Abstract
Evidence-Based Practice is premised on current research evidence, patient factors, and clinical expertise. The definition of clinical expertise has been the most contentious, primarily owing to the ambiguity of the construct. However, attempts have been made by the American Psychological Association to outline standards of clinical competence required for psychologists, irrespective of theoretical orientation, and the Improving Access to Psychological Therapies program in the UK has recently outlined a framework for therapist competences in cognitive behavioural therapy (CBT) in particular. This paper aims to review these recent conceptual developments in defining competence and addresses current training programs and certification standards that aim to ensure that CBT therapists acquire these standards of competence.
Similar content being viewed by others
References
Academy for Cognitive Therapy. (2005). Academy for cognitive therapy: Candidate handbook. Retrieved on July 8, 2009 from http://www.academyofct.org/Library/InfoManage/Displayfile.asp?InfoID=1049&SessionID={B06322FD-16E9-449C-A75C-C70779097D3D}&RC={B06322FD-16E9-449C-A75C-C70779097D3D}2120097&Action.
American Psychological Association. (2005). Policy statement on evidence-based practice in psychology. Retrieved on July 8, 2009 from www2.apa.org/practice/ebpstatement.pdf.
Baldwin, S. A., Wampold, B. E., & Imel, Z. E. (2007). Untangling the alliance-outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance. Journal of Consulting and Clinical Psychology, 75, 842–852.
Barnfield, T. V., Mathieson, F. M., & Beaumont, G. R. (2007). Assessing the development of competency during post-graduate cognitive-behavioural therapy training. Journal of Cognitive Psychotherapy: An International Quarterly, 21, 140–147.
Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. New York: Hoeber.
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.
Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.
Beck, A. T. (2005). The current state of cognitive therapy: A 40-year retrospective. Archives of General Psychiatry, 62, 953–959.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
Bennett-Levy, J., Lee, N., Travers, K., Pohlman, S., & Hamernik, E. (2003). Cognitive therapy from the inside: Enhancing therapist skills through practising what we preach. Behavioural and Cognitive Psychotherapy, 31, 145–163.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research, and Practice, 16, 252–260.
Borkovec, T. D., & Sharpless, B. (2004). Generalized anxiety disorder: Bringing cognitive behavioural therapy into the valued present. In S. Hayes, V. Follette, & M. Linehan (Eds.), New directions in behavior therapy (pp. 209–242). New York, NY: Guilford Press.
Brosan, L., Reynolds, S., & Moore, R. G. (2008). Self-evaluation of cognitive therapy performance: Do therapists know how competent they are? Behavioural and Cognitive Psychotherapy, 36, 581–587.
Buckley, P., Conte, H. R., Plutchik, R., & Karasu, T. B. (1981). Psychotherapy skill profiles of psychiatric residents. Journal of Nervous and Mental Diseases, 169, 733–737.
Clark, D. M. (2005). A cognitive perspective on social phobia. In W. R. Crozier & L. F. Alden (Eds.), The essential handbook of social anxiety for clinicians. New York: Wiley.
Craske, M. G., Antony, M., & Barlow, D. H. (1997). Mastery of your specific phobia: Therapist guide. New York, NY: Oxford University Press.
Craske, M. G., & Barlow, D. H. (2006). Mastery of your anxiety and panic: Therapist guide (4th ed.). New York, NY: Oxford University Press.
Crits-Christoph, P., Sigueland, L., Chittams, J., Barber, J. P., Beck, A. T., Frank, A., et al. (1998). Training in cognitive, supportive-expressive, and drug counseling therapies for cocaine dependence. Journal of Consulting and Clinical Psychology, 66, 484–492.
Davis, R., McVey, G., Heinmaa, M., Rockert, W., & Kennedy, S. (1999). Sequencing of cognitive-behavioral treatments for bulimia nervosa. The International Journal of Eating Disorders, 25, 361–374.
Dobson, K. S., & Shaw, B. F. (1993). The training of cognitive therapists: What have we learned from treatment manuals? Psychotherapy, 30, 573–577.
Dugas, M. J., & Ladouceur, R. (2000). Treatment of GAD: Targeting intolerance of uncertainty in two types of worry. Behavior Modification, 24, 635–657.
Eddy, D. M. (2005). Evidence-based medicine: A unified approach. Health Affairs, 24, 9–17.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Journal of Cognitive Psychotherapy, 38, 319–345.
Feeley, M., DeRubeis, R. J., & Gelfand, L. A. (1999). The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression. Journal of Consulting and Clinical Psychology, 67, 578–582.
Foa, E. B., & Rothbaum, B. O. (1998). Treating the trauma of rape: Cognitive behavioural therapy for PTSD. New York, NY: Guilford Press.
Heimberg, R. (2002). Cognitive behavioural group therapy for social phobia: Basic mechanisms and clinical strategies. New York, NY: Guilford Press.
Holtforth, M. G., & Castonguay, L. G. (2005). Relationship and techniques in cognitive behavioral therapy: A motivational approach. Psychotherapy: Theory, Research, Practice, and Training, 42, 443–455.
Horvath, A. O., & Bedi, R. P. (2002). The alliance. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 37–70). New York: Oxford University Press.
Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38, 139–149.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.
Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioural activation therapy for depression: Returning to contextual roots. Clinical Psychology Science and Practice, 8, 255–270.
Kavanaugh, D. J. (1994). Issues in multidisciplinary training of cognitive-behavioural internvetions. Behaviour Change: Journal of the Australian Behaviour Modification Association, 11, 38–44.
Kingdon, D., Tyrer, P., Seivewright, N., Ferguson, B., & Murphy, S. (1996). The Nottingham study of neurotic disorder: Influence of cognitive therapists on outcome. British Journal of Psychiatry, 169, 93–97.
Kozak, M. J., & Foa, E. B. (1997). Mastery of obsessive compulsive disorder: A cognitive behavioural approach therapist guide. New York, NY: Oxford University Press.
Lau, M. A., Dubord, G. M., & Parikh, S. V. (2004). Design and feasibility of a new cognitive-behavioural therapy course using a longitudinal interactive format. Canadian Journal of Psychiatry, 49, 696–700.
Luborsky, L., McLellan, T., Woody, G. E., O’Brien, C., & Auerbach, A. (1985). Therapist success and its determinants. Archives of General Psychiatry, 42, 602–611.
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450.
Miller, W. R., Yahne, C. E., Moyers, T. B., Martinez, J., & Pirritano, M. (2004). A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting and Clinical Psychology, 72, 1050–1062.
Padesky, C. A. (1996). Developing cognitive therapist competency: Teaching and supervision models. In P. M. Salkovskis (Ed.), Frontiers of cognitive therapy (pp. 266–292). New York: Guilford.
Persons, J. B. (1989). Cognitive therapy in practice: A case formulation approach. New York: Norton.
Resick, P. A., & Schnicke, M. K. (1993). Cognitive processing therapy for rape victims: A treatment manual. Newbury Park, CA: Sage Publications.
Roth, A. D., & Pilling, S. (2007). The competences required to deliver effective cognitive and behavioural therapy for people with depression and with anxiety disorders. Retrieved on July 8, 2009 from http://www.ucl.ac.uk/clinical-psychology/CORE/CBT_Framework.htm.
Roth, A. D., & Pilling, S. (2008). Using an evidence-based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders. Behavioural and Cognitive Psychotherapy, 36, 129–147.
Sackett, D. L., Strauss, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). New York: Churchill Livingston.
Salkovskis, P., & Clark, D. M. (1991). Cognitive therapy for panic disorder. Journal of Cognitive Psychotherapy, 5, 215–226.
Shaw, B. F. (1984). Specification of the training and evaluation of cognitive therapists for outcome studies. In J. Williams & R. Spitzer (Eds.), Psychotherapy research: Where are we and where should we go? (pp. 173–189). New York: Guilford Press.
Shaw, B. F., & Dobson, K. S. (1988). Competency judgments in the training and evaluation of psychotherapists. Journal of Consulting and Clinical Psychology, 56, 666–672.
Shaw, B. F., Elkin, I., Yamaguchi, J., Olmsted, M., Vallis, T. M., Dobson, K. S., et al. (1999). Therapist competence ratings in relation to clinical outcome in cognitive therapy of depression. Journal of Consulting and Clinical Psychology, 67, 837–846.
Smith, M. L., Glass, G. V., & Miller, T. I. (1980). The benefits of psychotherapy. Baltimore, MD: Johns Hopkins University Press.
Spring, B. (2007). Evidence-based practice in clinical psychology: What it is, why it matters; what you need to know. Journal of Clinical Psychology, 63, 611–631.
Spring, B., Pagoto, S., Whitlock, E., Kaufmann, P., Glasgow, R., Smith, K., et al. (2005). Invitation to a dialogue between researchers and clinicians about evidence-based behavioural medicine. Annals of Behavioral Medicine, 30, 125–137.
Steketee, G. S. (1993). Treatment of obsessive-compulsive disorder. New York, NY: Guilford Press.
Sudak, D. M. (2009). Training in cognitive behavioral therapy in psychiatry residency: An overview for educators. Behavior Modification, 33, 124–137.
Trepka, C., Rees, A., Shapiro, D. A., Hardy, G. E., & Barkham, M. (2004). Therapist competence and outcome of cognitive therapy for depression. Cognitive Therapy and Research, 28, 143–157.
Wampold, B. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Erlbaum.
Weissman, M. M., Verdeli, H., Gameroff, M. J., Bledsoe, S. E., Betts, K., Mufson, L., et al. (2006). National survey of psychotherapy training in psychiatry, psychology, and social work. Archives of General Psychiatry, 63, 925–934.
Young, J., & Beck, A. T. (1980). Cognitive therapy scale rating manual. Philadelphia: University of Pennsylvania. (unpublished manuscript).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rector, N.A., Cassin, S.E. Clinical Expertise in Cognitive Behavioural Therapy: Definition and Pathways to Acquisition. J Contemp Psychother 40, 153–161 (2010). https://doi.org/10.1007/s10879-010-9136-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10879-010-9136-2