The Fundamentals of Cognitive Behavioural Therapy

Module title	The Fundamentals of Cognitive Behavioural Therapy
Module code	PYCM104
Academic year	2023/4
Credits	20
Module staff	Dr Hayley Keeble (Convenor) Dr Rosie Powling (Convenor)

Duration: Term	1	2	3
Duration: Weeks		12

Number students taking module (anticipated)	30

Module description

This module will focus on delivering a systematic knowledge of the fundamental principles of CBT (such as, for example, collaborative empiricism, the therapeutic relationship). You will be encouraged to develop a critical understanding of the theoretical and research evidence for cognitive models and an ability to evaluate the evidence. The module will aim to enable you to have an understanding of how scientific principles inform CBT clinical practice.

The module will also focus on core clinical competencies (skills) necessary in undertaking CBT. This covers cognitive models, maintenance and developmental conceptualisations of cases, and the core aspects of the cognitive and behavioural process of therapy (such as formulation, measurement, rationale giving, structuring sessions, agenda setting, summarising, agreeing intersessional work, and relapse prevention). Teaching sessions will address the most up-to-date evidence for the effectiveness of CBT and training in applying CBT. Clinical skills tutorials will include role-play, experiential exercises and video and case demonstrations. Experiential exercises will encourage self-reflection, increase in self-awareness, and skill acquisition. Sessions will also incorporate a focus on therapists’ beliefs.

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 and the National Curriculum for CBT for SMHP (NHS England and NHS Improvement, 2019).

The module is taught/supervised by BABCP-accredited CBT therapists and/or clinical psychologists, 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 the fundamentals of Cognitive Behavioural Therapy CBT.
Develop critical knowledge of the theoretical and research literature of CBT.
Develop and update your knowledge of the fundamental principles of CBT theory, research and practice.
Develop an advanced knowledge and understanding of how scientific principles inform CB clinical practice.
Develop an advanced knowledge of core clinical skills necessary for CBT practice.
Develop the capacity to reflect critically on CBT theory, research and practice.
Develop skills in reflective practice that will enable you to make best use of clinical supervision in order to further your clinical skills and improve clinical practice.

Through attending the lectures and clinical skills tutorials you will develop the following academic and professional skills and demonstrate competency in:

evidence of theoretical, evidence-based interventions integrated within and guiding therapy.
implementing and critically evaluating a range of CBT interventions (such as setting goals, eliciting and evaluating thoughts, identifying and working with safety behaviours, problem solving) begin to take personal responsibility for clinical decision making in complex and unpredictable situations, including:
- assess patients for suitability for CBT for common mental health problems and severe mental health problems;
- deliver a clear CBT treatment rationale derived collaboratively and appropriate to the individual patient;
- construct maintenance and developmental CBT conceptualisations;
- set agenda for, pace and structure of CBT sessions;
- set agreed goals for treatment which are specific, achievable and measurable;
- work with clients using guided discovery, adopting an open and inquisitive style within the cognitive behavioural model;
- identify and evaluate key cognitions, working with automatic thoughts and helping the client develop an alternative perspective;
- identify and conceptualise common thinking errors and processing biases;
- identify and evaluating underlying assumptions, attitudes and rules;
- employ a range of change techniques such as pie charts, advantages and disadvantages, continuums, positive data logs;
- identify and evaluate core beliefs, employing a range of change techniques;
- elicit cognitions associated with upsetting emotion with skilful use of empathy;
- identify problematic cognitions, related behaviours, and constructing, carrying out and evaluating behavioural experiments;
- hold ongoing critical evaluation of the CBT conceptualisation with evidence of a clear treatment plan;
- develop CBT treatment plans for straightforward cases of anxiety and depression;
- develop CBT treatment plans for more complex presentations, including a range of depression and anxiety disorders and cases of comorbidity;
- form effective therapeutic relationship with evidence of teamwork, collaboration and joint summarising of sessions;
- deal with ending therapy and planning for long term maintenance of gains with evidence of a relapse prevention plan
demonstrate insightful knowledge of CBT and an ability to identify own values and beliefs and CBT’s application to your own lives.
making best use of supervision on the course and evidence of making use of and continuing to learn from on-going continuing professional development.
sensitively adapting CBT, and ensure equitable access to diverse cultures and values.
a working knowledge of the principles and practice, and competency in delivering high intensity psychological therapy within secondary mental health care.
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).
collaboration (working together with others to common aims).
managing profession relationships (including building and maintaining a working alliance, clarifying expectations, setting goals, drawing appropriately on the help and support of others, confronting issues constructively and ending working relationships positively).
information management (maintaining appropriate professional records in a timely, organised and sufficiently detailed manner).

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

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

1. Articulate in detail the theoretical, scientific, ethical, and professional principles unpinning CBT and their role in informing CBT therapeutic styles and interventions
2. Describe the journey of therapy from engagement to ending (including assessment, problem identification, formulation, change methods, and relapse planning) including:
3. Explain the concept of the therapeutic alliance and apply this knowledge to develop and maintain a therapeutic alliance with clients
4. Implement and critically evaluate a range of CBT interventions (such as setting goals, eliciting and evaluating thoughts, identifying and working with safety behaviours, problem solving)
5. Demonstrate insightful knowledge of CBT and identify your own values and beliefs and the application of CBT to your own life
6. Describe diagnostic classification and key characteristics of severe mental health problems and associated co-morbid conditions

ILO: Discipline-specific skills

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

7. Understand, interpret, critically evaluate, and apply theoretical ideas and evidence in clinical practice, supervision, and within peer learning and CPD
8. Analyse personal competencies and address these in relation to theoretical models of change

ILO: Personal and key skills

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

9. Select, organise and evaluate material to produce a coherent argument
10. Reflect on personal practice, to set personal learning goals and evaluate progress
11. Communicate understanding of theory and application to practice in written and verbal formats

Syllabus plan

An initial full day workshop will introduce programme members to the programme by providing an overview of requirements, content, method and context. This will be followed by a series of whole and half day workshops.

The curriculum will comprise the following:

Phenomenology, diagnostic classification and epidemiological characteristics of common mental health disorders
CBT theory and development
CBT Assessment and formulation
Risk assessment, mental state examination, personal, medical history
Knowledge of relevant pharmacological interventions
Application and suitability for CBT: guidelines, case applications and contra-indications (to include assessment of alcohol/substance misuse)
Fundamental principles of Cognitive Behavioural Therapy e.g. collaborative empiricism: clinical process – formulation, rationale giving, measurement, active treatment, relapse prevention: structuring sessions
- agenda setting, summarising, setting homework
Use of standard and idiosyncratic clinical measurement to monitor CBT process and outcome
The role of the therapeutic relationship in CBT
Assessment methodology: clinical and research: clinical trials; outcome studies
Theories and experimental studies of process.
Application of theory and method to the individual case
Application of CBT with more complex presentations, deriving CBT driven formulations in cases of co-morbidity
Ethical and professional issues
Cultural and diversity issues
Reflective practice
Effective use of supervision
Introduction to the Cognitive Therapy Rating Scale – Revised

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

Audio-visual 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 audio recording.

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

Scheduled Learning and Teaching Activities	Guided independent study	Placement / study abroad
75	125	0

Details of learning activities and teaching methods

Category	Hours of study time	Description
Scheduled Learning and Teaching	75	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. All sessions will include a theoretical and a clinical skills component. 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.
Guided independent study	125	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	Participation is required throughout formal teaching	All	Oral feedback on contributions within workshops and in a one-to-one session with individual tutors
CTS-R 1 plus required documentation	1 clinical session	3-4, 6-10	Oral
CTS-R 2 plus required documentation	1 clinical session plus 1000 words	3-4, 6-10	Written

Summative assessment (% of credit)

Coursework	Written exams	Practical exams
100	0	0

Details of summative assessment

Form of assessment	% of credit	Size of the assessment (eg length / duration)	ILOs assessed	Feedback method
Case report (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme)	100	4000 words	All	Written
	0
	0
	0
	0
	0
	0

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
Case report	Case report	All	Four weeks from the date feedback was given

Re-assessment notes

One assessment is 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 deferral, your re-assessment will be treated as it would be if it were your first attempt at the assessment and the overall module mark will not be capped.

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. (1976). Cognitive Therapy and the Emotional Disorders. London, Penguin.
Beck, J. S. (2011). Cognitive therapy: basics and beyond. 2^nd Ed.. New York: Guilford.
Beck, J. (2005). Cognitive therapy for challenging problems: What to do when the basics don’t work. New York: Guilford Press.
Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M. & Westbrook, D. (2004). Oxford Guide to Behavioural Experiments in Cognitive Therapy. Oxford: Oxford University Press.
Clark, D. M. & Fairburn, C. G. (Eds.) (1997). Science and practice of cognitive-behaviour therapy. Oxford: Oxford University Press.
Corrie, S., Townend, M., & Cockx, A. (2015) Assessment and Formulation in CBT. 2^nd Ed.. London: Sage
Greenberger, D. & Padesky, C. (2015). Mind Over Mood: Change How You Feel by Changing the Way You Think 2^nd Ed.. New York: Guilford Press
Hawton, K., Salkovskis, P. M., Kirk, J. & Clark, D. M. (1989). Cognitive-behaviour therapy for psychiatricproblems. Oxford: Oxford University Press.
Kazantzis, N., Deane, F. P.; Ronan, K. R. & L’Abate, L. (2005). Using homework assignments in Cognitive Behaviour Therapy. New York: Routledge
Kuyken, W., Padeskey, C., & Dudley, R. (2009). Collaborative Case Conceptualization: Working Effectively with Clients in Cognitive-Behavioural Therapy. New York: Guilford.
Leahy, R. L. (Ed) (2006). Contemporary cognitive therapy. New York: Guilford.
Roth, A. & Fonagy, P. (2005). What works for whom: A critical review of psychotherapy research 2^nd Ed. New York: Guilford Press.
Westbrook, D., Kennerley, H. & Kirk, J. (2011). An introduction to cognitive behaviour therapy: skills and applications. 2^nd Ed.. London: Sage.

Journals

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

Video Clips

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, personality disorder, 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, Cognitive Behavioural Therapy, CBT, psychological therapies practice, EIP, Personality Disorder

Credit value	20
Module ECTS	10
Module pre-requisites	None
Module co-requisites	PYCM105 Cognitive Behavioural Therapy (CBT) for Anxiety and Depression - Theory, PYCM106 Cognitive Behavioural Therapy (CBT) for Anxiety and Depression - Clinical Practice
NQF level (module)	7
Available as distance learning?	No
Origin date	16/10/2020
Last revision date	02/08/2023