Throughout my career as therapist in the NHS, I have been providing in-service training to colleagues who want to develop their skills as cognitive behaviour therapist or just want to integrate CBT approaches to their psychiatric, nursing, OT or social work practice. I am currently involved in three such projects:
I have trained community mental health clinicians to provide "CBT Skills Groups" to any service user, using a group protocol I wrote and a format (including 1:1 sessions and involving care co-ordinators) that I developed. I now act as consultant to this service to ensure its development and evaluation.
I am part of a group delivering a training programme that includes theory and practice modules to clinicians from all over AWP, so that they can deliver evidence-based therapies to service users suffering from depression and anxiety. And I am planning with a colleague a workshop on CBT supervision for more senior therapists so these trainees can be well supported in their therapy practice.
I am also providing and developing along with colleagues three one-day workshops on CBT approaches to psychosis for non-specialist mental health clinicians from all over AWP
I have also done training for services other than AWP, such as teaching primary care clinicians to use guided self-help with depressed patients and teaching Relapse Prevention Therapy to a smoking cessation service. I have also worked extensively as trainer/lecturer in CBT at the University of West of England at pre-registration and, more especially, post-graduate levels. For ten years I taught an introductory course on CBT and I also helped to develop and teach on a course in enhanced practice in CBT for psychosis. More recently, I worked for two years as lecturer and supervisor on UWE's very successful "High Intensity CBT" course, which was part of the national Improving Access to Psychological Therapies programme. I have found combining the roles of trainer and therapist to be very rewarding. For instance, part of the job of the trainer/lecturer is to present to the trainee/student the very latest knowledge in CBT theory, practice and research. Keeping abreast of this fast-moving subject is not easy but it has the great bonus of ensuring that I keep my practice as therapist well informed by the evolving and accumulating 'evidence-base' for CBT. On the other hand, my experience as cognitive behavioural therapist, which is grounded in Learning Theory, enhances my skill as trainer and I am able to draw upon many examples from my work as a therapist to illustrate CBT theory and practice to trainees.
My Experience as CBT Supervisor
Supervision is essential for developing one's CBT practice and ensuring safe, quality therapy is delivered to clients. I have been privileged to receive supervision from a number of very experienced therapists/supervisors and I continue to do, as recommended and required by the BABCP.
Throughout my career as therapist, I have been providing CBT supervision to clinical psychologists, psychiatrists, nurses, OTs, social workers and counsellors in 1:1 or group formats. Most of this has been done within AWP's secondary mental health services but I have also provided supervision to primary care psychological therapists, to trainees on courses at UWE, and to therapists in private practice.
I have had quite a lot of training from national experts in CBT supervision. Some of this has been through the IAPT programme so that I could supervise both High and Low Intensity IAPT trainees and therapists.
Based on this experience as supervisor and the training I have received, I was recently accredited by the BABCP as CBT supervisor, making me one of the few therapists in the region with this qualification. I continue to update my knowledge and training in CBT supervision, as required by the BABCP, and I even have supervision of my supervision practice!, which may sound like 'overkill', but is none-the-less very valuable.
My Experience as CBT Researcher
One of the great attractions to being a cognitive behavioural therapist is being able to provide evidence-based therapy. I have always felt I wanted to contribute to this well from which I draw so eagerly and I have had a go at a number of research projects within and with the support of AWP.
As the lone researcher or as lead of a research group while carrying a challenging clinical caseload, this has been difficult and I have to admit that for various reasons none of these projects resulted in published papers. For "failures", though, these projects were very successful in many ways.
These projects included a small random-controlled trial of guided self-help for depression in primary care, the effect of CBT training on mental health clinicians' therapeutic alliance with service users, and determining who benefits from stress management groups. I am currently planning with a colleague a controlled trial of CBT Skills Groups for CMHT service users and we are hopeful of bringing this project to a successful conclusion so that we can add to the knowledge about the most efficacious ways to deliver CBT within secondary mental health services.
I have had one experience of CBT research with Bristol University that did result in a paper published in a peer-reviewed professional journal (http://www.biomedcentral.com/1471-244X/11/82). Entitled "Group cognitive behavioural therapy for women with depression: pilot and feasibility study for a randomised controlled trial using mixed methods", this project sought to find a low cost, effective way to make CBT available to women from low income urban areas, a high risk group for depression and anxiety. My role in the study was to contribute to the writing of the group manual, to write a 'primer' on group CBT for the therapists, to train and supervise the therapists, and to contribute CBT expertise to the research team. The team is currently planning a larger trial of the group programme, which is known as "Back on Track".