Training

Bennett-Levy, J., & Beedie, A. (2007). The ups and downs of cognitive therapy training: What happens to trainees' perception of their competence during a cognitive therapy training course? Behavioural and Cognitive Psychotherapy, 35 (1), 61-75.

Correspondence Address:
James Bennett-Levy, Oxford Cognitive Therapy Centre, Warneford Hospital, Headington, Oxford, United Kingdom, OX3 7JX, james.bennett-levy@obmh.nhs.uk.

Abstract
One- and two-year cognitive therapy training programs are increasingly popular in the UK and overseas. Previous research has indicated that trainees show gains in competence, though this may at times be accompanied by self-doubt and stress. The present study sought specifically to gain the trainees' perspective: What happens to self-perception of competence (SPC) during cognitive therapy training - does it change over time? Do all elements of cognitive therapy skill show the same changes in SPC? Do individuals show different patterns of change? What environmental and internal factors influence changes in SPC? Twenty-four trainees on a one-year part-time training course completed a self-rated assessment of competence at six time points during the course. They also reported attributions about experiences that might have contributed to increases or decreases in SPC. Results demonstrated that SPC increases significantly over time, but there is considerable variation across different skills, and between individuals. A model developed from trainees' qualitative data indicated that the prime influences on SPC were new learning opportunities (acquiring knowledge, implementing knowledge, external evaluation, experiences with clients), self-reflection on performance, increased awareness of the standards required of a cognitive therapist, and emotional state, in particular emotionally salient memories and current stress. Practical implications of the findings for trainees, trainers and supervisors are discussed. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Haarhoff, B. A. (2006). The Importance of Identifying and Understanding Therapist Schema in Cognitive Therapy Training and Supervision. New Zealand Journal of Psychology , 35(3), 126-131.

Correspondence Address:
Beverly A. Haarhoff, School of Psychology, Massey University, Albany, Private Bag 102 904, North Shore Mail Centre, Auckland, New Zealand, B.A.Haarhoff@massey.ac.nz.

Abstract
The cognitive therapist's ability to identify, reflect upon, and constructively utilize, the content of his or her beliefs, assumptions, emotions, and behaviours which may be triggered by the interpersonal process occurring in the therapeutic relationship, is increasingly seen as an important part of a successful treatment outcome in cognitive therapy (Safran & Segal, 1996). Identifying "therapist schema" (Leahy 2001) is one mechanism which can be used in training and supervision to facilitate understanding more about how these factors may impact on therapy. Four groups of Cognitive Therapy trainees completed the "Therapists' Schema Questionnaire" (Leahy, 2001). A clear pattern emerged which showed the therapist schema; "demanding standards", "special superior person", and "excessive self-sacrifice" to be the most common schema identified in all four groups. This paper highlights some of the potential therapy interfering effects of therapist schema using the schema listed above. Practical suggestions consistent with the cognitive therapy model are proposed as useful supervision strategies with which to help trainees identify and understand their schema, in the context of the therapeutic relationship. (PsycINFO Database Record (c) 2009 APA, all rights reserved)

Lowe, M.R., Bunnell, D.W., Neeren, A.M., Chernyak, Y., Greberman, L. “Evaluating the real-world effectiveness of cognitive-behavior therapy efficacy research on eating disorders: A case study from a community-based clinical setting.” International Journal of Eating Disorders,44 (2011): 9-18.

Correspondence Address:
Not Available

Abstract
Objective: There is a growing consensus that there is a need to test the real-world effectiveness of eating disorder therapies that show promise in efficacy research. This article provides a narrative account of an NIMH-funded study that attempted to apply efficacy findings from CBT research to an Intensive Outpatient Program (IOP) at the largest community-based eating disorder program in the United States. Method: We describe the study as originally envisioned as well as the various challenges that the researchers and the IOP staff encountered in implementing this study. Results: The different training, assumptions, and "ways of knowing" of the research team and the treatment staff in regard to the nature of eating disorders and their treatment created multiple challenges for both groups during the study period. We describe valuable lessons learned about how to - and how not to - implement effectiveness designs in clinical settings that are relatively unfamiliar with empirically-based research findings. Discussion: It is hoped that our experience in attempting to apply efficacy-based research findings on eating disorders treatment in a community-based clinical setting will prove helpful to other researchers and service providers engaging in such translational research. © 2010 by Wiley Periodicals, Inc.

Milne, D. L., Baker, C., Blackburn, I., James, I., & Reichelt, K. (1999). Effectiveness of cognitive therapy training. Journal of Behavior Therapy and Experimental Psychiatry, 30(2) 81-92.

Correspondence Address:
Derek L. Milne, School of Neurology, Neurobiology and Psychiatry, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom, d.l.milne@ncl.ac.uk.

Abstract
Despite growing demands for effective training there remains a lack of convincing evaluations. Reviews of the training literature specify the need for multiple measures, homogeneous therapies, generalization assessments and longitudinal designs. The present analysis responds by evaluating the training of 20 mental health professionals (mean age 39 yrs) in cognitive therapy. The evaluation focused on changes in the professionals' competence and its generalization to their patients' (N = 20; aged 19-70 yrs) coping strategies. Results indicate that a 40-day training program led to significantly higher posttraining competence scores and to improved patient coping. Implications of these results for professional training and its evaluation are discussed. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Sholomskas, D. E., Syracuse-Siewert, G., Rounsaville, B. J., Ball, S. A., Nuro, K. F., Carroll, K. M. (2005). We Don't Train in Vain: A Dissemination Trial of Three Strategies of Training Clinicians in Cognitive-Behavioral Therapy. Journal of Consulting and Clinical Psychology,73 (1),106-115.

Correspondence Address:
Kathleen M. Carroll, Division of Substance Abuse, Yale University School of Medicine, Veterans Affairs Connecticut Healthcare Center (151D), West Haven, CT, US, 06516 kathleen.carroll@yale.edu.

Abstract
There has been little research on the effectiveness of different training strategies or the impact of exposure to treatment manuals alone on clinicians' ability to effectively implement empirically supported therapies. Seventy-eight community-based clinicians were assigned to 1 of 3 training conditions: review of a cognitive-behavioral therapy (CBT) manual only, review of the manual plus access to a CBT training Web site, or review of the manual plus a didactic seminar followed by supervised casework. The primary outcome measure was the clinicians' ability to demonstrate key CBT interventions, as assessed by independent ratings of structured role plays. Statistically significant differences favoring the seminar plus supervision over the manual only condition were found for adherence and skill ratings for 2 of the 3 role plays, with intermediate scores for the Web condition. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Weissman, M. M., Verdeli, H., Gameroff, M. J., Bledsoe, S. E., Betts, K., Mufson, L., Fitterling, H., & Wickramaratne, P. (2006). National survey of psychotherapy training in psychiatry, psychology, and social work. Archives of General Psychiatry, 63, 925-934.

Correspondence Address:
Myrna M. Weissman: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, 1051 Riverside Dr, Unit 24, New York, NY, US, 10032, mmw3@columbia.edu.

Abstract
Context: Approximately 3% of the US population receives psychotherapy each year from psychiatrists, psychologists, or social workers. A modest number of psychotherapies are evidence-based therapy (EBT) in that they have been defined in manuals and found efficacious in at least 2 controlled clinical trials with random assignment that include a control condition of psychotherapy, placebo, pill, or other treatment and samples of sufficient power with well-characterized patients. Few practitioners use EBT. Objective: To determine the amount of EBT taught in accredited training programs in psychiatry, psychology (PhD and PsyD), and social work and to note whether the training was elective or required and presented as a didactic (coursework) or clinical supervision. Design, Setting, and Participants: A cross-sectional survey of a probability sample of all accredited training programs in psychiatry, psychology, and social work in the United States. Responders included training directors (or their designates) from 221 programs (73 in psychiatry, 63 in PhD clinical psychology, 21 in PsyD psychology, and 64 in master's-level social work). The overall response rate was 73.7%. Main Outcome Measure: Requiring both a didactic and clinical supervision in an EBT. Results: Although programs offered electives in EBT and non-EBT, few required both a didactic and clinical supervision in EBT, and most required training was non-EBT. Psychiatry required coursework and clinical supervision in the largest percentage of EBT (28.1%). Cognitive behavioral therapy was the EBT most frequently offered and required as a didactic in all 3 disciplines. More than 90% of the psychiatry training programs were complying with the new cognitive behavior therapy requirement. The 2 disciplines with the largest number of students and emphasis on clinical training--professional clinical psychology (PsyD) and social work--had the largest percentage of programs (67.3% and 61.7%, respectively) not requiring a didactic and clinical supervision in any EBT. Conclusion: There is a considerable gap between research evidence for psychotherapy and clinical training. Until the training programs in the major disciplines providing psychotherapy increase training in EBT, the gap between research evidence and clinical practice will remain. (PsycINFO Database Record (c) 2006 APA, all rights reserved)