This article provides an overview of the role of psychopharmacotherapy in common emotional disorders for cognitive behaviour therapists. We consider some of the philosophical difference between CBT and medication, when medication might interfere with CBT, when it may enhance outcome and when it might be safely discontinued. We highlight how to differentiate side-effects and symptoms of discontinuation of antidepressants from that of the underlying disorder. The scope of this article is confined to common emotional disorders and does not discuss the interaction of CBT with medication in, e.g. schizophrenia, bipolar disorder or dementia.

Theevaluation of supervisor training has featured weak measurement and lacked a coherent framework, limiting effectiveness. A literature review was first conducted to clarify the current status of supervisor workshop evaluations, related to the promising fidelity framework. This consists of five criteria: the workshop's design, the training (competence of the trainer), the delivery of the workshop, the learning of the participants (receipt), and the clinical practice outcomes (enactment). Second, we applied this framework to the training of supervisors (n = 17) in a cognitive-behavioural therapy (CBT) approach, by analysing one trainer leading two successive supervisors’ workshops. The review of the literature indicated that there were significant psychometric and conceptual deficiencies in the current evaluation of supervisor training. The data from the case-study analysis suggest that the manual-based workshop could be delivered with high fidelity by this trainer (e.g. the CBT approach to supervision received 89% approval). The fidelity framework provided a systematic, feasible and coherent rationale for the evaluation of supervisor training. Our preliminary findings indicated that the workshop was successful. To fulfil its promise as an improved way of evaluating supervisor training, the framework should be piloted with other trainers, instruments and workshops, using controlled designs.

Implementing change in organizational systems is challenging, and implementing a new psychotherapeutic approach is no different. A literature exists on issues in implementation across a wide range of domains (technological, healthcare, justice). However, little of it is utilized in endeavours to implement innovations in psychological treatments. This paper draws on the implementation literature and on the experiences of the British Isles DBT Training Team (BIDBT) in implementing Dialectical Behaviour Therapy (DBT) in mental healthcare systems in the UK over the last 13 years. This paper describes principles and strategies of ‘organizational pre-treatment’ as a necessary prerequisite to implementation.