Low-intensity CBT Skills and Interventions. Группа авторов
me grounded, my mum Muriel and my sisters Julie and Wendy for fostering my Australian directness. While sometimes getting me in hot water, it has generally served me well. Finally, Professor Eugene Mullan for being my mentor but mostly a friend, enjoy your retirement.
Online resources
Low-Intensity CBT Skills and Interventions: A Practitioner's Manual is supported by online resources to aid study and assist in teaching, which are available at https://study.sagepub.com/farrand.
Worksheet templates and short exercises for a patient to work through independently or a practitioner and patient to work through together.
Weblinks to Psychological Wellbeing Practitioners (PWP) workbooks that can be used in low-intensity training and practice with patients. They cover topics such as ‘Managing Your Worry', ‘Unhelpful Thoughts', ‘Facing Your Fears’ and support the specific interventions described in the chapters.
Worksheet Templates
6.1 Example of a relapse prevention worksheet
9.1 Reflection record for use in clinical skills supervision
11.1 Behavioural activation schedule
11.2 Example of a classifying activity worksheet
11.3 Example of an activity grading worksheet
12.1 Thought diary
12.2 Evidence recording and revised thought
12.3 Behavioural experiments plan
12.4 Behavioural experiments review
14.1 Exposure goal diary
15.1 Jordan's areas of my life that are really important to me
15.2 Jordan's worry worksheet
15.3 Jordan's my types of worry
15.4 Jordan's my worry time
15.5 My worry time review
16.1 Example of an LICBT problem-solving worksheet
16.2 Jamie's problem list
17.1 Example CBT vicious cycle for sleep difficulties
17.2 Example sleep diary
17.3 Stimulus control worksheet
17.4 Sleep restriction worksheet
Workbooks and Resources
4.1 The Improving Access to Psychological Therapies Manual
4.2 Common Mental Health Disorders: Identification and Pathways to Care
9.1 IAPT Supervision Guidance
11.1 Get Active, Feel Good Workbook
11.2 Get Active, Feel Good: Helping Yourself to Get on Top of Low Mood Workbook
11.3 Case study: Jane
11.4 Case study: Mark
12.1 Unhelpful Thoughts: Challenging and Testing Them Out Workbook
13.1 Facing Your Fears Workbook
14.1 Obsessive Compulsive Disorder: A Self-Help Book
15.1 Managing Your Worries Workbook
16.1 From Problems to Solutions Workbook
20.1 Enhancing Resiliency: Finding Inner Strength to Manage the Demands of Clinical Practice
The worksheets and workbooks are Clinical Education, Development and Research (CEDAR), Psychology, University of Exeter interventions: http://cedar.exeter.ac.uk/.
Obsessive Compulsive Disorder: A Self-Help Book (Lovell and Gega, 2011) is from the University of Manchester: http://man.ac.uk/Fyl12C.
Introduction: Pedagogic Approach
Paul Farrand
The pedagogic approach adopted within Low-Intensity CBT Skills and Interventions has been organised and informed by the seminal work of Professor James Bennett-Levy. Professor Bennett-Levy's research has made a significant contribution to evidence-informed training for the psychological therapies workforce and has no doubt contributed to improving the effectiveness of cognitive behavioural therapy (CBT) in practice.
Cognitive Model of Skills Development
The Cognitive Model of Skills Development (Bennett-Levy, 2006) highlights the role of three systems – Declarative, Procedural, Reflective (DPR) – associated with competency development.
Declarative Knowledge
‘Knowing that’ represents factual knowledge the low-intensity CBT (LICBT) practitioner has regarding:common factors that form the basis of the clinical methodspecific factors representing the theoretical foundation and specific competences upon which the LICBT clinical method and interventions are based.
It is predominantly delivered using didactic pedagogic approaches such as lectures, clinical skills supervision and directed-learning activities such as reading.
There are increasing opportunities to deliver declarative knowledge through online technology-enhanced learning methods within a blended learning approach (Graham, 2006).
It presents opportunities to inform a component of university-directed or self-directed learning incorporated into standardised delivery.
Procedural Knowledge
‘Knowing how to, and when to’ apply specific factor skills associated with the clinical method (see Parts 2 and 3).
Although there may be a declarative element to procedural knowledge, pedagogic approaches that facilitate the transfer of declarative to procedural knowledge are required. Active pedagogic approaches include simulated structured role-plays, directly observed or recorded specific factor practice and clinical skills supervision of live patient clinical sessions.
Development of procedural knowledge is ongoing.
It is stimulated when the practitioner is required to apply already acquired procedural skills to newly experienced clinical challenges or adapt practice to accommodate patients with diversity.
Developing procedural knowledge is often implicit, with practitioners not fully aware of the application of common or specific factors.
Training providers and supervisors need to ensure that pedagogic approaches supporting the development of specific factors have an element of observation. This may require training providers to ensure an appropriate staff–student ratio to enable trainees get an appropriate level of feedback.
Reflection is the key system for facilitating ongoing competence development required for professional expertise.
Reflection
Making the implicit explicit enables the implicit nature of the development of procedural knowledge to be made explicit (Bennett-Levy, 2003).
Ongoing reflective practice has a seminal role in distinguishing expert from novice practitioners