CBT TRAINING & SUPERVISION
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CBT SUPERVISION
Of vital importance to clinicians practising CBT at any level is the provision of effective supervision. According to James (2007), who emphasises the role of learning and of knowledge acquisition, a consequence of the success of CBT is the need to ensure that practitioners are properly supervised. Pretorius (2006) appears to support this view and suggests that within CBT supervision there is an opportunity to discuss the cognitions and emotions of patients, to develop case conceptualisation, to consider treatment options and techniques, and to discuss goals as well as potential stumbling blocks in meeting them.
Importantly, Sloan et al (2000) note the role played by supervision in establishing effective therapeutic relationships with patients. The importance of supervision within a CBTcontext is not solely the domain of mental health practitioners. Sloan (1999) identifies that district nurses and health visitors provide ongoing care and support for clients with varying degrees of psychological distress in primary care. In this context, supervision is offered as a suitable resource during which technical and therapeutic skills in CBT
can be developed.
This framework is also recommended for those practitioners who seek a professional/educational focus from their clinical supervision (Sloan 1999). Sloan (2016) suggests that supervision requires considerable investment and commitment, but it is a golden opportunity, when provided effectively, to facilitate high-quality practice, learning and teaching.
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CBT TRAINING
The recent report on the national review of mental health nursing in Scotland (Scottish Executive 2006) argues that access to psychological training should be increased in the context of personal/service development. The report also suggests that it is important that psychological skills are developed in mental health nursing. However, it could be argued that whilst not all people working in health care want to become CBT therapists, it is important that each one has a clear understanding of the underlying principles of CBT.
It is for this reason that the Ayrshire CBT Clinic has developed CBT training reaching from the underlying principles to more a more advanced level.
Teaching involves the lecturer, via a variety of modes, imparting new information to the student (directly and/or indirectly) but also having the knowledge and skills that will allow the student to assimilate information they may already have. It could be viewed as a process of change. Learning, on the other hand, involves an increase in responsibility for the student in terms of the level of engagement and what they actually do with the teaching.
The students requires to have confidence in the lecturer both in terms of the qualifications/subject knowledge and also the ability to transfer such knowledge to the student. I have some fond (and not so fond) memories of the old style nurse training which I was privy to. For example, I can ‘proudly’ boast of receiving 100% for my module 5 Community exam. This was achieved, not by gaining a meaningful and lasting understanding of the subject, but by simply memorising and regurgitating a list of signs and symptoms that the lecturer put on the overhead and asked us to
copy – no questions, no variety and certainly no collaboration in the teaching/learning process!
What does appear to work however, is providing an environment of guided discovery whereby the student is encouraged to develop new knowledge and skills in addition to their existing knowledge and skills.