Chapter 13 Being a Competent CBT Therapist Being
+ Chapter 13 Being a Competent CBT Therapist
+ Being a Competent CBT Therapist n Competence in the populations and problems you are working with is a must n All therapists have the responsibility to provided the best possible therapy to clients n Number of years in practice and level of education (i. e. , master’s vs. Ph. D) does not determine therapeutic effectiveness n Rather, it is theoretical orientation based on evidence-based practice (e. g. , CBT) and quality of training n Training should continue indefinitely after graduation as along as one is in practice
+ Practice What You Preach n Part of being a competent therapist is not only fine-tuning one’s in-session skills but also practicing many of these skills on yourself, especially when distressed n Having experience of what it is like to be on the receiving end of some CBT techniques provides therapists with greater self-awareness and insight that can translate into greater skill competency and empathy when working with clients
+ Practice What You Preach n Examples of CBT techniques you can practice on yourself include: n Monitoring daily activities and behavioral activation, monitoring and modifying negative automatic thoughts (and emotions), identifying and modifying core beliefs, and using exposure techniques for many anxieties n There also books specifically developed to help therapists with self-awareness CBT techniques n e. g. , “Experiencing CBT from the Inside Out: A Self. Practice/Self-Reflection Workbook for Therapists” (Bennett. Levy et al. , 2015)
+ Practice What You Preach n If you find yourself having a strong aversion to practicing even some of the simpler CBT techniques, this could be a possible area of concern n If you do not see the benefit of using these empirically supported techniques on yourself (e. g. , “this is stupid” or “this won’t work on me”), this will most likely be noticed by your clients, resulting in your coming off as disingenuousness and, in turn, reducing their hope and motivation for change and having poor treatment outcomes
+ Consider Therapy with a CBT Therapist n If possible, consider being in the client’s chair to be on the receiving end of therapy with a CBT therapist n By being a client, you can learn what you find helpful and what you did not find helpful, ranging from basic therapeutic alliance skills to specific CBT skills n You may consider modifying your therapeutic approach after having more awareness of particular experiences from your clients’ perspective n Also, managing your own personal distress is good for your own personal growth and the well-being of your clients
+ Actually Do CBT with Your Clients n It is easy to “stray” from adherence to the CBT model if you are feeling insecure about your CBT skills and overwhelmed with many clients or a lot of paperwork n Like learning any new skill, you will learn the most through continuous practice and application n Just like with your clients, if there is some initial anxiety (which is completely normal!), “confront” your apprehension by gradually integrating new behaviors/skills into your daily practice n With time and support (i. e. , supervision), you will find that your anxiety will decrease while your self-efficacy as a CBT therapist increases
+ Receive CBT Supervision n It is vital that you receive CBT supervision as part of your training and post-graduate practice The more experienced your supervisor is in CBT, the greater potential for you to learn and master CBT skills n *If you truly want a CBT supervision experience, be wary of potential supervisors who say they are “familiar” with CBT or insist that their theoretical orientation is not important n
+ Receive CBT Supervision n Ideally, it is best to have your supervisor observe your sessions live (e. g. , one-way mirror, video feed, or ear bud) n If this is not possible, then video or audio recorded sessions are also appropriate n Any type of live/recorded session is better than verbal report because it can provide more contextual information and allows for continuous assessment of therapeutic skills and self-reflection n Often, verbal reports can result in forgetting important information, misinterpreting information, and the desire to present oneself in a positive light
+ Receive CBT Supervision n Another great option is group CBT supervision, which can both help you develop your technical skills and assist your conceptualization and treatment plan skills Group supervision may also provide the added option of watching otherapists at varying skill levels do CBT n CBT supervision groups allow for discussing challenging cases, exchanging knowledge about specific skills, and emergency consultation n n Supervision should always be an integral part of your practice regardless of skill level and years of experience
+ Observe Other Therapists Conduct Sessions n Ideally, the best way to promote the opportunity to observe CBT in action is to work with otherapists who actively practice CBT n Although it is helpful to watch well-trained and experienced professionals, especially for refining skills, it is also important to observe otherapists who are at a similar level of experience as you
+ Continue Building Conceptualization Skills n Remember that the effectiveness of your CBT skills is only as strong as your CBT case formulation and treatment plan n In other words, expert CBT skills have little value if clients’ problems and associated distress are not appropriately assessed n Receiving feedback from your supervisors and other experienced CBT therapists on your CBT case formulation is a great way to enhance your CBT conceptualization skills
+ Continue Training After Graduation n Read peer-reviewed articles, books, and treatment manuals n There also quality professional newsletters and blogs that cover modern CBT-related topics n The Beck Institute provides a high quality active blog across multiple CBT-related topics: www. beckinstitute. org/blog n Attend CBT related talks and workshops for additional live, up-to-date training
+ Continue Training After Graduation n Attending professional conferences is a great way to keep up to date with both the most recent research in the field and therapeutic skills being used in practice The Association for Behavioral and Cognitive Therapies (www. abct. org) is a great organization to maintain a professional affiliation with, including their active listservs, newsletter, and opportunities to network n The Academy of Cognitive Therapy (www. academyofct. org) provides a wealth of information related to training and research in CBT n n Overall, a competent CBT therapist is able to stay up-todate with evidence-based practices
+ Being a Competent CBT Therapist n Discussion n Activity Questions 13. 1 (p. 333) 13. 1: Practice for CBT Competence (p. 334)
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