Cognitive Behavioural Therapy (CBT) for Anxiety and Depression - Clinical Practice
| Module title | Cognitive Behavioural Therapy (CBT) for Anxiety and Depression - Clinical Practice |
|---|---|
| Module code | PYCM106 |
| Academic year | 2023/4 |
| Credits | 20 |
| Module staff | Dr Rosie Powling () |
| Duration: Term | 1 | 2 | 3 |
|---|---|---|---|
| Duration: Weeks | 12 and 12 in Term 1 Year 2 |
| Number students taking module (anticipated) | 30 |
|---|
Module description
This module will focus the development of clinical competency in CBT for Anxiety Disorders and Depression for people accessing secondary (Step 4 MH care). 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. Expert Clinical CBT Supervision will be the vehicle for scaffolding the development of clinical competency aligned to the theoretical workshops and lectures. Clinical Skills sessions will further support this development. There will be an emphasis on formulating these disorders both in isolation and when presenting co-morbidly with psychosis and bipolar disorder, or with personality disorder, with a consideration of 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 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.
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.
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 confidence in articulating clinical formulations underpinned by relevant and up-to-date theory and research.
Through attending the clinical skills 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 SMHP, 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
Teaching is delivered in Term 3 and in term 1 of the following university year.
- Clinical application of CBT theoretical and research knowledge into clinical practice
- Becoming a Reflective Practitioner
- Therapeutic Alliance
- Challenges within therapy
- Engagement and Endings
- Sharing and working collaboratively with formulations
- Ethical written Communication
- Effective use of Supervision
Video-recording of clinical sessions, ethics, and consent
- 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).
- Multiple trauma and early abuse history.
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 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 | Clinical Skills sessions will be used for role-play practice of skills, practical exercises or small group discussion of issues, as appropriate.. University clinical supervision is provided by University based accredited cognitive therapists. |
| Guided independent study | 125 | Reading and preparation for 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 |
|---|---|---|---|
| University Supervision Report | Participation is required in supervision | All | Written |
| Workplace Supervision Report | Participation is required in supervision | All | Written |
| CTS-R | 1 clinical session | 3-12, 15-18 | Oral |
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 |
|---|---|---|---|---|
| CTS-R plus required documentation (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme) | 100 | 1 clinical session plus 1000 words | 3-12, 15-18 | Written |
| Supervision report (this assessment must be passed; failure in this assessment will lead to failure in the module and the programme) (Pass/Fail) | 0 | Appropriate and ethical participation is required in supervision sessions across the module | 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 |
|---|---|---|---|
| CTS-R plus required documentation | CTS-R plus required documentation | 3-12, 15-18 | Four weeks from the date feedback was given |
| Supervision report | Completion of a remedial supervision plan and passing supervision report | All | 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 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.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 2nd 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
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
| Credit value | 20 |
|---|---|
| Module ECTS | 10 |
| Module pre-requisites | None |
| Module co-requisites | PYCM104 The Fundamentals of Cognitive Behavioural Therapy, |
| NQF level (module) | 7 |
| Available as distance learning? | No |
| Origin date | 16/10/2020 |
| Last revision date | 14/08/2023 |
