PT07 Agree goals for cognitive and behavioural therapy with the client

Overview

This standard is about achieving agreement on goals, and their ownership by the client, as an important factor in the successful outcome of therapy. Goals need to be more than expressions of sentiment, and this standard emphasises the need to express them in a way that can be clearly understood and put into practice. 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 2.) 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

1. the goals of treating common psychological problems
2. how to evaluate whether goals are likely to be achievable
3. how to evaluate when goals are motivating or demotivating for the client
4. the rationale for cognitive and behavioural therapy
5. how to facilitate the development of Specific, Measurable, Achievable, Realistic and Timebound (SMART) goals
   
   Working together in cognitive and behavioural therapy
   
6. verbal and non verbal behaviours
7. listening skills
8. effective and ineffective interpersonal behaviours
9. personal self awareness
10. how to engender trust
11. how to develop rapport
12. professional boundaries and codes of conduct
13. how to ‘read’ and interpret the client’s emotional reactions
14. possible sources of therapeutic impasse
    
    Principles and practice of cognitive and behavioural therapy
    
15. cognitive and behavioural models of depression and anxiety disorders and their underlying mechanisms
16. the principles underlying cognitive and behavioural approaches to common psychological problems
17. the psychological and social difficulties presented by clients with common psychological problems
18. the range of cognitive and behavioural therapy models and treatment plans that can be employed
19. the stages of human development throughout a life span and how they affect people and their needs
20. the impact of social relationships and environment on health and wellbeing
21. the changes in cognitive ability and the impact that age related transitions have on interpersonal networks
22. the effects and impact of prescribed medication, non-prescribed drugs and alcohol on the client’s health and wellbeing
23. how to adapt your communication to the client’s individual needs

Performance Criteria

You must be able to do the following:

1. help the client translate the things that concern them into a set of target problems that are amenable to intervention
2. help the client set goals for therapy that reflect the issues with which they presented
3. work with the client to ensure goals are:
1. specific
2. measurable
3. achievable
4. time bounded
5. ethical
4. work collaboratively with the client to prioritise the goals and agree the means of achieving them
5. assess the current severity of the client’s problems with standardised measures and generate a baseline against which to assess progress and outcomes
6. help the client review goals regularly or in the presence of newly elicited information

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