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PG Diploma in Psychological Therapies Practice (CYP) - CBT Pathway

Please see the following documents:

CAMHs Competency Framework (.pdf)‌
CBT Competency Framework (.pdf)‌

Welcome from Dr Alex Boyd, Co-Director of CYP Programmes

Welcome to the University of Exeter’s Postgraduate/Graduate Diploma programme in Evidence-Based Psychological Therapies for Children and Young People. This programme is part of the national Children and Young People’s Improving Access to Psychological Therapies (CYP IAPT) initiative and has a Cognitive Behavioural Therapy (CBT), Parenting (PT), 0-5, Systemic Family Practice (SFP) and ASD/LD pathway.

The overall aims of the CYP IAPT Programme are to transform mental health services for young people and their families/carers; to maximise their effectiveness and efficiency and thus improve access to evidence-based and outcome-monitored interventions.

The programme is heavily rooted within the development of clinical skills associated with a patient-centred approach and on the skills required to support CBT, PT, 0-5, ASD/LD and SFP evidence based therapies.

The continued development of these skills is embedded within a strong focus on practice-based supervision, which is a fundamental component of the training. As such your training should not just be seen as being the time you spend being taught within the University, but full time, based also around your clinical work undertaken within your work setting supplemented by your practice based supervision.

Successful completion of clinical and written assignments and appropriate participation in tutorials and workshops will lead to the awarding of a PG/Grad Diploma. We hope that you will be able to act as ‘product champions’ for CBT, parenting, 0-5s, ASD/LD and systemic practice and to be available as teachers and consultants, in the various CYP IAPT settings in which you work.

A major contributing resource to the programme is the knowledge and experiences that you as programme members bring. We intend to draw upon and honour this knowledge and experience in order to develop clinical skills and increase awareness and theoretical understanding. It is important, however, that understanding and use of theory is integrated with clinical application in a rigorous and constructively critical manner.

We hope you enjoy the training and look forward to meeting you over the coming months.

Meet the Programme Team

Name	Title	Email
Professor Catherine Gallop	Director of CEDAR PGT Programmes	c.a.gallop@exeter.ac.uk
Dr Alex Boyd	Director of CYP-IAPT Training Programmes	A.Boyd@exeter.ac.uk
Rosina Moore	CBT Supervisor and Tutor	rm645@exeter.ac.uk
Sabrina Hague	CBT Supervisor
Steve Branagan	CBT Supervisor	S.Branagan@exeter.ac.uk
Gavin Crisp	CBT Supervisor
David Mussell	Supervisor & KSA Tutor	D.Mussell@exeter.ac.uk
Sarah Waller	CBT Supervisor	S.Waller2@exeter.ac.uk
Ashley Low	CBT Supervisor	A.Low2@exeter.ac.uk
Natalie Cook	Programme Administrator	cyp-iapt@exeter.ac.uk
Markku Wood	External examiner (Northumbria University)

Introduction and Aims

In this Programme we aim to help you develop your practice in evidence-based psychological therapies for children, young people and families.

You will develop the knowledge and competencies required to be an effective practitioner, as determined by the relevant national curriculum for the CYP IAPT Programme.

We aim to provide you with a high quality and stimulating learning experience in a supportive environment that is enriched by an internationally recognised research environment, nationally recognised innovative clinical teaching approaches and current clinical practice.

The programme aims to ensure that all graduates meet recognised minimum clinical competence in working using CBT with young people with affective disorders.

Specific Programme Aims

On completion of the programme we hope that you will be able to:

Demonstrate generic and modality-specific skill competencies in evidence based psychological therapy as determined by the CYP IAPT national curriculum.
Synthesise the key underpinning knowledge in evidence based psychological therapies for children, young people and families.
Critique the context within which psychological therapies are provided (including relevant professional, ethical and legal frameworks).
Explain in detail the key theoretical bases for evidence-based psychological therapy models and link their relationship to practice and understand, interpret, critically evaluate, and apply evidence-based practice.
Evidence appropriate use of supervision in developing clinical skills.
Analyse and manage the implications of ethical dilemmas and work proactively with others to formulate solutions and manage complexity.
Function independently and reflectively as a learner and practitioner.

It is our intention that trainees from all diverse backgrounds and perspectives be well served by this course, that trainee’s learning needs be addressed both in and out of teaching sessions, and that the diversity that trainees bring to this cohort be viewed as a resource, strength and benefit. It is our intention to present materials and activities that are respectful of diversity: gender and gender identify, sexuality, disability, age, socioeconomic status, ethnicity, race, and culture. Your suggestions are invited, encouraged and appreciated. Please let us know ways to improve the effectiveness of the course for you personally or for other trainees or student groups. In addition, if any of our training sessions conflict with your religious events, or if you have a disability or other condition necessitating accommodation, please let us know so that we can make the necessary arrangements for you.

Our goal as a learning community is to create a safe environment that fosters open and honest dialogue. We are all expected to contribute to creating a respectful, welcoming, and inclusive environment. To this end, classroom discussions should always be conducted in a way that shows respect and dignity to all members of the class. Moreover, disagreements should be pursued without personal attack and aggression, and instead, should be handled with grace and care. This will allow for rigorous intellectual engagement and a deeper learning experience for all.

(Statements adapted from the University of Iowa, College of Education and Yale University - Dr. Carolyn Roberts, Assistant Professor, History of Science & History of Medicine, and African American Studies)

CBT Programme Structure

There are two modules within the CBT pathway. The core module and CBT module both worth 60 credits. For information about the core module, please see the core module handbook.

Code	Title	Credits
PYCM027	Core Skills for Working with Young People with Mental Health Problems and Their Families	60
PYCM028	Evidence Based CBT for Children and Young People In this module you will develop your practice in evidence-based psychological therapies for children, young people and families. You will develop the knowledge and core competencies required to be an effective CBT practitioner, as determined by the relevant national curriculum for the CYP IAPT Programme (such as CBT for Emotional Disorders).	60

Programme Governance

Staff Student Liaison Committee Meetings

Programme members are able to participate in the running of the programme through participation in Staff-Student Liaison Committee meetings. These will be held once per term where the programme team will meet with the trainee representatives and for some SSLC committee meetings, Lived Experience Group members to discuss general issues in programme delivery.

SSLC meetings will consider any changes made to programme delivery dependent upon previous module evaluations. The Programme Lead will report to the Director of Clinical Training or Director of Programmes within the College of Life and Environmental Sciences.

Attendance and Absences

As explained in the individual strand handbooks, this course is a clinically- applied training and as a result, the aim is for 100% attendance. If any teaching is missed, you need to evidence with your course team how you have made up the learning and developed the competencies.

Your programme teams will monitor attendance closely with you throughout your training. Please make sure you sign the register on arrival to ensure that your attendance is recorded correctly. In the case you miss any of the teaching days (both within and outside of the university) through ill health it is your responsibility to inform both your employer and the programme administrator.

Please note that student absences can affect the quality of the learning experiences of the course. As such we do not expect you to take holidays when teaching has been scheduled. Should exceptional circumstances for leave arise then any requests for absence must be made in writing to the Programme Leads and agreed prior to leave being taken.

Maximum Duration Permitted for Completion of IAPT Training

Extenuating circumstances, mitigations, and situations in the workplace may on occasion require a trainee to request an extension to the completion date of their assessed work. Wherever possible, we will work with your Workplace Supervisor to devise a realistic time-scale for completion of the programme. However, as this is a one year programme and the University allows interruption of studies for up to a maximum of one year it is expected that all trainees will complete within 3 years.

Please see the University TQA manual for guidelines on interruptions and withdrawal from studies.

For further information about Programme Governance, please see the Generic IAPT course handbook

Marking, Assessment and Progression

Notched Marking Guidelines

With effect from the 2016/7 academic session, the CLES Education Strategy Group has agreed to implement a notched marking scheme to support consistency and reliability within the assessment process. Within the marking scheme only certain marks may be used within each grade.

The marks available for award are described in the marking criteria document which is available to download here: CLES Generic Notched Marking Guidelines

Submitting Your Work

All written assessments should be word-processed using double-line spacing, font size of 11pt or 12pt and in a font that is easy to read, e.g. Arial, Verdana, Tahoma. All pages should be numbered. To assist with “blind marking” please do not put your name or ID number anywhere in your submission.

Written work must stay within the specified word count and there will not be an upper percentage margin. Markers will stop marking at the point where the limit has been reached.

All work must be submitted by 1.00pm on the submission date.

It is your responsibility as a student to ensure that all work arrives by the submission deadline and that the version you submit is complete. For example, submitting a Case Report without the reference list would automatically result in the work failing.

Citing and Referencing

Psychology has adopted the American Psychological Association (APA) conventions as the standard for citations and references. As such references must be completed in APA style. It is important that programme members are familiar with the precise details of citing and referencing. We use the standard of ‘a publishable article’ and we expect citations and references to adhere to that standard. The information given here is based on the latest edition of the Publication Manual of the APA. We would encourage you to consult these guidelines and copies are kept in the library, or can be obtained online at www.apastyle.org. There are many web sites providing summaries of the APA Style Guide (a Google search will identify these).

Please see this link for information about the Postgraduate Assessment scheme used within CEDAR.

Word Count Guidance

Please note that any words over the word count will not be marked.

The following content is NOT included in a final word count:

Abstract
Title
Contents page
Reference list
Bibliography
Footnotes (these should be used for references only; those containing large amounts of text will be treated as if they were part of the main body of text). Footnotes should only be used where directed by the module convenor.
Appendices
Words used in tables, graphs and other forms of data presentation (including titles of figures)
Equations

The following content IS included in a final word count:

Main body of text
In text quotations
In text references
Section headings
Footnotes containing large amounts of text (unless indicated otherwise by module convenor)

NB: Any tables or figures should be used judiciously to supplement and support the main body of the text for the assignment being submitted. Where tables and figures stand alone and are not referred to within the text, these will not be included within the marking and this can lead to assignments being failed. Reports or essays should make sense and be capable of being read without the tables or figures. If you have any doubts about this, please seek the advice of your tutor or a member of the academic team BEFORE making a submission.

Re-assessment Procedures

Referral: A referral is a further attempt permitted by the examiners, following initial failure of an individual module, or the assessment(s) or examination(s) for that module. There is no requirement to repeat attendance. The module mark following a referral is capped at the pass mark of 50% (postgraduate). For any assessment, candidates have a right to be referred on one occasion only. Where the Board of Examiners decides there are adequate grounds, such as medical reasons or exceptional personal circumstances, it may allow a deferral (i.e., re-assessment without the mark being capped), or permit a further referral.

In the event of any piece of work being referred it will be returned to the programme member with instructions from the programme administrator for its resubmission. Please do be aware that a failure on any assignment in a module results in the whole module being capped at 50%, regardless of what marks subsequent assignments in that module may achieve.

Marking and Appeals Procedure

If a student feels that there has been irregularity in the marking of an assignment and wishes to appeal against a provisional mark prior to the Examination Board, they should bring the grounds for their appeal in writing promptly to the attention of the Director of Clinical Training, who may then seek the opinion of an additional marker. The External Examiner would then review both marks and the correspondence. This will usually resolve the matter, but if a student still feels that he or she has grounds for a formal appeal, the university’s procedures for doing this can be found in the TQA manual. Marks are regarded as provisional until ratified by the APAC (see below).

Student Complaints Procedure

Information about the University Student Complaint Procedure can be found here.

Academic Probity

The definition of cheating and plagiarism in this document are taken from the University’s Teaching Quality Assurance (TQA).

Definitions and offences are outlined in the TQA here. Information on poor academic practice and academic misconduct is also outlined in detail here.

Assessment, Progression and Awarding Committees (APACs)

A Board of Examiners will meet at the end of each programme to recommend awards. The Board comprises the Programme Lead and the External Examiner(s). It is chaired by the Director of Clinical Training, in accordance with University procedures.

Results of students who have successfully completed the programme will be sent for ratification at the Vice Chancellor’s Executive Group meeting. Results of students who are unsuccessful will be considered at a Consequences of Failure Board. This Board will make recommendations for the consequences of failure for individual students. These recommendations will be approved (or otherwise) by the College Associate Dean for Education, who will submit recommendations to the Dean of Faculty for final approval.

On occasions the information contained within this programme handbook regarding programme governance and assessment may be different to that agreed at the wider college and university level. Such differences are due to the specific training and educational requirements encountered with programmes, in particular those required as part of the professional body accreditation process, the delivery of national curriculums and requirements of the SHA tender processes. Where there are differences, information contained within this programme handbook should take precedence.

It should be noted that you will not officially complete the programme until your award has been approved at this Board and approved by the Vice Chancellor’s Executive Group.

Teaching

Each year we begin the course with a focus on the core teaching module. Some of this teaching is delivered for all strands as a whole cohort, whereas other core sessions are delivered individually in strands. The majority of your core teaching will be completed by the end of term 1. Core teaching days will be clearly indicated on the timetable.

Teaching in Terms 1 and 2 is held every week. You will have a whole day tutorial on Mondays, with Tuesday mornings focused on supervision and Tuesday afternoons on skills-based practice. In Term 3 teaching moves to alternate weeks.

Teaching is carried out with a combination of both on campus and remote delivery. Where teaching is online, this is delivered mostly as live tutorials, via video-conferencing. There is also some asynchronous content to our online delivery. All necessary links to online teaching will be embedded in your timetable.

Core Teaching Days 2022

Term 1

Week 1 – 24^th Jan, 25^thJan, 26^th Jan (a.m.), 27^th Jan

Week 2 – 31st Jan (p.m.), 1^st Feb, 2^nd Feb, 4^th Feb

Week 3 – 7th Feb, 8^th Feb, 9^th Feb, 11^th Feb

Week 4 – 15^th Feb (p.m.)

Half Term 21^st-25^th Feb

Week 6 – 8th March (p.m.)

12 training days = 66 hours (each taught day = 5.5 hours)

Term 2

Week 5 – 24^th May (p.m.)

Week 8 – 21^ST June (p.m.)

1 training day = 5.5 hours (each taught day = 5.5 hours)

Total for year Core training hours = 71.5 hours

CBT Teaching Days 2022

Term 1

Week 1 – 26th Jan (p.m.),

Week 2 – 31^st Jan (a.m.)

Week 4 – 14th Feb, 15^th Feb (a.m.), 16^th Feb

Half Term 21^st Feb – 25^th Feb

Week 5 – 28th Feb, 1^st March

Week 6 – 7th March, 8^th March (a.m.)

Week 7 – 14th March, 15^th Mach

Week 8 – 21^st March, 22^nd March

Week 9 – 28^th March, 29^th March

Week 10 – 4^th April, 5^th April

15 training days = 82.5 hours (each taught day = 5.5 hours

Term 2: CBT

Week 1 – 25^th April, 26^th April

Week 2 – 2^nd May, 3^rd May

Week 3 – 9^th May, 10^th May

Week 4 – 16^th May, 17^th May

Week 5 – 23^rd May, 24^th May (a.m.)

(Half-term 30^th May – 3^rd June)

Week 6 – 6^th June, 7^th June Week 7 – 13^th June, 14^th June

Week 8 – 20^th June, 21^st June (a.m.)

Week 9 – 27^th June, 28^th June

Week 10 – 4^th July, 5^th July

Week 11 – 11^th July, 12^th July

Week 12 – 18^th July, 19^th July

Week 13 – 25^th July, 26^th July

25 training days = 137.5 hours (each taught day = 5.5 hours)

Term 3: CBT

Week 1 – 5^th Sept, 6^th Sept

Week 2 – 19^th Sept, 20^th Sept

Week 3 – 3^rd Oct, 4^th Oct

Week 4 – 17^th Oct, 18^th Oct

(Half-term 24^th Oct – 28^th Oct)

Week 5 – 31^st Oct, 1^st Nov

Week 6 – 14^th Nov, 15^th Nov

12 training days = 66 hours (each taught day = 5.5 hours)

Total for year CBT training hours = 286 hours

Grand total for Core and CBT training hours = 357.5 hours

Please note that the minimum taught hours required to satisfy BABCP accreditation regulations is 300 hours. Any absences which take the total hours attended below 300, MUST be accounted for by using the University’s “Missed Learning Activities” procedure detailed below under the section on attendance.

Please note also that the course is not formally completed until the successful submission of all examined work. The diploma is not awarded until the Academic Progress and Awards Committee (APAC) has met, normally in the Spring of the year following course completion.

Office Hours

The CYP-IAPT Programme team runs an open clinic between 4.30pm-5pm on a Tuesday. You can contact the team by email for any queries you may have. Alternatively, approach the help-staff at Washington Singer Reception Desk and if they cannot assist you, they will consult with the dedicated course administration team.

Feedback

Students must complete electronic feedback via Qualtrics. You will receive emails with links to complete the feedback. You will also need to evidence that you have completed feedback as part of your Clinical Portfolio assessment. Feedback provides a vital opportunity for students to give their opinions and thoughts on teaching sessions and allows the CYP-IAPT team to implement new suggestions and changes for future cohorts.

Location of Teaching

Teaching and supervision takes place both on campus and remotely. Remote teaching sessions are carried out using Zoom and supervision takes place over Microsoft Teams, as this currently meets information governance requirements for most organisations. On campus teaching takes place in the Washington Singer Building or Reed Hall, University of Exeter. Other rooms on campus may be needed from time to time for teaching and supervision and these will be marked on your timetable. We recommend that you regularly check your university email as any last minute changes to teaching arrangements will be communicated using this email address. For remote teaching, a register will be taken by the lecturer to confirm attendance. When on campus, there will be a paper register at Washington Singer reception which you are required to sign on attendance.

Structure and Timings of University days

Below are the current structure and timings for online delivery. These timings take into consideration fact that travel to campus is not currently required, but that regular breaks are needed in order to facilitate online working.

Mondays

9:30am – 4:30pm Whole group CBT teaching/workshops

Breaks (approx.):

10.30 (10 mins)

11.30 (10 mins)

12.30 (60 mins)

14.30 (10 mins)

15.30 (10 mins)

Tuesdays

9.30 – 10.00 Preparation for supervision groups

10.00 – 12.30 CBT group supervision

12.30 – 1.30 Lunch

13.30 – 16.30 Whole group CBT clinical skills tutorials

Please refer to the Core handbook for Core Teaching timings, as these may differ

Study Time

Trainees are required by National Guidance to have a minimum of 28 days study time in addition to taught hours. We have timetabled in 6 days study time during half terms. It is recommended that the remaining 22 days are spread throughout the year, either as a half day each week or an arrangement that works best for the programme member and their employer.

Attendance / Missed Session Learning Activity

The PGDip CYP-IAPT PTP (CBT for CYP) requires a high level of attendance in order to meet both the university and the BABCP required standards for the award as noted in the handbook. However, we appreciate that unforeseen circumstances do arise that make it difficult to attend occasional sessions. We therefore have provision to complete a Missed Session Learning Activity Record Form (see below). This does not apply to missed University supervision sessions. Neither does it apply to multiple missed sessions where programme suspension is likely.

Unfortunately we are unable to authorise annual leave during term time except in exceptional circumstances, should this be a concern then please discuss this with your tutor.

Download: Missed Session Learning Activity Record (CYP-IAPT - All Strands)

The decision as to whether a Missed Session Learning Activity plan requires completion for any given absence will be made by the academic team in consultation with individual trainees. Designing an appropriate missed session learning activity is the responsibility of the student but clear guidance is given here about how it should be done. The activity is based on the learning objectives from the missed session which are usually available from the session handout on ELE or from the lecturer. The learning outcomes must be recorded on the ‘Missed Session Learning Activity Record’.

The missed session learning activity requires active and creative engagement with the material in order to address the learning deficit in your CBT skill development following the missed session. It is often useful to determine whether any other students have missed the session and complete the activity together, allowing peer discussion and deeper reflection on the material. Students may also utilise small group work with peers, who may or may not have missed the session, and are willing to participate in an additional learning exercise to supplement their own knowledge and skill development. This allows for the use of role play and enhances applied clinical skills as well as theoretical knowledge. Learning activities are likely to include reflection on two or three relevant texts and / or recorded material linked to the learning outcomes.

Your learning activity will take approximately the duration of time missed e.g. a six hour learning activity for a missed teaching day. Self-directed study can be a part of the missed learning activity, although some more active engagement with fellow students is also required. A required part of any plan therefore, is evidence of active learning with your peers or clinical supervisor, such as discussion, role play or similar.

The missed session learning activity must be agreed with your Academic Tutor prior to completion of the activity. Your Academic Tutor is required to sign the plan twice – once to confirm agreement with the proposal, and once to confirm completion of the activity. If the initial signature is not sought, you may need to complete a further learning activity.

Accreditation

The British Association for Behavioural and Cognitive Psychotherapies (BABCP) is the current accreditation body for cognitive behavioural therapists. The Exeter University CYP-IAPT CBT course is accredited by the BABCP as a Level 2 Accredited Course. This is a big advantage when applying for provisional accreditation once the course has been completed. More detail about this will be provided as the course progresses. In the meantime, you are welcome to look at the BABCP’s website, and to approach any of the course academic team with queries you may have regarding this. All students are now required to register membership with the BABCP before starting their training course.

Competencies

The University of Exeter CYP IAPT CBT Programme has been designed in line with the generic CAMHS competency Framework (Roth and Pilling, 2011 see page 15) and the CYP IAPT national curriculum. For the CBT pathway, the CBT Competencies Framework will also be drawn upon where appropriate (Roth & Pilling, 2007 see page 16).

For further information the CYP IAPT national curriculum, please download:

CYP IAPT Curriculum for ERG

For further information on CAMHS Competencies and CBT competencies please visit the UCL CORE page.

IAPT disorder specific models are those referred to within the CBT competencies framework – references for these models are available by accessing this framework online at the above link, and more specifically for children and young people by consulting the CYP-IAPT national curriculum document, hyper-linked as above.

Key Manuals / Papers for each Anxiety Disorder / Depression

CBT for Anxiety

The evidence base for CBT for children and young people with anxiety disorders refers to both anxiety disorders generally and to specific anxiety disorders.

There is guidance from NICE for GAD and panic disorder (CG 22, updated by CG113) which does not include children and adolescents. PTSD (CG 026), OCD and body dysmorphic disorder (CG 031) as well as Social Anxiety Disorder (CG159) have guidance which covers the age range including children and adolescences.

There is no further NICE guideline on the other anxiety disorders, as they present in childhood, young people, or in adults. The most substantial evidence base for CBT for GAD, separation anxiety and social phobia in children and young people comes from trials of the Coping Cat manual (Kendall & Hedtke, 2006) and related manuals.

There is an emerging evidence base from trials of CBT with children and young people with varied diagnoses of anxiety disorders. In addition, there are well-designed trials of CBT for specific anxiety disorders in children and adolescents not covered by NICE guidance to date. Within this complex and evolving evidence base, the curriculum is not prescriptive about which of the evidence based CBT competences, with their associated models, should be taught. There is in any case, as would be expected, substantial overlap between the evidence based CBT approaches. Therefore the following will be covered within the CYP CBT strand.

PTSD NICE CG 26; Roth, Calder & Pilling (2011) Ehlers & Clark (adapted by Smith)

OCD NICE CG 31; Roth, Calder & Pilling (2011) March & Mulle (1998) & Salkovskis (1999) (adapted to CYP)

GAD (Kendall & Hedtke, 2006 a&b). For older adolescents, consult NICE CG 22 and CG 113 f or adults – Borkovec & Sharpless (2004).

Panic Disorder For older adolescents, consult NICE CG 22 and CG 113 for adults. Clark (1986, 1996). There is little evidence base for CBT for panic disorder in children and younger adolescents.

Social Phobia (Kendall & Hedtke, 2006 a&b); Clark (2005)

Separation Anxiety Disorder (Kendall & Hedtke, 2006 a&b): Schneider & Lavallee (2013).

Specific Phobia (Kendall & Hedtke, 2006 a&b). Kirk, J. & Rouf, R. (2004). Ost, L. G. (1989).

References:

Kendall (GAD, Social Anxiety, specific phobia)

Kendall, P. C., & Hedtke, K. A. (2006a). Cognitive-Behavioural Therapy for Anxious

Children: Therapist Manual: Third Edition. Ardmore: Workbook Publishing.

Kendall, P. C., & Hedtke, K. A. (2006b). The Coping Cat Workbook: Second Edition. Ardmore: Workbook Publishing.

GAD

Borkovec, T. D., & Sharpless, B. (2004). Generalized Anxiety Disorder: Bringing Cognitive Behavioral Therapy into the Valued Present. In S. Hayes, V. Follette, & M. Linehan (Eds.), New directions in behavior therapy. New York: Guilford Press.

Bernstein, D. A., Borkovec, T. D., & Hazlett-Stevens, H. (2000). New directions in progressive relaxation training: A guidebook for helping professionals. Westport, CT: Praeger Publishers.

Borkovec, T. D. Protocol manuals Combined self-control desensitisation and cognitive therapy manual Applied relaxation and self-control desensitisation

OCD:

Salkovskis, P. M (1999). Understanding and treating obsessive compulsive disorder Behavior Research and Therapy, 37, S29-52.

Bolton, D., Williams, T., Perrin, S., Atkinson, L., Gallop, C., Waite, P., & Salkovskis, P. M. (2011). Randomized controlled trial of full and brief cognitive-behaviour therapy and wait-list for paediatric obsessive-compulsive disorder.Journal of Child Psychology and Psychiatry, 52, 1269-1278.

March, J. S., & Mulle, K. (1998) OCD in Children and Adolescents: A Cognitive-Behavioural Treatment Manual. New York: Guilford Press.

Waite, P. & Williams, T. (2009). Obsessive Compulsive Disorder: Cognitive Behaviour Therapy with Children and Young People. CBT with children, adolescents and families. Hove: Routledge.

PTSD:

Ehlers and Clark (2000) model and treatment protocol, adapted for young people (Smith et al. 2007, 2010).

Ehlers, A., & Clark, D.M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345.

Ehlers, A., Clark, D. M., Hackmann, A., McManus, F., Fennell, M., & Grey, N. (in press). Cognitive Therapy for Posttraumatic Stress Disorder: a therapist’s guide. Oxford: Oxford University Press.

Smith, P., Perrin, S., Yule, W., & Clark, D.M. (2010). Post-Traumatic Stress Disorder – CBT with children and young people. Hove: Routledge.

Smith, P., Yule, W., Perrin, S, Tranah, T., Dalgleish, T., & Clark D.M. (2007). Cognitive behavioural therapy for children and adolescents – a preliminary randomised controlled trial. Journal of the American Association for Child and Adolescent Psychiatry, 46, 1051-1061

Panic

Clark, D.M. (1996) Panic Disorder: From Theory to Therapy. In: Salkovskis, P.M. (Ed) Frontiers of Cognitive Therapy. New York: The Guilford Press.

Clark, D.M. (1986) A cognitive approach to panic. Behaviour Research and Therapy, 24 (4), 461-470.

Clark, D.M. and Salkovskis P.M. (in press) Panic Disorderin Hawton, K., Salkovskis, P.M., Kirk, J. & Clark, D.M. (Eds). Cognitive Behaviour Therapy: A Practical Guide (2nd Edition). Oxford: Oxford University Press.

Separation Anxiety:

Schneider, S., Lavallee, K., (2013). Separation Anxiety Disorder. In Essau, C. A. & Ollendick, T. (Eds). The Wiley-Blackwell Handbook of The Treatment of Childhood and Adolescent Anxiety. Chichester: Wiley-Blackwell.

Schneider, S., Blatter-Meunier, J., Herren, C., Adornetto, C., In-Albon, T., Lavallee, K. (2011). Disorder-specific cognitive-behavioral treatment for Separation Anxiety Disorder in young children: A randomized waitlist-controlled trial. Psychotherapy and Psychosomatics, 80, 206-215

Social Anxiety:

Clark, D. M. (2005). A cognitive Perspective on Social Phobia, in Ray. W., Crozier W. R. and Alden, L.L .The Essential Handbook of Social Anxiety for Clinicians. Chichester: John Wiley & Sons Ltd.

Specific Phobias

Kirk, J. & Rouf, R. (2004). Specific Phobias. In J. Bennet-Levy, G.Butler, M. Fennell, A. Hackmann, M. Mueller & D. Westbrook (Eds.), Oxford Guide to Behavioural Experiments in Cognitive Therapy. Oxford: Oxford University Press.

Ost, L. G. (1989). One session treatment for specific phobias. Behaviour Research and Therapy, 27, 1-7.

Depression

The NICE guideline on depression in children and young people (2005 updated 2015) concluded that a number of psychological treatments were helpful as a first line of treatment. Evidence from RCTs was limited for all types of psychological treatments and although CBT had the widest range of research evidence the results from studies on CBT were mixed. Overall, there is not sufficient evidence to suggest that CBT is clearly superior to a number of other psychological treatments such as IPT, psychotherapy or family therapy. Research findings since 2007 have not radically altered the evidence base used by the NICE guidance group.

The on-going large RCT in the UK (the IMPACT study) comparing CBT, child psychotherapy and psychiatric management will add significantly to our knowledge of the effectiveness of these three treatments with clinically referred children and young people.

For the treatment of depression, Child IAPT workers will be trained in the NICE guidance (2015) including, for example, recognising the need for psychiatric review and consideration of medication as an adjunct to psychological therapy. Within this framework, Children and Young People’s IAPT workers will be trained to deliver CBT for children and young people. The course will be predominantly focused on depression in adolescence, as it is much more common in adolescents than younger children. IAPT workers will need to be able to adapt the approach to younger children and this will be considered in a specific part of the module. Therefore, the following will be covered within the CYP-IAPT CBT strand.

Brent, D, A.,& Poling, K. L. S. W. (1997). Cognitive Therapy Treatment Manual for Depressed and Suicidal Youth. Star Centre Publications (for clients aged 13-18 years).

Harrington, R., & Wood, A. (1996). Cognitive-Behavioural Manual for use with Child Patients with Depressive Disorders. (for clients aged 9-17years)

IMPACT Trial (2010). A manual for the delivery of CBT in the treatment of young people with depression (unpublished draft).

Martel, C.R., Addis, M.E., & Jacobson N. S. (2001). Depression in Context; Strategies for Guided Action New York: W. W. Norton (adapted for adolescents).

Ritschel, L. A. & Ramirez, C. L. (2011). Behavioral Activation for Depressed Teens: A Pilot Study. Cognitive and Behavioral Practice 18, 281–299

NICE Guidelines

CG22

National Institute for Health and Clinical Excellence. (2004). Anxiety: management of

anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care. Manchester: NICE.

CG113

National Institute for Health and Clinical Excellence. (2011). Generalised anxiety

disorder and panic disorder (with or without agoraphobia) in adults: management in

primary, secondary and community care (partial update). Manchester: NICE.

CG28

National Institute for Health and Clinical Excellence. (2015). Depression in children and young people: identification and management in primary, community and secondary care. Manchester: NICE.

CG31

National Institute for Health and Clinical Excellence. (2005). Obsessive Compulsive

Disorder: core interventions in the treatment of obsessive compulsive disorder and body dysmorphic disorder. Manchester: NICE.

CG 026

National Institute for Health and Clinical Excellence. (2005). Post-traumatic Stress

Disorder: the management of PTSD in adults and children in primary and secondary

care. London: Royal College of Psychiatrists and British Psychological Society.

CG159

National Institute for Health and Clinical Excellence. (2013). Social Anxiety Disorder: recognition, assessment and treatment. Manchester: NICE.

Tutorials

There are three types of tutorials in the programme:

1. Whole group academic tutorials/teaching:

Purpose

Opportunity to reflect on any HW set
Opportunity to review literature
Opportunity to ask questions, give and receive feedback
Opportunity to address any queries around assessments

2. Whole group clinical skills based tutorials

Purpose

To consolidate learning from workshops
To provide opportunity for further skills practice
Opportunity to reflect on any HW set
Opportunity to ask questions, give and receive feedback

3. Individual tutorials

1 x half hour tutorial per term

Purpose

Opportunity to review and reflect on your development and the course
Opportunity to give and receive feedback on assessed work.
Opportunity to give and receive feedback on the course.
To review your clinical portfolio.
A safe environment for addressing personal development.

NB: If trainees have any concerns or issues that may be impacting on their ability to participate fully in the training or causing them any distress or concern; trainees are strongly encouraged to notify either their tutor or any member of the course team as soon as possible, rather than wait for their 1:1 tutorial.

Preparation

Trainees are required to bring up to date forms each term for their individual tutorials, to include where appropriate:

Reflective Practice Summary
Clinical Log
Supervision Log
Teaching Log
Supervisors Reports

Forms

Supervision

Throughout the course trainees receive group supervision from course supervisors within the university and from their workplace based supervisors. Please see separate Supervision Guide and Clinical Portfolio for details of supervision. Should there be any difficulties that arise within your supervisory relationship, in the first instance please try to work with your supervisor to address these. If difficulties continue, please discuss this with your 1:1 tutor or the Programme Lead. We normally change groups and supervisor at university after the first term – there are no further changes after that.

Confidentiality and Anonymisation in Assessments & Clinical Portfolio

Maintaining confidentiality is a vital aspect of maintaining professional standards. Common over-sights by trainees are the inclusion of identifying information in an appendix (e.g. name of service; identifying information of client or professionals involved), providing excessive information about client and family or geographic location. When writing, always ask yourself if you need to include that bit of information, and if so, is it possible to anonymise it more – for example: X lived in a rural county rather than saying Somerset; a counselling service in the South West of England, rather than saying Checkpoint or Off the Record.

A brief statement in the introduction to case reports and other client-related assessments should make it clear that any names being used have been changed to protect the confidentiality of children and young people and their families/parents/carers. Care should be exercised in anonymising documents included as appendices to reports and other written assessments, especially documents included in the clinical portfolio. Any details that identify a child or young person or a parent/carer should be deleted or blanked out. If using a felt-tip pen to blank out these details DO make sure that the details cannot still be read when the paper is held up to the light, for example. Other names and addresses (apart from the trainee’s own name and employing service for the clinical portfolio) should also be blanked out – e.g. names and addresses of GP surgeries. Service details should NOT be identified at all for case presentations and case reports. It is also good practice not to include information that might identify the author of assignments, such as details of their profession, for example.

Any breaches in confidentiality in any assessments will result in the assessment automatically being returned to the trainee for urgent attention, or will result in a fail if a serious breach – see below.

You are expected to seek parent / carer consent in every instance possible, alongside consent from all young people. Where parent / carer consent is not possible, for example when a young person is over 16 years or considered Gillick competent and where a parent / carer is not involved in their treatment, it is acceptable to submit a consent form for the young person only. In this case, please state clearly in your submission why parental consent was not sought and how Gillick competence was considered (if relevant).

The following principles have been agreed as the process to follow where there are breaches in confidentiality in assessments submitted as part of the CEDAR PGT training programmes:

Case presentations:

1. With case presentations, no identifiable information should be presented on the client or the service.

2. A minor breach in case presentations, where confidentiality/anonymisation has occurred and been acknowledged by the author, but then a minor mistake(s) gets picked up will be returned to the author for correction. The trainee will have 48 hours to reply and correct the errors in the presentation handouts, otherwise it will be marked as a fail.

3. When major breaches are present or anonymisation has not occurred and/or been made explicit, this will be an automatic fail and the trainee would need to resubmit a second submission correcting the error (and making any other changes if there are other resubmission criteria).

Case Reports:

1. In Case Reports there should be no identifiable information in relation to the client or service.

2. A minor breach in Case Reports, where confidentiality/anonymisation has occurred and been acknowledged by the author, but then a minor mistake(s) gets picked up will be returned to the author for correction. The Trainee will have 48 hours to reply and correct the errors, otherwise it will be marked as a fail.

3. When major breaches are present or anonymisation has not occurred and/or been made explicit , this will be an automatic fail and the trainee would need to resubmit a second submission correcting the error (and making any other changes if there are other resubmission criteria).

Clinical Portfolios:

1. In the clinical portfolio, the trainee and the service can be identified but no identifiable information on clients should be included.

2.If confidentiality breaches occur in a clinical portfolio in relation to clients, this will be marked as an automatic fail and the trainee will be asked to address the area of concern (and any other changes) for resubmission.

Self-Practice, Self-Reflection

Trainees will have the opportunity to engage regularly throughout the course in pre-set self-practice CBT tasks designed to prepare for or deepen learning in the concurrent taught components of the course. Trainees will be invited to complete self-practice, self-reflection tasks linked to specific teaching topics.

See the following reference for further information:

Bennett-Levy, J., Turner, F., Beaty, T., Smith, M., Paterson, B., & Farmer, S. (2001). The value of self-practice of cognitive therapy techniques and self-reflection in the training of cognitive therapists. Behavioural and Cognitive Psychotherapy, 29, 203-220.

CBT Reading List

Disorder Specific books and publications:

Depression

Brent, D., & Poling, K. (1997). Cognitive therapy treatment manual for depressed and suicidal youth. Pittsburgh: Star Centre Publications University of Pittsburgh Medical Centre.

Harrington, R., & Wood, A. (1996) Cognitive-Behavioural Manual for use with Child Patients with Depressive Disorders.

IMPACT Trial (2010). A manual for the delivery of CBT in the treatment of young people with depression (unpublished draft).

Martel, C.R., Addis, M.E., & Jacobson N. S. (2001). Depression in Context; Strategies for Guided Action New York: W. W. Norton adapted for adolescents

Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2010). Behavioral Activation for Depression: A Clinician's Guide. New York: Guilford Publishers

Ritschel, L.A., Ramirez, C. L., Jones^,M., & Craighead, W. E. (2011). Behavioral Activation for Depressed Teens: A Pilot Study. Cognitive and Behavioral Practice. 18 281–299.

Verduyn, C., Rogers, J. & Wood, A. (2009). Depression. Cognitive Behaviour Therapy with Children and Young people. Hove: Routledge.

McCauley, E., Schloredt, K.A., Gudmundsen, G.R., Martell, C.R., & Dimidjian, S. (2016). Behavioral Activation with Adolescents. New York: Guilford Publishers

Generic Anxiety References

Kendall, P. C., & Hedtke, K. A. (2006a). Cognitive-Behavioural Therapy for Anxious Children: Therapist Manual: Third Edition. Ardmore: Workbook Publishing.

Kendall, P. C., & Hedtke, K. A. (2006b). The Coping Cat Workbook: Second Edition. Ardmore: Workbook Publishing.

Salkovskis, P. M (1996). The cognitive approach to anxiety: Threat beliefs, safety seeking behavior, and the special case of health anxiety and obsessions. In P.M. Salkovskis (ed). Frontiers of Cognitive Therapy. New York: Guildford Press.

General Anxiety Disorder (GAD)

Borkovec, T.D., & Sharpless, B. (2004). Generalized Anxiety Disorder: Bringing Cognitive Behavioral Therapy into the Valued Present. In S. Hayes, V. Follette, & M. Linehan (Eds.), New directions in behavior therapy. New York: Guilford Press.

Bernstein, D.A., Borkovec, T.D., & Hazlett-Stevens, H. (2000). New directions in progressive relaxation training: A guidebook for helping professionals. Westport, CT: Praeger Publishers

Borkovec, T.D. Protocol manuals Combined self-control desensitisation and cognitive therapy manual Applied relaxation and self-control desensitization.

Dugas, M.J., & Robichaud, M. (2007). Cognitive-behavioral treatment for Generalized Anxiety Disorder: From science to practice. New York: Routledge.

Obsessive Compulsive Disorder (OCD)

Bolton, D., Williams, T., Perrin, S., Atkinson, L., Gallop, C., Waite, P., & Salkovskis, P. M. (2011). Randomized controlled trial of full and brief cognitive-behaviour therapy and wait-list for paediatric obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, 52 (12), pp. 1269-1278.

March, J. S., & Mulle, K. (1998). OCD in Children & Adolescents: A Cognitive Behavioral Treatment Manual. New York: The Guildford Press

Salkovskis, P. M (1999). Understanding and treating obsessive compulsive disorder Behavior Research and Therapy, 37, S29-52.

Waite, P. & Williams, T. (2009). Obsessive Compulsive Disorder. Cognitive Behaviour Therapy with Children and Young people. Hove: Routledge.

Panic Disorder

Clark, D.M. (1996) Panic Disorder: From Theory to Therapy. In: Salkovskis, P.M. (Ed) Frontiers of Cognitive Therapy. New York: The Guilford Press.

Clark, D.M. (1986) A cognitive approach to panic. Behaviour Research and Therapy, 24 (4), 461-470.

Social Anxiety

Clark, D. M. (2001). A cognitive perspective on social phobia. In W. R. Crower. & L. E. Alden (Eds). International handbook of social anxiety: Concepts, research & interventions relating to the self and shyness. Chichester: John Wiley & Sons.

Specific Phobias

Ost, L. G. (1989). One session treatment for specific phobias. Behaviour Research and Therapy, 27, 1-7.

Post Traumatic Stress Disorder

Ehlers, A., & Clark, D.M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy. 38, 319-345.

Smith, P., Yule, W., Perrin, S, Tranah, T., Dalgleish, T., & Clark, D.M. (2007). Cognitive behavioural therapy for children and adolescents – a preliminary randomised controlled trial. Journal of the American Association for Child and Adolescent Psychiatry. 46, 1051-1061.

Smith, P., Perrin, S., Yule W., & Clark, D. M. (2010). Post Traumatic Stress Disorder. Cognitive Behaviour Therapy with Children and Young people. Hove: Routledge.

Separation Anxiety:

Generic Essential CBT Texts

Fuggle, P., Dunsmuir, S., & Curry, V. (2013). CBT with children, young people and their families. London: Sage.

Howells, L. (2018). Cognitive behavioural therapy for adolescents and young adults: An emotion regulation approach. Oxford: Routledge.

Westbrook, D., Kennerley, H., & Kirk, J. (2007). An introduction to cognitive behaviour therapy: Skills and applications. London: Sage.

Additional useful treatment and reference CBT Texts

Albano, A. M., & DiBartolo, P. M. (2007). Cognitive-Behavioral Therapy for Social Phobia in Adolescents: Therapist Guide: Stand up, Speak out (Treatments That Work). New York: Oxford University Press

Bennett-Levy, J., Thwaites, R., Haarhoff, B. & Perry, H. (2015). Experiencing CBT from the Inside Out: A Self-Practice/Self-Reflection Workbook. Guildford: Guildford Press.

Bennett-Levy, J., Thwaites, R., Haarhoff, B. & Perry, H. Reflective practice in cognitive behavioural therapy: The engine of lifelong learning. http://www.cbttraining.com.au/wp-content/uploads/pdf_publications/Stedmon_Dallos_ch7.pdf

Carr, A. (2000). What works with children and adolescents? A critical review of psychological interventions for children, adolescents and their families. London: Brunner-Routeledge.

Chorpita, B. (2007). Modular Cognitive Behavioral Therapy for Childhood Anxiety Disorders. Guildford: The Guildford Press.

Farrington, A., & Dalton, L. (2005). Getting Through Depression with CBT: A Young Person's Guide. Blue Stallion Publications.

Friedberg, R. D. and McClure, J. M. (2002). Clinical Practice of Cognitive Therapy with Children and Adolescents: The nuts and bolts. Guildford: The Guildford Press.

Graham, P. & Reynolds, S. (2013). Cognitive Behaviour Therapy for Children and Families (3^rd Ed.). Cambridge: Cambridge University Press.

Greenberger, D., & Padesky, C. (2015). Mind Over Mood (2^nd Ed.). New York: The Guildford Press.

Greenberger, D., & Padesky, C. (1995). A Clinician’s Guide to Mind Over Mood. New York: The Guildford Press.

Gurney-Smith, B. (2005). Getting Through Anxiety with CBT: A Young Person's Guide. Whitney: Blue Stallion Publications.

Holdaway, C., & Connolly, N. (2005). Getting Through It with CBT: A Young Persons Guide to Cognitive Behavioural Therapy. Whitney: Blue Stallion Publications.

Kendall, P. C. (2012). Child & Adolescent Therapy: Cognitive-Behavioral Procedures. New York: The Guildford Press.

Leahy, R. & Holland, S. (2012). Treatment Plans & Interventions for Depressive & Anxiety Disorders. New York: The Guildford Press.

Reinecke, M A., Datillio, F. M. and Freeman, A. (Eds) (2003). Cognitive Therapy for Children and Adolescents: A Case Book for Clinical Practice. New York: The Guildford Press

Stallard, P. (2002). Think Good- Feel Good: A cognitive therapy workbook for children and young people. Chichester:John Wiley & Sons Ltd.

Stallard, P. (2005). A Clinicians Guide to Think Good-Feel Good: Using CBT with children and young people: Using CBT with Children and Young People. Chichester: John Wiley & Sons Ltd.

Stallard. P. (2009). Anxiety. Cognitive Behaviour Therapy with Children and Young people. Hove: Routledge.

Weisz, J. R. & Kazdin, A. E. (2010). Evidence-Based Psychotherapies for Children and Adolescents. New York: Guildford Press.

Useful Websites

British Association of Cognitive Behavioural Therapists

http:www.babcp.com

Choice and Partnership Approach

http://www.camhsnetwork.co.uk

IAPT

http://www.iapt.nhs.uk

Child Outcomes Research Consortium

http://www.corc.uk.net

MindEd

www.minded.org.uk

Young Minds

http://www.youngminds.org.uk

Outcomes, Research & effectiveness

http://www.ucl.ac.uk/CORE

NHS Health and social care bill 2011:

https://www.gov.uk/government/publications/health-and-social-care-bill-2011-combined-impact-assessments

No Health without Mental Health:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_123766

Roth & Pilling (2007) & Roth, Calder & Pilling (NHS Education for Scotland Competence Framework for Workers in CAMHS Settings, 2011):

http://www.ucl.ac.uk/clinical-psychology/CORE/competence_frameworks.htm

Turpin & Wheeler (2011):

http://www.iapt.nhs.uk/silo/files/iapt-supervision-guidance-revised-march-2011.pdf

NICE Guidelines

CG22

National Institute for Health and Clinical Excellence. (2004). Anxiety: management of

anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care. Manchester: NICE.

CG113

National Institute for Health and Clinical Excellence. (2011). Generalised anxiety

disorder and panic disorder (with or without agoraphobia) in adults: management in

primary, secondary and community care (partial update). Manchester: NICE.

CG28

National Institute for Health and Clinical Excellence. (2015). Depression in children and young people: identification and management in primary, community and secondary care. Manchester: NICE.

CG31

National Institute for Health and Clinical Excellence. (2005). Obsessive Compulsive

Disorder: core interventions in the treatment of obsessive compulsive disorder and body dysmorphic disorder. Manchester: NICE.

CG 026

National Institute for Health and Clinical Excellence. (2005). Post-traumatic Stress

Disorder: the management of PTSD in adults and children in primary and secondary

care. London: Royal College of Psychiatrists and British Psychological Society.

CG159

National Institute for Health and Clinical Excellence. (2013). Social Anxiety Disorder: recognition, assessment and treatment. Manchester: NICE.

CBT Supervision and Clinical Practice

Supervision and cases

As part of the programme you will receive at least two hours of university-based group supervision a week. This will amount to over 50 hours of group supervision over the course year (please note group supervision hours must be divided by number of practitioners in the group and multiplied by 2 when being logged). You will also receive weekly individual supervision from your workplace supervisor over the year. Over the course of the year you need to have received 70 hours of supervision and 200 hours of supervised CBT practice.

You will need to see at least eight completed cases (seen for 5 sessions or more from start to completion/termination) and have received 5 hours minimum of supervision, from a supervisor who is a BABCP accredited/accreditable therapist, on each of these cases. The University will provide the supervision for up to 4 of these cases.

Three of these eight cases must be closely supervised. This means in addition to the above criteria, they will also have to have been formally assessed using video or live practice and assessed to be to a reasonable standard as judged by the CTS-R.

Please note that when calculating your supervision hours for the 8 cases all group supervision will be divided by the number of supervisees in the group and then multiplied by two.

We have provided a supervision contract for you and both your supervisors to work through during your initial meetings to help you discuss and agree the nature and content of your supervision. This will form the Supervision Contract between yourself, your University Supervisor and Workplace Supervisor. Please do adapt this to your individual needs if helpful, it is only meant to be a suggested format.

Supervision Feedback

We have provided the BABCP’s supervisee feedback form on supervision which can be a useful tool to help you review supervision with your supervisor at the end of each term. At the end of each supervision session we will ask you to provide feedback to your supervisor by using the Helpful Aspects of Supervision Questionnaire (HASQ). This should be reviewed on an ongoing basis with your supervisor and we would encourage you to give accurate and constructive feedback using this tool so that you can gain the most from your supervision sessions over the course of the year.

Your Supervisors

Your University based supervisor will provide you with intensive skills-based supervision, helping to develop your CBT competencies and theory practice links. They will supervise up to 4 cases over the year. The aim is for your University supervision to focus on the 3 closely supervised cases as a minimum. This means you should try to hand in your CTSR competency tapes on the cases that you bring to University supervision.

Your workplace based supervision will also involve caseload supervision. They will hold an overview of all your clinical cases. They will also support you in applying CBT theory and techniques to your cases and will be able to support you in working in your clinical setting and dealing with clinical issues such as risk.

Both your workplace and University based clinical supervisors will be offered training in the requirements of supervision and the clinical assessment associated with the programme. They will also be offered ongoing continued professional development (CPD) and supervision of CBT supervision. It is generally expected that workplace supervisors, as well as being CBT therapists accredited with the BABCP, will also have successfully completed a CYP-IAPT supervisor’s course in CBT, or currently be attending one.

Your Role as Supervisee

In addition to filling in the clinical and supervision logs and reports (see below) you will also need to think about your role as a supervisee. This will include coming prepared for your supervision (see supervision preparation form), keeping notes on discussions in supervision and carrying through jointly agreed action points (see record of supervision) and bringing a summary of your supervision to your 1:1 tutorials (see ongoing summary of supervision hours).You will also be expected to bring weekly video clips of your session with the client. If you have any concerns about your cases or supervision please do raise these with your supervisors in the first instance.

In order to develop a reflective approach to the work you carry out and link theory, practice and supervision, a total of 6 self-rated CTSRs (Log A) should be submitted and three Reflective Practice Logs (Log B).

In order to ensure that you make the most effective use of supervision we suggest you read the guidance included within the supervisors’ reports of this handbook. In addition we have included below some suggested content of supervision and supervision methods and topics.

Content of supervision

Content of supervision will focus on the acquisition of knowledge, conceptualisation and clinical skills within a cognitive behavioural model(s).

Associated issues will also be discussed when it is relevant to do so e.g. medication, hospitalisation, case management.

Identification (and collaborative change of these if appropriate) of supervisee thoughts, attitudes, beliefs and values and the impact of these on therapeutic and professional behaviour.

Discussion and working through relationship and process aspects of supervision.

Supervision methods and topics

Discussion of therapeutic relationship and engagement issues.

Case conceptualisation/formulation.

Rehearsal of therapeutic techniques e.g. simulation, role-play.

Discussion about therapeutic strategies.

Case Presentations.

Homework.

Review of audio and videotapes*

Direct observation of practice

Identification of supervisee thoughts, attitudes, beliefs with exploration of the impact of these on therapeutic and professional behaviour.

Review of risk and therapist/service user safety.

Review of clinical guidelines/manuals.

Review of psychoeducational material.

Experiential exercises.

Other strategies as agreed.

* You will be expected to bring video tapes of your cases to the University on a weekly basis and regularly to your service supervision.

Clinical Portfolio

At the end of the course each programme member is required to submit a clinical portfolio. This clinical portfolio forms one of the required assessments for module PSYM 301. It also meets the CYP IAPT curriculum requirements. We encourage you to complete the paperwork on an ongoing basis in your portfolio and you will need to bring these to your termly 1:1 tutorials.

Please note that we are currently developing a paperless online system for clinical portfolios and we will advise you on this as development progresses.

Supervision Reports

At the end of terms 1 and 2 both supervisors will complete formative supervisor’s reports. You will need to submit these to the course on the assessment dates and keep a copy for your records. At the end of term 3 both supervisors will complete summative supervisor’s reports, which need to be satisfactorily passed in order for the course to be successfully completed. These also need to be submitted to the course on the assessment date with copies kept for your own records. It is also required that Term 3 summative supervisor’s reports are included within the clinical portfolio – one for the workplace and one for the university supervisor. If concerns are highlighted in these reports that indicate that the supervisors cannot sign you off as being satisfactory for that stage in your training, an action plan meeting will be arranged between the supervisor and a member of the programme team.

Practice Competency Tapes

You will need to submit 3 therapy tapes over the year (one formative and two summative). An appropriate consent form(s) and front sheet should be included. You will also need to submit a CTSR and reflective log when you submit a tape.

For those trainees who do not have a core profession, they will need to include their completed KSA portfolio alongside the clinical portfolio at the end of the year (see University KSA Tutor for details of KSA). In preparation for this, please advise your 1:1 tutor each term on how you are progressing with completing your KSA portfolio.

Normally your 1:1 tutor will be a trained KSA assessor –where this is not the case you will have a separate meeting with the KSA tutor to assist you in completing your KSA portfolio.

Forms to download:

KSA Portfolio Checklist

KSA Portfolio Form

Formative Reports - Term 1 & 2

At the end of term 1 and 2 trainees need to submit a "Formative University Supervisor Report" and "Formative Workplace Supervisor Report". These reports are reviewed with your university tutor. Where a trainee does not pass their supervisor's reports this will be addressed with the trainee and their tutor and supervisor.

To assist with assessment of your ability to use supervision and your competence, strengths and areas for improvement, the adapted Dreyfus scale (1989), as used with the CTS-R (2001), will be used as a guide to facilitate feedback on competency.

Incompetent ‑ The therapist commits errors and displays poor and unacceptable behaviour, leading to negative therapeutic consequences.

Novice ‑ At this level the therapist displays a rigid adherence to taught rules and is unable to take account of situational factors. He/she is not yet showing any discretionary judgment.

Advanced Beginner ‑ The therapist treats all aspects of the task separately and gives equal importance to them. There is evidence of situational perspective and discretionary judgment.

Competent ‑ The therapist is able to see the tasks linked within a conceptual framework. He/she makes plans within this framework and uses standardised and routinised procedures.

Proficient ‑ The therapist sees the patient's problems holistically, prioritises tasks and is able to make quick decisions. The therapist is clearly skilled and able.

Expert ‑ The therapist no longer uses rules, guidelines or maxims. He/she has deep tacit understanding of the issues and is able to use novel problem‑solving techniques. The skills are demonstrated even in the face of difficulties (e.g. excessive avoidance).

Competence level Examples

Incompetent	0	Absence of feature, or highly inappropriate performance
Novice	1	Inappropriate performance, with major problems evident
Advanced Beginner	2	Evidence of competence, but numerous problems and lacking consistency
Competent	3	Competent, but some problems and/or inconsistencies
Competent	4	Good features, but minor problems and/or inconsistencies
Proficient	5	very good features, minimal problems and/or inconsistencies
Expert	6	Excellent performance, or very good even in the face of patient difficulties