Cognitive Behavioural Therapy (CBT) for Psychosis and Bipolar Disorder - Clinical Practice
| Module title | Cognitive Behavioural Therapy (CBT) for Psychosis and Bipolar Disorder - Clinical Practice |
|---|---|
| Module code | PYCM109 |
| Academic year | 2023/4 |
| Credits | 20 |
| Module staff | Ms Eleanor Spare () |
| Duration: Term | 1 | 2 | 3 |
|---|---|---|---|
| Duration: Weeks | 10 | 10 and 10 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 psychosis or bipolar disorder for people accessing secondary (Step 4 MH care). The module aims to develop advanced clinical skills and competency in Cognitive Behavioural Therapy (CBT) for these disorders, improving proficiency in the core techniques of CBT, and developing competencies in the specialist techniques applied to psychosis or bipolar disorder. 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 anxiety disorders and depression, or other long-term conditions, with a consideration of adaptions to treatment in the presence of diagnostic complexity.
The module is underpinned by the Roth and Piling (2013) CBT Competency Framework for the delivery of CBT to people with psychosis or bipolar disorder and by the National Curriculum for CBT for SMHP (NHS England & NHS Improvement, 2019).
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 psychosis and bipolar disorder.
The module is taught/supervised by BABCP-accredited CBT therapists and/ or clinical psychologists experienced in working both with common mental health disorders, and psychosis and bipolar disorder, 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 psychosis and bipolar disorder including
- demonstrating the technical expertise needed in the formulation of individual cases and execution of therapy methods;
- assessing the individual’s experience psychosis and bipolar disorder, both alone and in the context of SMHP, taking into account clinical manifestations, co-morbidity, past history, present life situation, interpersonal and relationship functioning, and course and outcome;
- assessing risk factors associated with psychosis and bipolar disorder and integrate risk management within treatment plans;
- collaboratively constructing maintenance formulations and treatment plans in cases of psychosis and bipolar disorder, both alone and in relation to SMHP, taking into account client needs, goals, and preferences;
- negotiating the end of therapy and plan for long term maintenance of gains with evidence of a relapse prevention plan.
- 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. Understand and critically evaluate theories and models of psychosis
- 2. Articulate the cognitive behavioural rationale for interventions offered for the clients lived experience of psychosis and bipolar disorder
- 3. Collaboratively and skilfully work with clients living with psychosis or bipolar disorder, and with their families, using CBTp to reduce distress, enhance understanding, engender change, and reduce the impact of the experience on the persons life course and their valued relationships
- 4. Work collaboratively with clients living with psychosis or bipolar disorder on a CBTp therapy journey from engagement to ending including:
- 5. Formulate client lived experience, and their potential vulnerability factors and maintenance factors, within a recognised CBTp formulation/ model, and equally to evidence the ability to work with idiosyncratic formulations that are theoretical congruent with CBTp
- 6. Describe and critically analyse contemporary models for psychosis and bipolar disorder in SMHP, their evidence bases and treatment methods derived from them
- 7. Describe commonly used assessment measures for people with psychosis and bipolar disorder, including in the context of SMHP, including their purpose and properties, and 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. 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
- 9. 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
- 10. 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...
- 11. Understand, interpret, critically evaluate, and apply theoretical ideas and evidence in clinical practice, supervision, and within peer learning and CPD
- 12. 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...
- 13. Select, organise and evaluate material to produce a coherent argument
- 14. Reflect on personal practice, to set personal learning goals and evaluate progress
- 15. Communicate understanding of theory and application to practice in written and verbal formats
Syllabus plan
The teaching is delivered in Term 2 and 3, and across university year 2 term 1 (course runs January to December across university years)
The content will include:
- 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
- Psychological modelling of Psychosis and Bipolar Disorder
- The phenomenology of Psychosis and Bipolar Disorder including lived experience
- Theories and models of Psychosis and Bipolar Disorder
- CBTp assessment and formulation
- Working with ’Negative Symptoms’
- Understanding Thought Disorder
- Using Imagery and Metaphor effectively in CBTp
- Working with emotional avoidance
- Psychosis and trauma
- Hearing voices
- Paranoia – living with a sense of threat
- Delusional disorder – working with the ripples, not the stone.
- Working effectively towards change through focusing on the sense of self in Psychosis and Bipolar Disorder
- CBTp: Cognitive Interventions, Behavioural Interventions, Working with Emotion
- The uses of idiosyncratic formulating of experience, CBTp models, and the use of theoretically underpinned protocol driven CBTp interventions
- Evaluation of CBTp Competency through CBTp Clinical Supervision and the use of the CTS-R
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 | All | Oral |
| CTS-R | 1 clinical session | All | Oral |
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 | All | Written |
| 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 | All | 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 |
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 | All | 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
- Chadwick, P. (2006). Person Based Cognitive Therapy for Distressing Psychosis. Chichester, Wiley.
- Chadwick, P., et al. (1996). Cognitive Therapy for Delusions, Voices and Paranoia. Chichester, Wiley-Blackwell.
- Freeman, D. & Garety, P. (2004). Paranoia: The psychology of persecutory delusions. Hove: Psychology Press.
- Gumley, A. & Schwannauer, M. (2006) Staying well after psychosis: A cognitive interpersonal approach to recovery and relapse prevention. Chichester: Wiley.
- Kingdon, D. and D. Turkington (2005). Cognitive Therapy of Schizophrenia. New York The Guilford Press.
- Kingdon, D.G., & Turkington, D. (2002). Psychosis and cognitive-behavioral therapy: case studies and clinical experience. Chichester: Wiley.
- Larkin, W. & Morrison, A. (2006) Trauma and psychosis: New directions for theory and therapy London: Routledge
- Morrison A. (2001). A casebook of cognitive therapy for psychosis. Hove: Guilford.
- Morrison, A. P., et al. (2004). Cognitive Therapy for Psychosis: A Formulation-based Approach. Hove, Brunner – Routledge.
| Credit value | 20 |
|---|---|
| Module ECTS | 10 |
| Module pre-requisites | None |
| Module co-requisites | PYCM107 Working with Complexity: Essential Competencies for Working with People with Psychosis and Bipolar Disorder, |
| NQF level (module) | 7 |
| Available as distance learning? | No |
| Origin date | 16/10/2020 |
| Last revision date | 14/08/2023 |
