Cognitive Behavioural Therapy (CBT) for Personality disorder - Clinical Practice
| Module title | Cognitive Behavioural Therapy (CBT) for Personality disorder - Clinical Practice |
|---|---|
| Module code | PYCM112 |
| Academic year | 2023/4 |
| Credits | 20 |
| Module staff | Dr Claire Hepworth () |
| 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 personality 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 (CBT PD), improving proficiency in the core techniques of CBT, and developing competencies in the specialist techniques applied to personality 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 personality disorder and by the National Curriculum for CBT for SMHP (NHS England and 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 personality 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 personality 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 personality disorder
- Develop practical skills in formulating and adapting treatment protocols in the presence of co-morbid anxiety disorders and/or depression
- 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 personality disorder
- 2. Articulate the cognitive behavioural rationale for interventions offered for the clients lived experience of personality disorder, and assess the individuals experience pf personality 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; Collaboratively construct maintenance formulations and treatment plans in cases of personality disorder, both alone and in relation to SMHP, taking into account client needs, goals, and preferences
- 3. Collaboratively and skilfully work with clients living with personality 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 personality disorder on a CBTp therapy journey from engagement to ending, including: demonstrating the technical expertise needed in the formulation of individual cases and execution of therapy methods; formulating 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 CBT PD
- 5. Describe and critically analyse contemporary models for personality disorder in SMHP, their evidence bases and treatment methods derived from them
- 6. Assess risk factors associated with personality disorder and integrate risk management within treatment plans
- 7. Describe commonly used assessment measures for people with personality 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. 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. In addition, 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; Negotiate the end of therapy and plan for long term maintenance of gains with evidence of a relapse prevention plan
- 9. 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
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 10. Understand, interpret, critically evaluate, and apply theoretical ideas and evidence in clinical practice, supervision, and within peer learning and CPD
- 11. 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...
- 12. Select, organise and evaluate material to produce a coherent argument
- 13. Reflect on personal practice, to set personal learning goals and evaluate progress
- 14. 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 Personality disorder
- The phenomenology of Personality disorder including lived experience
- Theories and models of Personality disorder
- CBT PD assessment and formulation
- Using Imagery and Metaphor effectively in CBT PD
- Working with emotional avoidance and emotional dysregulation
- Working with Self-Harm and Suicidality
- Distress Tolerance
- Personality disorder and trauma
- Hearing voices
- Dissociation
- Interpersonal Challenges
- Working effectively towards change through focusing on the sense of self in Personality disorder
- CBT PD: Cognitive Interventions, Behavioural Interventions, Working with Emotion
- The uses of idiosyncratic formulating of experience, CBT PD models, and the use of theoretically underpinned protocol driven CBT PD interventions
- Evaluation of CBT PD Competency through CBT PD 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 |
|---|---|---|
| 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) | 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
- Brief Cognitive-Behavioral Therapy for Suicide Prevention by Craig J. Bryan (Author), David M. Rudd (Author), Publisher: Guilford Press; 1 edition (24 Sept. 2018)
- Mindfulness-Based Cognitive Therapy with People at Risk of Suicide: Working with People at Risk of Suicide by J. Mark G. Williams (Author), Melanie Fennell (Author), Thorsten Barnhofer (Author), Rebecca Crane (Author), Sarah Silverton (Author), Publisher: Guilford Press; 1 edition (24 April 2017)
- Cognitive Therapy for Personality Disorders: A Guide for Clinicians by Kate Davidson, Publisher: Routledge; 1 edition (24 Aug. 2007)
- Cognitive Therapy of Personality Disorders, Third Edition by Aaron T. Beck (Editor), Denise D. Davis (Editor), Arthur Freeman (Editor), Publisher: Guilford Press; 3 edition (19 Jan. 2016)
- CBT Workbook for Personality Disorders: A Step-by-Step Program for Learning and Practicing Eight Core Skills for Change (New Harbinger Self-Help Workbook) (A New Harbinger Self-Help Workbook) by Jeffrey C. Wood, Publisher: New Harbinger; Illustrated edition (21 Jun. 2010)
- Working Effectively with 'Personality Disorder': Contemporary and Critical Approaches to Clinical and Organisational Practice by Jo Ramsden (Author, Editor), Sharon Prince (Editor), Julia Blazdell (Editor), Publisher: Luminate (6 July 2020)
- Motivational Interviewing, Third Edition: Helping People Change (Applications of Motivational Interviewing) by Miller R. William (Author), Stephen Rollnick (Author), Publisher: Guilford Press; 3 edition (5 Oct. 2012)
- Cognitive Therapy for Challenging Problems: What to Do When the Basics Don't Work by Judith S. Beck (Author), Publisher: Guilford Press; 1 edition (17 Aug. 2011)
Indicative learning resources - Web based and electronic resources
Additional Indicative Reading guidance will be given in the lectures and on ELE.
| Credit value | 20 |
|---|---|
| Module ECTS | 10 |
| Module pre-requisites | None |
| Module co-requisites | PYCM110 Working with Complexity: Essential Competencies for Working with People with Personality Disorder, |
| NQF level (module) | 7 |
| Available as distance learning? | No |
| Origin date | 16/10/2020 |
| Last revision date | 02/08/2023 |
