Cognitive Behavioural Therapy (CBT) for Anxiety and Depression

Module title	Cognitive Behavioural Therapy (CBT) for Anxiety and Depression
Module code	PYCM076
Academic year	2021/2
Credits	30
Module staff	(Convenor) (Convenor)

Duration: Term	1	2	3
Duration: Weeks		10	8

Number students taking module (anticipated)	20

Module description

This module will focus on common mental health disorders frequently presenting in Secondary Care services such as depression and anxiety disorders. The module aims to develop advanced skills in Cognitive Behavioural Therapy (CBT) for these disorders, improving proficiency in the fundamental techniques of CBT, and developing competencies in the specialist techniques applied to depression and anxiety disorders. Specific models, evidence base, assessment and specialist treatment strategies will be covered in workshops on a range of disorders including depression, social anxiety, post-traumatic stress disorder (PTSD) and generalised anxiety disorder (GAD). The clinical workshops and tutorials will also provide a strong foundation in the evidence base for working with CBT and common mental health disorders and address the most up-to date research developments. There will be an emphasis on formulating these disorders both in isolation and when presenting co-morbidly with psychosis and bipolar disorder and considering adaptions to treatment in the presence of diagnostic complexity.

The module is underpinned by the Roth and Piling (2007) CBT Competency Framework for the delivery of CBT to people with depression and anxiety disorders.

This module will provide you with supervision of your clinical practice in order to develop the core clinical competencies (practical skills) necessary to deliver CBT for common mental health disorders. You will be provided with supervision of your clinical practice in the treatment of depression and anxiety.

The module is taught/supervised by BABCP-accredited CBT therapists and the content is updated regularly in line with the emerging evidence base.

Module aims - intentions of the module

The aim of this module is to enable you to:

Develop practical competency in CBT for common mental health disorders such as depression and anxiety disorders
Develop practical skills in formulating and adapting treatment protocols in the presence of co-morbid psychosis or bipolar disorder
Develop critical knowledge of the theoretical and research literature of CBT with common mental health disorders

Through attending the related workshops, clinical skills tutorials and supervision sessions you will develop the following academic and professional skills:

critical analysis (the ability to critically appraise research, literature and opinions of others, and your own work in the light of data tracking and analysis)
problem formulation and problem solving (the ability to synthesise information from theory/literature with complex data from practical experience to make sense of experience and formulate solutions)
reflective practice (the ability to reflect on theoretical knowledge and procedural experience and to learn from this and apply learning to practice)

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

1. Describe in detail the phenomenology, diagnostic classifications and epidemiological characteristics of depressive and key anxiety disorders, both in general and when present with SMI
2. Describe and critically analyse contemporary models for depressive disorders and key anxiety disorders in SMI, their evidence bases and treatment methods derived from them
3. Demonstrate the technical expertise needed in the formulation of individual cases and execution of therapy methods
4. Assess the individuals experience depression or anxiety disorder, both alone and in the context of SMI, taking into account clinical manifestations, co-morbidity, past history, present life situation, interpersonal and relationship functioning, and course and outcome
5. Assess risk factors associated with depression or anxiety and integrate risk management within treatment plans
6. Describe commonly used assessment measures for people with common mental health problems, including in the context of SMI, including their purpose and properties
7. Apply outcome measures in a way that is scientifically and therapeutically appropriate, and takes into account any difficulties the client may have in completing measures
8. Collaboratively construct maintenance formulations and treatment plans in cases of depression or anxiety disorder, both alone and in relation to SMI, taking into account client needs, goals, and preferences
9. Negotiate the end of therapy and plan for long term maintenance of gains with evidence of a relapse prevention plan
10. Demonstrate use of clinical judgment in order to adapt and titrate standard interventions for common co-existing disorders and integrate them into the treatment, and to decide when and how to integrate emerging evidence with current practice, and whether, when and how to work beyond the evidence base
11. Demonstrate a task-focused approach to intervention while being sensitive to (and being directed by) the clients needs and capacities and tolerance of emotional content, and maintaining a consistent sense of collaboration with the client
12. Draw on a formulation to identify the most appropriate focus and sequence of interventions most likely achieve change, and to ensure that this sequence is congruent with the clients perceptions of what would be most useful to them

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

13. Understand, critically evaluate, and apply theoretical ideas and evidence relating to specific disorders outlined in Module Specific Skills
14. Reflect on therapeutic skills identifying areas for personal development in relation to theoretical models of change for specific disorders as outlined in Module Specific Skills

ILO: Personal and key skills

On successfully completing the module you will be able to...

15. Select, organise and evaluate clinical material to produce a coherent formulation
16. Reflect upon personal practice, set personal learning goals and monitor progress
17. Apply and tailor knowledge of theory and practice to the treatment of individual patients through evidence of utilisation of formulation, intervention and evaluation
18. Communicate understanding of theory and application to practice in written and verbal formats

Syllabus plan

The majority of the teaching is delivered in Year 1 Terms 2 and 3

Introduction to depression, and depression within SMI (phenomenology, epidemiology, aetiology, impact, diagnosis, treatment guidelines, psychological models).
Introduction to anxiety disorders, and anxiety disorders within SMI (phenomenology, epidemiology, aetiology, impact, diagnosis, treatment guidelines, psychological models).
Assessment, measurement and formulation of CMHP: part 1 (general assessment and formulation of depression and anxiety disorders).
Behavioural model of depression, part 1: accessing reward (key skills: activity scheduling, skills training).
Cognitive model of depression, part 1: information processing biases (key skills: identifying and challenging automatic thoughts).
Cognitive model of depression, part 2: rules for living (key skills: identifying conditional assumptions and exploring alternatives).
Cognitive model of depression, part 3: core beliefs (key skills: identifying core beliefs and exploring alternatives).
Behavioural model of depression, part 2: working with unhelpful secondary coping behaviours (key skills: functional analysis, identifying and enacting alternatives to avoidance and rumination).
Behavioural Activation (Martell et al. 2010).
Anxiety, part 1: behavioural approaches, with reference to Specific Phobias (key skills: graded exposure, applied relaxation and tension).
Anxiety, part 2: cognitive approaches, with reference to Specific Phobias and Panic Disorder (key skills: thought testing and behavioural experiments).
Anxiety, part 3: social phobia (additional key skills: working with longstanding beliefs, working with self-focussed attention, social context and impact of behaviour).
Anxiety, part 4: GAD (additional key skills: working with meta-beliefs, managing worry).
Anxiety, part 5: Single event trauma.
Working with checking and reassurance-seeking (with reference to OCD, health anxiety, BDD).
Advanced formulation and treatment planning of CMHP within SMI: (key skills: ability to formulate psychosis / bipolar disorder in relation to CMHP and vice versa, ability to construct a treatment plan based on this).

All sessions will include reference to literature, including research into outcome and processes of therapy.

Formative experiences are provided through discussion and role-play throughout workshops and clinical supervision, participation is required throughout formal teaching and supervision.

Recordings of clinical sessions are made throughout the clinical work conducted in appropriate clinic settings. Codes of Ethics [e.g. BABCP Standards of Conduct, Performance and Ethics and/or workplace policies] are strictly adhered to in terms of making the recordings, seeking permission for use and storage of information. Signed consent forms are required to show clients have understood the reasons for and manner of recording

Learning activities and teaching methods (given in hours of study time)

Scheduled Learning and Teaching Activities	Guided independent study	Placement / study abroad
80	220	0

Details of learning activities and teaching methods

Category	Hours of study time	Description
Scheduled Learning and Teaching	80	Teaching will be a combination of whole day and half-day workshops delivered both face-to-face and using flipped-classroom online platforms. These sessions will combine didactic, experiential and discussion methods of teaching and learning aimed at the integration of theoretical and research knowledge with practice. Workshops will be led by a variety of speakers with expertise in specific problems and settings. A part of each session will be used for role-play practice of skills, practical exercises or small group discussion of issues, as appropriate. Teaching sessions will be across all terms of the programme. University clinical supervision is provided by University based accredited cognitive therapists. Teaching sessions will be across terms 2 and 3.
Guided independent study	220	Reading and preparation for workshops, tutorials, treatment of patients and formative and summative assessment preparation. Self-practice and self-reflection tasks.

Formative assessment

Form of assessment	Size of the assessment (eg length / duration)	ILOs assessed	Feedback method
Formative experiences are provided through discussion and role-play throughout workshops and clinical supervision	Participation is required throughout formal teaching and supervision	All	Oral feedback on contributions within workshops, supervision, and in a one-to-one session with individual tutors
CTS-R plus required documentation	1 clinical session plus 1000 words	3-12, 15-18	Oral (Supervisors)
Clinical portfolio	As per requirements stipulated in the programme handbook	3, 8, 12, 15, 17	Oral (Tutors)

Summative assessment (% of credit)

Coursework	Written exams	Practical exams
50	0	50

Details of summative assessment

Form of assessment	% of credit	Size of the assessment (eg length / duration)	ILOs assessed	Feedback method
CTS-R plus required documentation (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme)	50	1 clinical session plus 1000 words	3-12, 15-18	Written (Academic Team)
Case report (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme)	50	4000 words	All	Written (Academic Tea,)

Details of re-assessment (where required by referral or deferral)

Original form of assessment	Form of re-assessment	ILOs re-assessed	Timescale for re-assessment
CTS-R plus required documentation	CTS-R plus required documentation	3-12, 15-18	Resubmission required four weeks from the date feedback was given
Case report	Case report	All	Resubmission required four weeks from the date feedback was given

Re-assessment notes

Two assessments are required for this module. In all cases re-assessment will be the same as the original assessment. Where you have been referred/deferred for any form of assessment detailed above you will have the opportunity to retake within four weeks from the date that feedback was provided.

If you pass re-assessments taken as a result of referral (i.e. following initial failure in the assessment), the overall module mark will be capped at 50%.

If you fail re-assessments taken as a result of referral (i.e. following initial failure in the assessment), you will be failed in the module and as a consequence you will be failed in the programme and your registration as a student of the University will be terminated.

Indicative learning resources - Basic reading

Beck, A.T., Rush, A.J., Shaw, B.F. & Emery, G. (1979) Cognitive Therapy of Depression. New York: Guilford Press
Clark, A. & Beck, A.T. (2010) Cognitive Therapy of Anxiety Disorders. New York: Guilford Press
Dugas, M, & Robichaud, M. (2007) CBT for GAD. Oxford: Routledge
Hope, D., Heimberg, R. & Turk, C. (2006) Managing Social Anxiety. Oxford: Oxford University Press
Kozak, M & Foa, E. (1997) Mastery of OCD. Oxford: Oxford University Press
Leahy, R. (2010) Cognitive Therapy Techniques: A Practitioner's Guide. New York: Guilford Press
Leahy, R., Holland, S., & McGinn, L. (2011) Treatment Plans and Interventions for Depression and Anxiety Disorders 2^nd Ed..New York: Guilford Press
Martell, C., Dimidjian, S., & Herman-Dunn, R. (2010) Behavioral Activation for Depression: A Clinician's Guide. New York: Guilford Press
Steketee, G. & Wilhelm, S. (2006) Cognitive Therapy for Obsessive-Compulsive Disorder: A Guide for Professionals. Oakland, CA: New Harbinger Publishing Inc.
Wells, A. (1997) Cognitive Therapy for Anxiety Disorders. Chichester: Wiley
Zinbarg, R., Craske, D., & Barlow, D. (2006) Mastery of you Anxiety and Worry. Oxford: Oxford University Press

Indicative learning resources - Web based and electronic resources

Behaviour Research and Therapy
Behavioural and Cognitive Psychotherapy
Cognitive and Behavioural Practice
Cognitive Therapy and Research
International Journal of Cognitive Therapy
Journal of Consulting and Clinical Psychology

Indicative learning resources - Other resources

There are video clips of role play practice from international CBT and CBTp leaders available on YouTube, e.g Professor Doug Turkington, Aaron T. Beck, and of the lived experience of common mental health problems and of psychosis and bipolar disorder, e.g. Johnny Benjamin, Bipolar UK, Rethink, Anxiety UK. Please be discerning in your choice of publically available video material to support your learning; if in doubt please discuss with the module convenor.

Key words search

Psychosis, bipolar disorder, CBT, Cognitive Behavioural Therapy, CBTp, psychological therapies practice

Credit value	30
Module ECTS	15
Module pre-requisites	None
Module co-requisites	PYCM075 The Fundamentals of Cognitive Behavioural Therapy
NQF level (module)	7
Available as distance learning?	No
Origin date	29/06/2018
Last revision date	05/08/2020