Teaching and Supervising Cognitive Behavioral Therapy

Teaching and Supervising Cognitive Behavioral Therapy is the first comprehensive package to provide empirically-validated CBT training and supervisory techniques. Applicable to a variety of behavioral health care disciplines, this multi-modal guide provides educators with the information and tools that can help improve educational outcomes. An examination of CBT developments over the past twenty years leads into a discussion of practical applications for improving CBT education, while addressing the technological advances that facilitate dissemination and the specific challenges posed to confidentiality and patient care. The digital component contains additional audio and video content, plus downloadable worksheets that reinforce and expand upon the strategies presented.

Coverage includes advice geared specifically toward the most commonly-encountered problems, with video of training sessions that address issues like frustration with patients, disbelief in psychotherapy, dislike of the method, and lack of skills. Readers will gain insight into effective goal setting, and implement a structured approach to supervision.

• Examine existing literature and research on training, supervision, and evaluation
• Integrate theory with practical strategies to improve learning outcomes
• Customize training approaches to specifically suit different professional groups
• Fit the methods to the environment, including workshops, webinars, and podcasts

Mental health professionals who favor an empirically-based approach to therapy will appreciate the effectiveness of an empirically-based approach to pedagogy. Backed by over two decades of CBT research and the insight of leading CBT experts, Teaching and Supervising Cognitive Behavioral Therapy provides trainers with the tools and information they need to improve therapist educational outcomes.

DONNA M. SUDAK, M.D. is Professor, Senior Associate Training Director, and Director of Psychotherapy Training in the Department of Psychiatry at the Drexel University College of Medicine.

R. TRENT CODD, III, Ed.S., is the President and founder of the Cognitive-Behavioral Therapy Center of WNC, P.A., located in Asheville, NC.

JOHN W. LUDGATE, PHD, is a licensed psychologist who works at the Cognitive-Behavioral Therapy Center of Western North Carolina.

LESLIE SOKOL, PHD, is a distinguished founding fellow, past president, and Credentialing Chair of the Academy of Cognitive Therapy.

MARCI G. FOX, PHD, is a licensed psychologist and has been in private practice for almost twenty years.

ROBERT P. REISER, PHD, is a licensed psychologist and a Fellow of the Academy of Cognitive Therapy.

DEREK L. MILNE, PHD, is a clinical psychologist and a Fellow of the British Psychological Society.

Acknowledgments xvii

Foreword xix

About the Authors xxi

1 CBT Training and Supervision: An Overview 1
John Ludgate

Historical Roots of CT Training and Supervision 1

Current Training Opportunities 6

Classification and Review of Training Programs 8

Effectiveness of Training 13

Best Practices for Training 15

Best Practices for Supervision 15

Some Distinctive Features of CBT Training and Supervision 16

Future Directions for CBT Training and Supervision 19

Summary 20

References 21

2 Core Competencies in Cognitive Behavioral Therapy Training 25
Donna M. Sudak

What Are Competencies? 26

Existing Competency Frameworks 26

The British Association of Behavioural and Cognitive Psychotherapies (BABCP) Core Curriculum 28

Essential Competencies in CBT Training 30

Teaching Methods 31

Summary 34

Learning Exercises 34

References 35

3 Empirically Supported Educational Methods 37
R. Trent Codd III

Primary Findings 38

Other Important Considerations 52

Interventions Pending Further Study 58

Summary 61

Learning Exercises 61

Notes 61

Resources for Further Study 62

References 64

4 Measures of Competence in Cognitive Behavioral Therapy 67
Donna M. Sudak

Measures of Evaluation of Competence in CBT and Evidence for Their Reliability and Validity 68

Assessment of Case Conceptualizations 70

Scoring the Cognitive Therapy Scale 73

Accreditation as a CBT Provider 80

Summary 81

Learning Exercises 81

References 82

5 Feedback in Cognitive Behavioral Therapy Training 85
Donna M. Sudak

Feedback and Skill Training 86

Providing Formative Feedback 86

Adult Learning and Feedback 87

Providing Summative Feedback (Did You Reach the Goal?) 87

When Feedback Sessions Go Wrong 89

Why Don’t We Like to Give Feedback? 90

Problematic Trainees 90

Competence Is Insufficient: Addicting Trainees to Lifelong Learning 92

Summary 94

Learning Exercises 94

References 94

6 Teaching CBT for Specific Disorders 97
Leslie Sokol and Marci G. Fox

Teaching CBT for Depression 97

Teaching CBT for Anxiety Disorders 102

Teaching CBT for Personality Disorders 109

Learning Exercise 112

Teaching CBT for Substance Abuse 113

Teaching CBT for Serious Mental Illness 116

Summary 119

References 119

7 Technology in CBT Training and Supervision 121
R. Trent Codd III

Technological Applications for Supervision 121

Technological Applications for Instruction 122

Ethical and Legal Contexts 125

Other Considerations When Selecting Technology 128

Additional Factors 129

Summary 131

Learning Exercises 131

Notes 131

Reference 131

8 Graduate Training 133
Robert Reiser and Derek L. Milne

Problems with Graduate Training in CBT 134

Summary 141

Learning Exercises 141

References 141

9 CBT in Psychiatry Residency Training 145
Donna M. Sudak

History of CBT Training in Psychiatric Residencies 146

Understanding Residency Training 146

Problem Areas in Training Psychiatry Residents in CBT 148

Planning Training in CBT in Psychiatric Residencies 152

Faculty Development 156

Summary 157

Learning Exercises 157

References 157

10 Continuing Education for Therapists in Practice 159
John Ludgate

Background and Evolution of CBT Training for Therapists 160

Current CBT Training Options 161

Considerations for Practitioners Evaluating Training Options 164

Effectiveness of CBT Training for Therapists 166

Review of Trainings Studies 170

Designing Training 172

Summary 177

Learning Exercises 178

References 180

11 Training and Supervising Nontraditional Care Providers 183
R. Trent Codd III and John Ludgate

Nontraditional Groups 185

Designing Training for Nontraditional Groups 186

Training Design Process 188

Training Methods 189

Evidence Base for Training Nontraditional Groups in CBT 193

Conclusions from the Evidence Base 196

Best Practices for Training 198

Summary 203

References 203

12 Evidence-Based Supervisory Practices in CBT 207
Derek L. Milne and Robert Reiser

What Are the Evidence-Based Supervisory Practices in CBT? 208

Evidence-Based CBT Supervision Practices 209

Setting the Stage for Competency-Based Supervision 209

Facilitating Experiential Learning: The Initial Effects of Supervision 218

Summary 219

Learning Exercises 220

References 223

13 Training CBT Supervisors 227
Leslie Sokol and Marci G. Fox

The Supervisory Experience 227

Nuts and Bolts of Supervision 231

Problems That Affect Supervision 237

Summary 240

Learning Exercises 240

References 241

14 Self-Management in CBT Training and Supervision 243
John Ludgate

Extent of the Problem 243

Consequences of Therapist Distress and Burnout 244

Reasons for Inadequate Self-Care 244

Predictors of Distress Reactions 245

CBT as a Method of Self-Management for Therapists 246

Illustrations of the CBT Model 252

Improved Self-Care for Therapists 254

Training and Supervision Implications 254

Summary 258

Learning Exercises 259

References 261

Index 265

About the Companion Website 280

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