limiting conclusions and pointing to important areas for future research.
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Affiliation(s)
- Hannah E. Frank
- Psychology Department, Temple University, Philadelphia, Pennsylvania
| | - Emily M. Becker-Haimes
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Hall Mercer Community Mental Health, Philadelphia, Pennsylvania
| | - Philip C. Kendall
- Psychology Department, Temple University, Philadelphia, Pennsylvania
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Batchelor R, Catanzano M, Kerry E, Bennett SD, Coughtrey AE, Liang H, Curry V, Heyman I, Shafran R. Debate: Lessons learned in lockdown - a one-day remotely delivered training on low-intensity psychological interventions for common mental health conditions. Child Adolesc Ment Health 2020; 25:175-177. [PMID: 32674222 DOI: 10.1111/camh.12402] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/05/2020] [Indexed: 12/18/2022]
Abstract
The coronavirus pandemic has highlighted the need for remote technologies to be used in child and adolescent mental health services. With the UK being placed in lockdown one week before a scheduled 'face-to-face' low-intensity CBT training day due to COVID-19, there was a need for rapid adaptations to be made to the content, structure and format of a training day for practitioners in mental health services, to suit the online environment. The content covered the core areas of low-intensity CBT in children and adolescents. Findings showed that the one-day low-intensity training day increased knowledge and understanding in all key areas measured, and was positively received, providing further evidence for the effectiveness and acceptability of remote delivery. Given discussed benefits of remote delivery, as well as rapid developments in technologies helping to address some of the challenges raised, going forward, remote delivery could continue to be beneficial for increasing access to much needed evidence-based interventions.
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Affiliation(s)
| | - Matteo Catanzano
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ellie Kerry
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Sophie D Bennett
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Anna E Coughtrey
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Holan Liang
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Vicki Curry
- Anna Freud Centre for Children and Families, London, UK
| | - Isobel Heyman
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Roz Shafran
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Cromarty P, Gallagher D, Watson J. Remote delivery of CBT training, clinical supervision and services: in times of crisis or business as usual. COGNITIVE BEHAVIOUR THERAPIST 2020; 13:e33. [PMID: 34191942 PMCID: PMC7468679 DOI: 10.1017/s1754470x20000343] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 11/05/2022]
Abstract
The worldwide coronavirus pandemic has forced health services to adapt their delivery to protect the health of all concerned, and avoid service users facing severe disruption. Improving Access to Psychological Therapies (IAPT) services in particular are having to explore remote working methods to continue functioning. Australian IAPT services have utilised remote delivery methods and disruptive technologies at their core from inception. This was to maintain fidelity and clinical governance across vast distances but has allowed training, supervision and service delivery to continue virtually uninterrupted through coronavirus restrictions. On this basis, key recommendations for remote working are outlined. Remote methods are defined as (1) real time delivery, (2) independent delivery and (3) blended delivery. These are applied across three broad areas of remote training, remote clinical supervision and remote service delivery. Recommendations may be of great benefit to IAPT training institutions, clinical supervisors and service providers considering a move towards remote delivery. Challenges, adaptations and examples of applying remote methods are outlined, including case examples of methods applied to low-intensity and high-intensity cognitive behavioural therapy. Remote methods can safeguard service continuity in times of worldwide crisis and can contribute to reducing the impact of increased mental health presentations post-COVID-19. KEY LEARNING AIMS To understand the core areas of remote training, clinical supervision and service delivery.To review and distinguish between three broad methods of remote working.To understand how to plan remote working via key recommendations and case examples.
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Are you sitting (un)comfortably? Action-based supervision and supervisory drift. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AbstractAction-based methods such as behavioural experiments, role-play and (by extension) ‘chairwork’ are powerful techniques recommended in core supervisory texts for cognitive behavioural therapy (CBT). Despite this, experiential methods are seldom used by supervisors, suggesting that supervision often drifts from a ‘doing process’ to a ‘talking process’. A number of factors contribute to this divergence from best practice, including limited confidence and a lack of familiarity with experiential procedures amongst supervisors. To address this, the current paper presents a variety of action-based techniques for enhancing supervisees’ technical, perceptual, interpersonal, reflective and personal competencies. Behavioural experiments, empty-chair, multi-chair and role-playing exercises for maintaining treatment fidelity, enhancing empathic attunement, repairing therapeutic ruptures, resolving impasses and working through negative countertransference are described, amongst others. Further research is needed to establish the nature and extent of supervisory drift, as well as the efficacy of action-based methods.Key learning aimsAs a result of reading this paper, readers should:(1)Understand why supervision sometimes drifts from being a ‘doing’ process.(2)Appreciate the value of experiential, action-based supervisory methods.(3)Feel competent using action-based methods to enhance supervisees’ clinical skills.
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Alpers G, Steiger-White F. Simulationspatienten im universitären Psychologiestudium: Einführung einer innovativen Methode zur Stärkung praxisorientierter Lehre in klinischer Psychologie und Psychotherapie. VERHALTENSTHERAPIE 2020. [DOI: 10.1159/000507740] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Alfonsson S, Lundgren T, Andersson G. Clinical supervision in cognitive behavior therapy improves therapists’ competence: a single-case experimental pilot study. Cogn Behav Ther 2020; 49:425-438. [DOI: 10.1080/16506073.2020.1737571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sven Alfonsson
- Department of Clinical Neuroscience Karolinska Institutet & Stockholm Health Care Services, Centre for Psychiatry Research, Stockholm, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Tobias Lundgren
- Department of Clinical Neuroscience Karolinska Institutet & Stockholm Health Care Services, Centre for Psychiatry Research, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Clinical Neuroscience Karolinska Institutet & Stockholm Health Care Services, Centre for Psychiatry Research, Stockholm, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
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Spain D, Happé F. How to Optimise Cognitive Behaviour Therapy (CBT) for People with Autism Spectrum Disorders (ASD): A Delphi Study. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2019. [DOI: 10.1007/s10942-019-00335-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AbstractChildren and adults with autism spectrum disorders (ASD) can benefit from cognitive behaviour therapy (CBT), yet the prevailing opinion is that this requires adaptations to accommodate commonly experienced socio-communication and neuropsychological impairments. There are, however, no empirically-derived guidelines about how best to adapt standard practice. In a three round Delphi survey, we asked expert clinicians and clinical-researchers, based in England, about how to optimise the design, delivery and evaluation of CBT for people with ASD. Of 50 people approached, 18 consented to take part in Round 1, nine in Round 2 and eight in Round 3. Using a five-point scale, participants rated the degree to which 221 statements—pertaining to the referral process, assessment, engagement, formulation, goal setting, therapy structure, interventions and techniques, homework, outcome measurement, managing endings and therapist attributes—were integral to CBT. The consensus was that 155 statements represented essential or important components of CBT. Adaptations to the structure and process of therapy were consistently endorsed, and an individualised formulation-derived approach was favoured when deciding upon which interventions and techniques to offer. Further studies are needed to clarify if adapted CBT is associated with improved treatment outcomes and acceptability.
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Maiwald LM, Kühne F, Junga YM, Rudolph D, Witthöft M, Lüthke L, Heid E, Weck F. Erfolgreiche Supervision in der Psychotherapieausbildung. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2019. [DOI: 10.1026/1616-3443/a000563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Supervision fand als Forschungsgegenstand in der Kognitiven Verhaltenstherapie vergleichsweise wenig Beachtung. Fragestellung: Ziel der explorativen Studie war es, Voraussetzungen und Auswirkungen erfolgreicher Supervision zu erheben. Methode: Elf Supervisor_innen und zehn Supervisand_innen des Weiterbildungsstudiengangs Psychologische Psychotherapie (Verhaltenstherapie) wurden mittels halbstrukturierter Leitfadeninterviews befragt. Die Auswertung erfolgte anhand der qualitativen Inhaltsanalyse nach Mayring. Ergebnisse: Es wurden Personenmerkmale (z. B. Kritikfähigkeit, Offenheit, Strukturiertheit), eine tragfähige Supervisionsbeziehung (z. B. vertrauensvolle Atmosphäre) sowie Methoden (z. B. Videoanalyse) als Voraussetzungen für erfolgreiche Supervision beschrieben. Diese dienen vor allem der Förderung psychotherapeutischer Kompetenzen. Schlussfolgerung: Erfolgreiche Supervision ist strukturiert und interpersonell effektiv gestaltet. Vermutlich spielen Merkmale der Supervisand_innen (z. B. Kritikfähigkeit) eine bedeutsamere Rolle als bisher angenommen. Theoretische Annahmen stützend wurden die Auswirkungen vorwiegend in der Förderung psychotherapeutischer Kompetenzen gesehen.
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Affiliation(s)
- Lisa Marie Maiwald
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Franziska Kühne
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Potsdam
| | - Yvonne Marie Junga
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Potsdam
| | - Daniela Rudolph
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Michael Witthöft
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Lisa Lüthke
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Evelyn Heid
- Abteilung für Klinische Psychologie, Psychotherapie und Experimentelle Psychopathologie, Johannes Gutenberg-Universität Mainz
| | - Florian Weck
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Potsdam
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Bearman SK, Bailin A, Sale R. Graduate school training in CBT supervision to develop knowledge and competencies. CLINICAL SUPERVISOR 2019. [DOI: 10.1080/07325223.2019.1663459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sarah Kate Bearman
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Abby Bailin
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Rafaella Sale
- Department of Educational Psychology, The University of Texas at Austin, Austin, Texas, USA
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Hendriks WJAJ, Bakker N, Pluk H, de Brouwer A, Wieringa B, Cambi A, Zegers M, Wansink DG, Leunissen R, Klaren PHM. Certainty-based marking in a formative assessment improves student course appreciation but not summative examination scores. BMC MEDICAL EDUCATION 2019; 19:178. [PMID: 31151456 PMCID: PMC6544949 DOI: 10.1186/s12909-019-1610-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Study motivation and knowledge retention benefit from regular student self-assessments. Inclusion of certainty-based learning (CBL) in computer-assisted formative tests may further enhance this by enabling students to identify whether they are uninformed or misinformed regarding the topics tested, which may trigger future study actions including instructor consultation. METHODS Using a cross-over study design involving two out of thirteen computer-assisted formative assessments (CAFAs) of a first-year cell biology course, we compared student-instructor interactions, student learning experiences and final exam scores between two (bio)medical science student cohorts who worked with different CBL-containing CAFAs. RESULTS A total of 389 students participated in the study. After completion 159 (41%) filled in a questionnaire on their experience with CBL during supervised CAFAs. In the control group the median duration of student-instructor interactions was 90 s (range 60-140 s), and this increased with 20 s to 110 s (range 60-150 s) in the group working with a CBL-based CAFA. The number of interactions was similar in both groups (0.22 per student per hour, regardless of CBL inclusion). Forty percent of the students expected that CBL would positively influence their study behavior, and 23% also anticipated a positive effect on examination scores. Student examination scores, however, were not affected by CBL. Almost half of the students (43%) were in favor of CBL inclusion in future computer-assisted learning modules, whereas 33% did not see merit in including CBL in CAFAs. CONCLUSIONS Incorporation of CBL in a single formative assessment led to a slight increase in student-instructor interaction times, but had effect neither on the number of student-instructor interactions nor on exam scores. CBL inclusion positively influenced student's appreciation of the coursework, presumably by helping students to evaluate their mastery level and identify misconceptions. A more extensive enrollment of CBL beyond an individual formative assessment, throughout a course or a curriculum, may possibly reveal positive effects on study efficacy.
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Affiliation(s)
- Wiljan J A J Hendriks
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Geert Grooteplein 26, 6525, GA, Nijmegen, The Netherlands.
| | - Nicole Bakker
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Geert Grooteplein 26, 6525, GA, Nijmegen, The Netherlands
| | - Helma Pluk
- Department of Biochemistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arjan de Brouwer
- Department of Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bé Wieringa
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Geert Grooteplein 26, 6525, GA, Nijmegen, The Netherlands
| | - Alessandra Cambi
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Geert Grooteplein 26, 6525, GA, Nijmegen, The Netherlands
| | - Mirjam Zegers
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Geert Grooteplein 26, 6525, GA, Nijmegen, The Netherlands
| | - Derick G Wansink
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Geert Grooteplein 26, 6525, GA, Nijmegen, The Netherlands
| | - Ron Leunissen
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter H M Klaren
- Department of Animal Ecology and Physiology, Institute for Water and Wetland Research, Radboud University, Nijmegen, The Netherlands
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‘Courses for Horses’: designing, adapting and implementing self practice/self-reflection programmes. COGNITIVE BEHAVIOUR THERAPIST 2019. [DOI: 10.1017/s1754470x19000138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractSelf-Practice/Self-Reflection (SP/SR) has been proposed both as an adjunct to therapy training programmes, and also as a means for therapist development among experienced therapists. Research suggests it develops aspects of knowledge and skill that may not be addressed through other training methods. With increasing interest in SP/SR, a growing evidence base regarding both participant benefits and potential risks from SP/SR, and the development of SP/SR programmes across a range of therapeutic modalities, we argue it is timely to identify a set of principles that can guide the design, adaptation and implementation of SP/SR programmes. At this stage, there is little empirical evidence to guide trainers wishing to implement SP/SR in different contexts. Accordingly, these principles have been derived from reflection on developing, testing and implementing SP/SR programmes as well as on other training and supervisory experience. The first set of principles detailed in Section 1 draw on various theories of learning and development and frame the processes involved, the next principles speak to the content of SP/SR programmes, and the final principles address structure. Within Section 2, the principles are then considered for their practical implications. In Section 3, the sharing of what are initially private self-reflections is then considered together with some implications for SP/SR programmes, especially when there is assessment involved. We argue that SP/SR will continue to progress with well-designed standard programmes, careful implementation, thoughtful adaptation, ongoing innovation, and especially more evaluation.Key learning aims(1)To understand the principles for designing, adapting and implementing SP/SR programmes that are drawn from theory and from the authors’ experience of developing and implementing SP/SR programmes over the last 20 years.(2)To understand the possible factors that guide the processes, content and structure of SP/SR programmes.(3)To understand how best to maximize effective engagement and learning (and limit harm) when planning or implementing an SP/SR programme.
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Bennett-Levy J. Why therapists should walk the talk: The theoretical and empirical case for personal practice in therapist training and professional development. J Behav Ther Exp Psychiatry 2019; 62:133-145. [PMID: 30391704 DOI: 10.1016/j.jbtep.2018.08.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 08/07/2018] [Accepted: 08/19/2018] [Indexed: 12/27/2022]
Abstract
The key proposition of this invited essay is that personal practice (PP), coupled with self-reflection, is central to the development of the most effective therapists. To date, the discussion about personal practice in therapist training and professional development has largely revolved around the value of personal therapy, subscribed to by some schools of psychotherapy but not by others. However, since the turn of the century a new landscape of personal practices for therapists has emerged. In particular, two forms of personal practice, meditation programs and self-practice/self-reflection (SP/SR) programs, have developed a growing evidence base. Here it is proposed that there is now a strong theoretical and empirical case to accord personal practice an explicit role in therapist training and professional development. The case rests on recent research suggesting that: (1) personal and interpersonal qualities of therapists play a key role in client outcomes; and (2) personal practice is the most effective way to achieve changes in therapists' personal and interpersonal qualities. It is suggested that the research agenda needs to move beyond asking whether or not personal practice is effective towards a more sophisticated set of questions: what personal practice, facilitated by whom, is most effective with which practitioners, in what contexts, at what point in time? To make further progress, trainers and researchers need to be supported to include personal practices in therapist training and to undertake research to evaluate their impacts.
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Affiliation(s)
- James Bennett-Levy
- University Centre for Rural Health, University of Sydney, PO Box 3074, Lismore, NSW 2480, Australia.
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How beginning cognitive behavioural therapists develop professional confidence. COGNITIVE BEHAVIOUR THERAPIST 2018. [DOI: 10.1017/s1754470x1800003x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractEvidence exists that the effectiveness of psychotherapy depends more on therapists’ variables than on their theoretical orientation or the techniques they use. Nevertheless, relatively little is known regarding the process of cognitive behavioural psychotherapists’ development. The purpose of the study was to explore how beginning cognitive behavioural therapy (CBT) practitioners develop, considering various professional and personal influences. Eight in-depth interviews with beginning therapists were conducted, and the Grounded Theory Method was used for data analysis. The developmental process was conceptualized as Gaining Professional Confidence, and three phases of this process were identified: (1) Externally Based Confidence in CBT Methods, (2) Internalized Confidence in CBT Methods, and (3) Therapists’ Self-Confidence. The results indicate that trainees’ self-reflection on their personal qualities, values, attitudes and preferences should be given more attention in CBT training, as this plays a crucial role in their overall professional development.
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Bennett-Levy J, Finlay-Jones A. The role of personal practice in therapist skill development: a model to guide therapists, educators, supervisors and researchers. Cogn Behav Ther 2018; 47:185-205. [DOI: 10.1080/16506073.2018.1434678] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- James Bennett-Levy
- University Centre for Rural Health, University of Sydney, Lismore, Australia
| | - Amy Finlay-Jones
- School of Psychology and Speech Pathology, Curtin University, Perth, Australia
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Trainees’ experience of cognitive behavioural therapy training: a mixed methods systematic review. COGNITIVE BEHAVIOUR THERAPIST 2018. [DOI: 10.1017/s1754470x17000253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractResearch in the field of cognitive behavioural therapy (CBT) has primarily focused on the acquisition and development of skills and competence. Little is known regarding the experience of training from trainees’ perspectives. This systematic review aimed to review and critique the research conducted on the experience of CBT training. Four electronic databases were searched for published studies reporting on the experience of CBT training. Thirteen articles were selected based on pre-determined inclusion and exclusion criteria and were assessed for quality using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD; Sirriyeh et al., 2012). Due to the lack of consistency in the study designs and outcome measures used, a narrative synthesis of the findings was conducted. Findings were categorized within three themes for synthesis: ‘experience of benefit’, ‘internal processes of engagement’ and ‘external influences on engagement’. Overall, this review was able to draw conclusions regarding the experiences of aspects of CBT training from relatively good quality research. However, the review also highlights the lack of studies exploring specific hypotheses regarding the experience of training.
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Keeping metaphor in mind: training therapists in metaphor-enhanced cognitive behaviour therapy. COGNITIVE BEHAVIOUR THERAPIST 2018. [DOI: 10.1017/s1754470x18000077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractOver the last decade, there has been increasing interest in the use of metaphor in cognitive behaviour therapy. However, to date, there has been only very limited research on the use of metaphor in CBT sessions, and no studies which have examined how to train therapists in this skill. The present study is the first in the literature to explore how we might train therapists in metaphor-enhanced CBT. Twelve therapists attended two half-day training workshops, 2 weeks apart. Details of the content of the training workshop are provided. The therapists rated the workshop quality and provided structured self-report ratings and reflections on their ongoing application of learning over a 3-month period which were compared with pre-training ratings. Therapists reported significantly increased awareness of metaphors, with increased confidence in responding intentionally to client metaphors and bringing them into shared conceptualizations. In addition, there were significant increases in reported time spent elaborating on client metaphors, and use of metaphors when conceptualizing with clients. Barriers and solutions to application of learning are discussed.
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