B
PT10 Guide and monitor progress made in cognitive and behavioural therapy
Overview
This standard shows how the cognitive and behavioural therapist uses measurement and self-monitoring as part of the process of therapy for the client. Measurement and self-monitoring also help the therapist to track and evaluate the process through which they are taking the client.
This standard describes therapeutic practice that has been shown to benefit adult clients engaged in cognitive and behavioural therapy for healthcare reasons, particularly depression and anxiety disorders. (See reference in the additional information section on page 3.) To apply this standard, practitioners also need to take account of the multiple problems and complex co-morbidities that individual clients may bring to therapy. Cognitive and behavioural therapy should be offered as part of an explicit and structured approach agreed within the treatment team and with the client.
Users of this standard will need to ensure that they are receiving supervision and that their practice reflects up to date information and policies. This standard should be understood in the context of the Digest of National Occupational Standards for Psychological Therapies.
Version No 1
Knowledge and Understanding
You will need to know and understand:
Goals for cognitive and behavioural therapy
- the goals of treating common psychological problems
- how to evaluate whether goals are likely to be achievable
- how to evaluate when goals are motivating or demotivating for the client
- how to evaluate progress toward goals
Measurement for cognitive and behavioural therapy
- effective standardised measures
- techniques for the client to self-monitor
- how the client may reveal their comfort or discomfort with the way in which therapy is going
- structured diagnostic criteria for the client’s psychological problem
- methods of measuring behaviour, emotion and cognition
- the use of standardised questionnaires and assessment measures
- standardised measures of common psychological problems
- the interpretation of changes in scores on measurement tools
Working together in cognitive and behavioural therapy
- verbal and non verbal behaviours
- listening skills
- effective and ineffective interpersonal behaviours
- personal self awareness
- how to engender trust
- how to develop rapport
- how to identify when you are controlling sessions at the cost of client engagement or collaboration
- how the client may reveal their comfort or discomfort with the way in which therapy is going
- professional boundaries and codes of conduct
- how to ‘read’/interpret the client’s emotional reactions
- possible sources of therapeutic impasse
Principles and practice of cognitive and behavioural therapy
- cognitive and behavioural models of depression and anxiety disorders and their underlying mechanisms
- the principles underlying cognitive and behavioural approaches to common psychological problems
- the psychological and social difficulties presented by clients with common psychological problems
- the range of cognitive and behavioural therapy models and treatment plans that can be employed
- evidence based cognitive and behavioural techniques used in treatment of depression and anxiety disorders
- the stages of human development throughout a life span and how they affect people and their needs
- the impact of social relationships and environment on health and wellbeing
- the changes in cognitive ability and the impact that age related transitions have on interpersonal networks
- the effects and impact of prescribed medication, non-prescribed drugs and alcohol on the client’s health and wellbeing
- how to adapt your communication to the client’s individual needs
Performance Criteria
You must be able to do the following:
- generate an accurate concurrent measurement of behaviours to complement the client’s recall
- choose measures of the targeted problem that reflect:
- the client’s perceptions of the problem
- the client’s preferences and abilities
- establish a baseline and subsequent measures of progress at points agreed with the client throughout the intervention
- help the client monitor specific patterns of their symptoms
- help the client use in-session practice to begin self-monitoring
- help the client identify and resolve any issues which make self-monitoring problematic
- ensure that the client’s targets for self-monitoring are clearly defined and detailed
- ensure that the client understands how to use the self-monitoring tools
- offer the client feedback on any apparent change or no change in thoughts, feelings and behaviour
- assess whether progress as measured is clinically significant
- adapt the intervention in the light of information from self monitoring and in relation to client progress
-
identify what may be learned from the monitoring data for your own practice and that of others
Additional Information
This National Occupational Standard was developed by Skills for Health.
This standard is derived from research reported in Roth A D and Pilling S (2007) The competences required to deliver effective cognitive and behavioural therapy for people with depression and with anxiety disorders. Department of Health/University College London.
This standard has indicative links with the following dimension within the NHS Knowledge and Skills Framework (October 2004).
Dimension: HWB4 Enablement to address health and wellbeing needs