Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-02T23:28:42.109Z Has data issue: false hasContentIssue false
  • English
  • Français

Training novice clinical psychologist trainees to implement effective CBT for anxiety disorders: training model and clinic outcomes

Published online by Cambridge University Press:  12 December 2016

Fiadhnait O'Keeffe ,
Sue Watson  and
Stuart Linke
Fiadhnait O'Keeffe*
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, UK
Sue Watson
Affiliation:
Research Department of Clinical, Educational and Health Psychology, University College London, UK
Stuart Linke
Affiliation:
Camden and Islington NHS Foundation Trust, London, UK
*
*Author for correspondence: Professor F. O'Keeffe, Research Department of Clinical, Educational and Health Psychology, University College London, UK (email: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

The need for development of effective models of training and superivision for trainee clinical psychologists to build CBT competencies and to implement high-quality CBT is frequently highlighted. Effectiveness of trainee therapist outcomes working within different models of training, supervision and services is also important to establish. This paper reports on the development and outcome effectiveness of a model of training and supervision aimed at increasing CBT clinical skills and competence of trainee clinical psychologists offering CBT for anxiety disorders in an anxiety disorders clinic (ADC) in inner-city London. Details of the training and supervision model are provided, which was conducted over a period of 3 months, with ongoing weekly supervision throughout the intervention period. Pre- and post-intervention data were analysed from service users who attended the ADC over a 2-year period. Over the 2-year period, 10 trainees treated 57 clients. Data from completer and intention-to-treat samples indicated that scores on four outcome measures improved significantly: at post-therapy, 75% of service users who completed the intervention showed reliable and clinically significant recovery or improvement. When supported by appropriate training and supervision, as outlined in this training model, initially inexperienced trainee psychologists can achieve outcomes comparable to those obtained in other secondary-care settings with qualified therapists.

Keywords

Anxietycognitive behaviour therapyoutcomessupervisiontraining
Type
Education and supervision
Information
the Cognitive Behaviour Therapist , Volume 9 , 2016 , e38
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommended follow-up reading

Bados, A, Balaguer, G, Saldana, C (2007). Outcome of cognitive-behavioural therapy in training practice with anxiety disorder patients. British Journal of Clinical Psychology 46, 429–435.Google Scholar
Mason, L, Grey, N, Veale, D (2016). My therapist is a student? The impact of therapist experience and client severity on cognitive behavioural therapy outcomes for people with anxiety disorders. Behavioural and Cognitive Psychotherapy 44, 193–202.Google Scholar

References

Bados, A, Balaguer, G, Saldana, C (2007). Outcome of cognitive-behavioural therapy in training practice with anxiety disorder patients. British Journal of Clinical Psychology 46, 429–435.Google Scholar
Barkham, M, Margison, F, Leach, C, Lucock, M, Mellor-Clark, J, Evans, C, Benson, L, Connell, J, Audin, K, McGrath, G (2001). Service profiling and outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies. Journal of Consulting and Clinical Psychology 69, 184–196.Google Scholar
Barkham, M, Gilbert, N, Connell, J, Marshall, C, Twigg, E (2005). Suitability and utility of the CORE-OM and CORE-A for assessing severity of presenting problems in psychological therapy services based in primary and secondary care settings. British Journal of Psychiatry 186, 239–246.Google Scholar
Beck, A, Steer, R (1990). Beck Anxiety Inventory Manual. San Antonio, TX: Psychological Corporation.Google Scholar
Beck, A, Steer, A, Brown, G (1996). Beck Depression Inventory Manual, 2nd edn. San Antonio, TX: Psychological Corporation.Google Scholar
Bennett-Levy, J, Beedie, A (2007). The ups and downs of cognitive therapy training: what happens to trainees’ perceptions of their competence during a cognitive therapy training course? Behavioural and Cognitive Psychotherapy 35, 61–75.CrossRefGoogle Scholar
Bennett-Levy, J, Butler, G, Fennell, M, Hackmann, A, Mueller, M, Westbrook, D (2004). The Oxford Guide to Behavioural Experiments in Cognitive Therapy. Oxford: Oxford University Press.Google Scholar
Boschen, M (2007). Reconceptualizing emetophobia: a cognitive–behavioural formulation and research agenda. Journal of Anxiety Disorders 21, 407–419.Google Scholar
Bowlby, J (1988). A Secure Base. London: Routledge and Kegan Paul.Google Scholar
Cahill, J, Barkham, M, Stiles, W (2010). Systemic review of practice-based research on psychological therapies in routine clinic settings. British Journal of Clinical Psychology 49, 421–453.Google Scholar
Centre for Economic Performance (2006). The depression report. A new deal for depression and anxiety disorders. London School of Economics and Political Science Centre for Economic Performance.Google Scholar
Clark, D (1986). A cognitive approach to panic. Behaviour Research and Therapy 24, 461–470.Google Scholar
Clark, D (1988). A cognitive model of panic attacks. In: Panic: Psychological Perspectives (ed. Rachman, S. & Maser, J.), pp. 121–132. Hillsdale, NJ: Erlbaum.Google Scholar
Clark, D (2004). Developing new treatments: on the interplay between theories, experimental science and clinical innovation. Behaviour Research and Therapy 42, 1089–1104.Google Scholar
Clark, D, Wells, A (1995). A cognitive model of social phobia. In: Social Phobia: Diagnosis, Assessment and Treatment (ed. Heimberg, R., Leibowitz, M., Hope, D. & Schneier, R.), pp. 69–93. New York: Guilford Press.Google Scholar
Connell, J, Barkham, M, Stiles, W, Twigg, E, Singleton, N, Evans, O, Miles, J (2007). Distribution of CORE-OM scores in a general population, clinical cut-off points and comparison with the CIS-R. British Journal of Psychiatry 190, 69–74.Google Scholar
Dugas, M (2004). Cognitive-behavioral treatment of generalized anxiety disorder: learning to tolerate uncertainty and emotional arousal. Manual. Concordia University, Montreal.Google Scholar
Ehlers, A, Clark, D (2000). A cognitive model of post-traumatic stress disorder. Behaviour Research and Therapy 38, 319–345.Google Scholar
Haynes, R, Corey, G, Moulton, P (2003). Clinical Supervision in the Helping Professions: A Practical Guide. Pacific Grove, CA: Brooks/Cole.Google Scholar
Jacobson, N, Truax, P (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59, 12–19.Google Scholar
Kuyken, W, Padesky, C, Dudley, R (2009). Collaborative Case Conceptualisation: Working Effectively with Clients in Cognitive-behavioral Therapy. New York: Guilford Press.Google Scholar
Lee, D (2005). The perfect nurturer: a model to develop a compassionate mind within the context of cognitive therapy. In: Compassion: Conceptualisations, Research and Use in Psychotherapy (ed. Gilbert, P.), pp. 326–351. Sussex: Routledge.Google Scholar
Lincoln, T, Winfried, R, Hahlweg, K, Frank, M, von Witzleben, I, Schroeder, B, Fiegenbaum, W (2003). Effectiveness of an empirically supported treatment for social phobia in the field. Behaviour Research and Therapy 41, 1251–1269.Google Scholar
Mannix, K, Blackburn, I, Garland, A, Gracie, J, Moorey, S, Reid, B, Standard, S, Scott, J (2006). Effectiveness of brief training in cognitive behaviour therapy techniques for palliative care practitioners. Palliative Medicine 20, 579–584.Google Scholar
Mason, L, Grey, N, Veale, D (2016). My therapist is a student? The impact of therapist experience and client severity on cognitive behavioural therapy outcomes for people with anxiety disorders. Behavioural and Cognitive Psychotherapy 44, 193–202.Google Scholar
McEvoy, P, Nathan, P (2007). Effectiveness of cognitive behavior therapy for diagnostically heterogeneous groups: a benchmarking study. Journal of Consulting and Clinical Psychology 75, 344–350.Google Scholar
Mellor-Clark, J, Barkham, M, Connell, J, Evans, C (1999). Practice-based evidence and need for a standardised evaluation system: Informing the design of the CORE system. European Journal of Psychotherapy, Counselling and Health 2, 357–374.CrossRefGoogle Scholar
Mullin, T, Barkham, M, Mothersole, G, Bewick, B, Kinder, A (2006). Recovery and improvement benchmarks for counselling and the psychological therapies in routine primary care. Counselling and Psychotherapy Research 6, 68–80.CrossRefGoogle Scholar
Mundt, J, Marks, I, Shear, K, Greist, J (2002). The Work and Social Adjustment Scale: a simple measure of impairment of functioning. British Journal of Psychiatry 180, 461–464.Google Scholar
NICE (2004). Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care. (Clinical Guideline 26). London: National Institute for Health and Clinical Excellence.Google Scholar
Perris, C (1994). Supervising cognitive psychotherapists and training supervisors. Journal of Cognitive Psychotherapy 8, 83–101.CrossRefGoogle Scholar
Richards, D, Suckling, R (2009). Improving access to psychological therapies: phase IV prospective cohort study. British Journal of Clinical Psychology 18, 377–396.Google Scholar
Roth, A, Fonagy, P (2005). What Works for Whom: A Critical Review of Psychotherapy Research, 2nd edn. New York: Guilford Press.Google Scholar
Roth, A, Pilling, S (2008). Using an evidence-based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders. Behavioural and Cognitive Psychotherapy 36, 129–147.CrossRefGoogle Scholar
Roth, A, Pilling, S, Turner, J (2010). Therapist training and supervision in clinical trials: implications for clinical practice. Behavioural and Cognitive Psychotherapy 38, 291–302.Google Scholar
Salkovskis, P (1985). Obsessional-compulsive problems: a cognitive-behavioural analysis. Behaviour Research and Therapy 23, 571–583.Google Scholar
Veale, D, Lambrou, C (2006). The psychopathology of vomit phobia. Behavioural and Cognitive Psychotherapy 34, 1–12.Google Scholar
Wells, A (1997). Cognitive Therapy of Anxiety Disorders. A Practice Manual and Conceptual Guide. John Wiley & Sons, Chichester.Google Scholar
Wells, A, Matthews, G (1994). Attention and Emotion. A Clinical Perspective. Hove, UK: Erlbaum.Google Scholar
Westbrook, D, Kirk, J (2005). The clinical effectiveness of cognitive behaviour therapy: outcome for a large sample of adults treated in routine practice. Behaviour and Research Therapy 43, 1243–1261.Google Scholar
Westbrook, D, Sedgwick-Taylor, A, Bennett-Levy, K, Butler, G, McManus, F (2008). A pilot evaluation of a brief CBT training course: impact on trainees satisfaction, clinical skills and patient outcomes. Behavioural and Cognitive Psychotherapy 36, 569–579.Google Scholar
Young, J, Beck, A (1980). The Cognitive Therapy Scale: Rating Manual. Psychotherapy Research Unit: PA.Google Scholar
Zivor, M, Salkovskis, P, Oldfield, V, Kushnir, J (2013). Formulation in cognitive behaviour therapy for obsessive-compulsive disorder: aligning therapists, perceptions and practice. Clinical Psychology: Science and Practice 20, 143–151.Google Scholar
Submit a response

Comments

No Comments have been published for this article.