Teaching and Supervising Cognitive Behavioral Therapy E-Book

Donna M. Sudak

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 550

Veröffentlichungsjahr: 2015

Beschreibung

A total CBT training solution, with practical strategies for improving educational outcomes.

Teaching and Supervising Cognitive Behavioral Therapy is the first comprehensive package to provide empirically-validated CBT training and supervisory techniques. Applicable to a variety of behavioral health care disciplines, this multi-modal guide provides educators with the information and tools that can help improve educational outcomes. An examination of CBT developments over the past twenty years leads into a discussion of practical applications for improving CBT education, while addressing the technological advances that facilitate dissemination and the specific challenges posed to confidentiality and patient care. The digital component contains additional audio and video content, plus downloadable worksheets that reinforce and expand upon the strategies presented.

Coverage includes advice geared specifically toward the most commonly-encountered problems, with video of training sessions that address issues like frustration with patients, disbelief in psychotherapy, dislike of the method, and lack of skills. Readers will gain insight into effective goal setting, and implement a structured approach to supervision.

• Examine existing literature and research on training, supervision, and evaluation
• Integrate theory with practical strategies to improve learning outcomes
• Customize training approaches to specifically suit different professional groups
• Fit the methods to the environment, including workshops, webinars, and podcasts

Mental health professionals who favor an empirically-based approach to therapy will appreciate the effectiveness of an empirically-based approach to pedagogy. Backed by over two decades of CBT research and the insight of leading CBT experts, Teaching and Supervising Cognitive Behavioral Therapy provides trainers with the tools and information they need to improve therapist educational outcomes.

Leseprobe

CONTENTS

Cover

Title Page

Copyright

Acknowledgments

Foreword

About the Authors

Chapter 1: CBT Training and Supervision

Historical Roots of CT Training and Supervision

Current Training Opportunities

Classification and Review of Training Programs

Effectiveness of Training

Best Practices for Training

Best Practices for Supervision

Some Distinctive Features of CBT Training and Supervision

Future Directions for CBT Training and Supervision

Summary

References

Chapter 2: Core Competencies in Cognitive Behavioral Therapy Training

What Are Competencies?

Existing Competency Frameworks

The British Association of Behavioural and Cognitive Psychotherapies (BABCP) Core Curriculum

Essential Competencies in CBT Training

Teaching Methods

Summary

Learning Exercises

References

Chapter 3: Empirically Supported Educational Methods

Primary Findings

Other Important Considerations

Interventions Pending Further Study

Summary

Learning Exercises

Notes

Resources for Further Study

References

Chapter 4: Measures of Competence in Cognitive Behavioral Therapy

Measures of Evaluation of Competence in CBT and Evidence for Their Reliability and Validity

Assessment of Case Conceptualizations

Scoring the Cognitive Therapy Scale

Accreditation as a CBT Provider

Summary

Learning Exercises

References

Chapter 5: Feedback in Cognitive Behavioral Therapy Training

Feedback and Skill Training

Providing Formative Feedback

Adult Learning and Feedback

Providing Summative Feedback (Did You Reach the Goal?)

When Feedback Sessions Go Wrong

Why Don't We Like to Give Feedback?

Problematic Trainees

Competence Is Insufficient: Addicting Trainees to Lifelong Learning

Summary

Learning Exercises

References

Chapter 6: Teaching CBT for Specific Disorders

Teaching CBT for Depression

Teaching CBT for Anxiety Disorders

Teaching CBT for Personality Disorders

Learning Exercise

Teaching CBT for Substance Abuse

Teaching CBT for Serious Mental Illness

Summary

References

Chapter 7: Technology in CBT Training and Supervision

Technological Applications for Supervision

Technological Applications for Instruction

Ethical and Legal Contexts

Other Considerations When Selecting Technology

Additional Factors

Summary

Learning Exercises

Notes

Reference

Chapter 8: Graduate Training

Problems with Graduate Training in CBT

Summary

Learning Exercises

References

Chapter 9: CBT in Psychiatry Residency Training

History of CBT Training in Psychiatric Residencies

Understanding Residency Training

Problem Areas in Training Psychiatry Residents in CBT

Planning Training in CBT in Psychiatric Residencies

Faculty Development

Summary

Learning Exercises

References

Chapter 10: Continuing Education for Therapists in Practice

Background and Evolution of CBT Training for Therapists

Current CBT Training Options

Considerations for Practitioners Evaluating Training Options

Effectiveness of CBT Training for Therapists

Review of Training Studies

Designing Training

Summary

Learning Exercises

References

Chapter 11: Training and Supervising Nontraditional Care Providers

Nontraditional Groups

Designing Training for Nontraditional Groups

Training Design Process

Training Methods

Evidence Base for Training Nontraditional Groups in CBT

Conclusions from the Evidence Base

Best Practices for Training

Summary

References

Chapter 12: Evidence-Based Supervisory Practices in CBT

What are the Evidence-Based Supervisory Practices in CBT?

Evidence-Based CBT Supervision Practices

Setting the Stage for Competency-Based Supervision

Facilitating Experiential Learning: The Initial Effects of Supervision

Summary

Learning Exercises

References

Chapter 13: Training CBT Supervisors

The Supervisory Experience

Nuts and Bolts of Supervision

Problems that Affect Supervision

Summary

Learning Exercises

References

Chapter 14: Self-Management in CBT Training and Supervision

Extent of the Problem

Consequences of Therapist Distress and Burnout

Reasons for Inadequate Self-Care

Predictors of Distress Reactions

CBT as a Method of Self-Management for Therapists

Illustrations of the CBT Model

Improved Self-Care for Therapists

Training and Supervision Implications

Summary

Learning Exercises

References

Index

About the Companion Website

What's Available on the Companion Website

Customer Care

End User License Agreement

List of Tables

Table 1.1

Table 1.2

Table 2.1

Table 2.2

Table 2.3

Table 2.4

Table 5.1

Table 5.2

Table 8.1

Table 10.1

Table 10.2

Table 10.3

List of Illustrations

Figure 14.1

Guide

Cover

Table of Contents

Begin Reading

Chapter 1

Pages

iii

iv

xiii

xiv

xv

xvi

xvii

xviii

xix

xx

xxi

xxii

xxiii

xxiv

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67

68

69

70

71

72

73

74

75

76

77

78

79

80

81

82

83

84

85

86

87

88

89

90

91

92

93

94

95

96

97

98

99

100

101

102

103

104

105

106

107

108

109

110

111

112

113

114

115

116

117

118

119

120

121

122

123

124

125

126

127

128

129

130

131

132

133

134

135

136

137

138

139

140

141

142

143

144

145

146

147

148

149

150

151

152

153

154

155

156

157

158

159

160

161

162

163

164

165

166

167

168

169

170

171

172

173

174

175

176

177

178

179

180

181

182

183

184

185

186

187

188

189

190

191

192

193

194

195

196

197

198

199

200

201

202

203

204

205

206

207

208

209

210

211

212

213

214

215

216

217

218

219

220

221

222

223

224

225

226

227

228

229

230

231

232

233

234

235

236

237

238

239

240

241

242

243

244

245

246

247

248

249

250

251

252

253

254

255

256

257

258

259

260

261

262

263

264

265

266

267

268

269

270

271

272

273

274

275

276

277

278

279

280

Teaching and Supervising Cognitive Behavioral Therapy

Donna M. Sudak

R. Trent Codd III

John Ludgate

Leslie Sokol

Marci G. Fox

Robert Reiser

Derek L. Milne

Copyright © 2016 by John Wiley & Sons, Inc. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey.

Published simultaneously in Canada.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax [phone], or on the Web at www.copyright.com. Requests to the publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, 201-748-6011, fax [phone], or online at www.wiley.com/go/permissions.

Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages. Readers should be aware that Internet Web sites offered as citations and/or sources for further information may have changed or disappeared between the time this was written and when it is read.

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering professional services. If legal, accounting, medical, psychological or any other expert assistance is required, the services of a competent professional should be sought.

For general information on our other products and services, please contact our Customer Care Department within the U.S. at 800-956-7739, outside the U.S. at 317-572-3986, or fax [phone].

Wiley publishes in a variety of print and electronic formats and by print-on-demand. Some material included with standard print versions of this book may not be included in e-books or in print-on-demand. If this book refers to media such as a CD or DVD that is not included in the version you purchased, you may download this material at http://booksupport.wiley.com. For more information about Wiley products, visit www.wiley.com.

Library of Congress Cataloging-in-Publication Data is on file and available from the Library of Congress

ISBN 978-1-118-91608-7 (paper), ISBN 978-1-119-17977-1 (PDF), ISBN 978-1-119-17978-8 (ePub)

Cover design by Wiley

Cover image: © mpetersheim/Thinkstock

List of Appendixes

(Online atwww.wiley.com/go/sudak)

Appendix I: Recommended Readings and A/V Resources

Audio/Visual Resources for CBT Training and Supervision

Recommended Readings for CBT Training and Supervision

Appendix II: Forms and Tools

ACCS Feedback Form: Assessment of Core CBT Skills

ACCS Submission Cover Sheet: Assessment of Core CBT Skills

CBT Knowledge Quiz and Score Sheet

Form 1: Interview Template: Nontraditional Employees

Form 2: Nontraditional Trainee Survey

Interview Template for Administrator of Nontraditional Trainees

Intructional Use of Training Videos

Reflective Writing Exercise

SAGE Record Sheet Complete: Agenda Setting Video

SAGE Record Sheet: Blank

The Change Project

Websites with Scales to Track Patient Outcomes

Appendix III: Manuals

ACCS User's Manual: Assessment of Core CBT Skills

Evidence-Based Clinical Supervision Guidelines

SAGE Rating Manual

Appendix IV: Sample Syllabi, Course Modules, and Training Design Sample

CBT Course Didactic Syllabus (postgraduate year 3)

Curriculum Design: Integrating a Competency-Based Approach within Graduate Education in CBT

Sample Course Module I: Key Elements in CBT

Sample Course Module II: Ability to Structure Sessions

Sample Course Module III: Use of Guided Discovery/Socratic Questioning

Sample Syllabus Training Nontraditional Trainees

Sample Syllabus Outline of Competency-Based Skills

Training Design Sample

Appendix V: Confidential File Deletion Protocol

Confidential File Deletion PowerPoint

Appendix VI: Training Opportunities

CBT Training Opportunities in the United States and Overseas

Appendix VII: Video Library

Goal Setting for Supervisors

Frustration

CBT Supervision: Agenda Setting

Dealing with Difficulty to Identify with Negative Thoughts (in-home setting): Part I

Dealing with Difficulty to Identify with Negative Thoughts (in-home setting): Part II

Dealing with Homework Noncompliance (in-home setting): Part 1

Dealing with Homework Noncompliance (in-home setting): Part II

Working with In-Home Setting Distractions: Part I

Working with In-Home Setting Distractions: Part II

Dealing with Automatic Thoughts (in-home setting): Part I

Dealing with Automatic Thoughts (in-home setting): Part II

Problematic Trainee: CBT Seems Superficial

Problematic Trainee: Trainee Does Not Believe in Psychotherapy

Problematic Trainee: Trainee Does Not Have Necessary Skills

Problematic Trainee: Trainee Afraid CBT Will Damage Therapeutic Alliance

Fluency Training Procedure

Appendix VIII: Podcasts

Cognitive Behavioral Therapy with Families and Couples: Frank Datillio

Tourette's: Cognitive Behavioral Therapy with Tourette's Syndrome: Doug Woods

Index

Acknowledgments

From all authors: Collectively, we express deep gratitude to Aaron T. Beck, a towering light without whom none of what we do and teach would be possible. We also acknowledge the important international dissemination and training efforts of the members of the Academy of Cognitive Therapy.

Donna Sudak: To Howard and Laura, my most cherished family.

R. Trent Codd III: To Ginger, Isabella, and Caroline for your incredible love and support. For my clinical supervisors, professors, and mentors who had tremendous impact on my professional development, especially Larry Goble, Marc Branch, and my late friend Walter Lawless.

John Ludgate: I express tremendous appreciation for the following inspirational mentors, trainers, and supervisors from whom I have had the privilege of learning: Ivy Blackburn, Fred Wright, Bob Berchick, Ruth Greenberg, and David Clark.

Leslie Sokol: To my devoted and loving family, Bob, Chad, Alex, and Max. To Naomi Dank, my champion, who truly valued and encouraged my role as a teacher.

Marci Fox: I owe a tremendous thank you to my amazing family, Stuart, Jesse, Ethan, and Carly Fox. I am your biggest fan and you are my biggest inspiration.

Robert Reiser: To my wonderful family: Susan, Evan, Spencer, Luke, and granddaughter Lily.

Derek Milne: I hope that the materials I've provided will support supervisors and be a suitable recompense for all those in England who helped me develop them; thanks to them for their commitment to clinical supervision.

Foreword

Teaching and Supervising Cognitive Behavioral Therapy is the first comprehensive text to provide empirically validated, effective training and supervisory approaches to teachers and supervisors from a variety of disciplines that use a cognitive behavior therapy (CBT) approach. Despite the substantial interest in the practice of cognitive behavioral therapy, until recently there has not been a corresponding pursuit of evidence-informed training and dissemination methods. For example, it took more than twenty years from the publication of Cognitive Therapy of Depression in 1979 for CBT training to be required in psychiatry residencies. Likewise, dissemination of CBT remains poor in other disciplines, including psychology. In addition to broader uptake, there is a need for the field to develop more effective training programs and to deepen CBT's impact across multiple disciplines of caregivers, which will be assisted by effective supervision.

The authors of this book are expert CBT practitioners, supervisors, and teachers whose experiences enrich their review of the available evidence on effective training and supervision. In addition, this book provides an approachable framework for using technological aids to teaching and supervision in an accessible manner. The learning exercises and practical understanding of different trainee groups, along with the online resources provided with this book, will undoubtedly contribute to the effort to develop more robust CBT training. As such, I believe this book will be an excellent tool for individual trainers and educational programs alike.

—A. T. Beck, MD, University Professor of Psychiatry Emeritusand author of Cognitive Therapy and the Emotional Disorders

About the Authors

Donna M. Sudak, MD, is professor, senior associate training director, and director of psychotherapy training in the Department of Psychiatry at the Drexel University College of Medicine. She is a clinician-educator with a wealth of national and international experience in teaching and patient care, and she has received numerous teaching awards. She has made a number of significant contributions to the literature in CBT education and has played a major role in developing suggested curricula and guidelines for resident competency in cognitive behavior therapy. She also has authored multiple publications regarding combining treatment with medication and CBT.

In addition to her teaching responsibilities at Drexel University College of Medicine, Dr. Sudak is an adjunct faculty member at the Beck Institute for Cognitive Therapy and Research. She is past president of the Academy of Cognitive Therapy, the editor of the PIPE examination, and serves on multiple national committees in Association of Behavioral and Cognitive Therapies and American Association of Directors of Psychiatric Residency Training (AADPRT), including having been named the incoming program chair for the 2016 Annual Meeting at AADPRT.

R. Trent Codd III, EdS, is the president and founder of the Cognitive-Behavioral Therapy Center of WNC, P.A., an interdisciplinary group practice located in Asheville, North Carolina. In addition to rendering clinical services at the center, he provides clinical consultation and training in CBT locally and nationally. He codirects an intensive training program in CBT each year and is on the clinical faculty of Lenoir-Rhyne University. Additionally, he is a licensed professional counselor as well as a fellow, certified trainer/consultant, and credentialing committee member of the Academy of Cognitive Therapy.

John Ludgate, PhD, is a licensed psychologist who has worked as a psychotherapist for nearly thirty years. He currently works at the Cognitive-Behavioral Therapy Center of Western North Carolina. In addition to having an active clinical practice, he is involved extensively in training and supervision in CBT, locally and nationally. He trained at the Center for Cognitive Therapy in Philadelphia, obtaining a postdoctoral fellowship in cognitive therapy from the University of Pennsylvania. He subsequently became assistant director of training at the center. In the early 1990s he was a research clinical psychologist at the University of Oxford in England and served as a protocol therapist in several outcome studies of panic disorder, agoraphobia, social phobia, and hypochondriasis. He has written a number of books on CBT, including Heal Yourself: A CBT Approach to Reducing Therapist Distress and Increasing Therapeutic Effectiveness (2012), Cognitive Behavior Therapy and Relapse Prevention in Depression and Anxiety (2009), and Maximizing Psychotherapeutic Gains and Preventing Relapse in Emotionally Distressed Clients (1990). He cowrote Overcoming Compassion Fatigue: A Practical Resilience Workbook (2014) with Martha Teater and was coeditor with Jesse Wright, Michael Thase, and Aaron T. Beck of Cognitive Therapy with Inpatients: Developing a Cognitive Milieu (1992). He is a founding fellow of the Academy of Cognitive Therapy and serves on the credentialing committee of the academy.

Leslie Sokol, PhD, is a licensed psychologist, expert in cognitive behavior therapy, internationally recognized speaker, and coauthor of Think Confident, Be Confident (2009). She is a distinguished founding fellow, past president, and credentialing chair of the Academy of Cognitive Therapy. She was the director of education at the Beck Institute for Cognitive Behavior Therapy for nearly fifteen years. Her private practice is in the Philadelphia suburbs.

Marci G. Fox, PhD, is a licensed psychologist and has been in private practice for nearly twenty years. She has worked closely with Dr. Sokol, Dr. Judith Beck, and Dr. Aaron T. Beck at the Beck Institute for Cognitive Behavior Therapy in Philadelphia for almost the same amount of time. As an Academy of Cognitive Therapy certified trainer/consultant and former adjunct Faculty Member at the Beck Institute, she trains individuals in cognitive therapy both nationally and internationally, and helps mental health professionals to improve their clinical skills and pinpoint specific areas of remediation. Dr. Fox has a founding fellow distinction as well as an invited placement on the board of examiners and credentials committee of the Academy of Cognitive Therapy. Dr. Fox has lectured for years on cognitive therapy as well as confidence and self-esteem. She has coauthored the books Think Confident, Be Confident: A Four-Step Program to Eliminate Doubt and Achieve Lifelong Self-Esteem (2009) and Think Confident, Be Confident for Teens: A Cognitive Therapy Guide to Overcoming Self-Doubt and Creating Unshakable Self-Esteem (2011). Dr. Fox has published in peer-reviewed journals and diverse publications in the area of cognitive behavior therapy.

Robert Reiser, PhD, is a licensed psychologist and a fellow of the Academy of Cognitive Therapy. Since 2006, he has collaborated with Derek Milne on a series of research projects involving the development of an instrument (SAGE) to assess competence in supervision. He has written and coauthored journal articles and has contributed book chapters with Derek Milne focusing on evidence-based approaches to clinical supervision, including the International Handbook of Clinical Supervision (edited by Ed Watkins and Derek Milne, 2014). After ten years of teaching a graduate-level CBT course, he is now actively engaged in supervision and training in a CBT for psychosis implementation and dissemination project. Over several years he has served as a consulting supervisor for the CBT-D national training program with the Veterans Administration.

Derek L. Milne is a clinical psychologist and a fellow of the British Psychological Society, with extensive experience as a supervisor, supervisor trainer, and supervision researcher. Since 1996, he has led the first ever systematic R&D program on clinical supervision, developing our understanding and seeking to enhance practice within the field of mental health (especially CBT supervision). This research program has followed the evidence-based practice rationale and has included extensive collaboration within the National Health Service. This started with theory-building work (systematic reviews), then involved a series of n = 1 studies (including the development of an instrument to assess competence in supervision), and related efforts to foster an evidence-based practice (for example, a national pilot study of a supervisor training manual). This program is summarized in Evidence-Based Clinical Supervision (2009). In 2010 he retired as director of The Doctorate in Clinical Psychology at Newcastle University, but he continues to teach and research supervision. His latest work is The International Handbook of Clinical Supervision (2014), coedited with Ed Watkins.

Chapter 1CBT Training and SupervisionAn Overview

John Ludgate

To help readers understand the current recommendations for cognitive behavioral therapy (CBT) training and supervision, this chapter begins with a review of the historical roots and subsequent development of CBT training and supervision worldwide. In addition, the chapter describes the advantages and disadvantages of existing formats for training and briefly reviews the literature on the effectiveness and benefits of CBT training. Last, future directions regarding research and practice in the field of CBT training and supervision are outlined.

Historical Roots of CT Training and Supervision

The evolution of a cognitive model and the development of Beck's cognitive therapy has been described in several texts (Weishaar, 1993; Wills, 2009). The development of training in cognitive therapy (CT) is closely linked with the history of cognitive therapy itself. In the 1960s Aaron Beck, a psychiatrist in Philadelphia, now widely regarded as the father of cognitive behavioral therapy, became interested in determining the factors involved in the development and maintenance of depression. He formulated his initial cognitive model of depression in papers in 1963 and 1964 (Beck, 1963, 1964). The theory was elaborated in his book (1967).