Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T05:18:57.424Z Has data issue: false hasContentIssue false

Improving the Quality of Cognitive Behaviour Therapy Case Conceptualization: The Role of Self-Practice/Self-Reflection

Published online by Cambridge University Press:  15 February 2011

Beverly Haarhoff*
Affiliation:
Massey University, Auckland, New Zealand
Kerry Gibson
Affiliation:
Massey University, Auckland, New Zealand
Ross Flett
Affiliation:
Massey University, Auckland, New Zealand
*
Reprint requests to Beverly Haarhoff, Department of Psychology, Massey University, 33 Rosecamp Road, Beach Haven, Auckland 0626, New Zealand. E-mail: b.a.haarhoff@massey.ac.nz

Abstract

Background: CBT case conceptualization is considered to be a key competency. Prior to the publication in 2009 of Kuyken, Padesky and Dudley's book, little has been documented concerning methods for training conceptualization skills and the conceptualization process is usually perceived as predominantly an intellectual process. In this paper, the Declarative-Procedural-Reflective model of therapist skill acquisition provides a route to understanding how different kinds of knowledge systems can be integrated to enhance therapist skill acquisition. Method: Sixteen recent graduates of a postgraduate diploma in cognitive behaviour therapy worked independently through a self-practice/self-reflection workbook designed to lead them through a series of CBT interventions commonly used to elicit the information required for a CBT conceptualization. Results: The participants’ self-reflections were thematically analyzed and uncovered the following inter-related themes: increased theoretical understanding of the CBT model, self-awareness, empathy, conceptualization of the therapeutic relationship, and adaptation of clinical interventions and practice. Conclusions: A tentative conclusion reached, based on the self-reflections of the participants, was that targeted self-practice/self-reflection enhanced case conceptualization skill by consolidating the Declarative, Procedural and Reflective systems important in therapist skill acquisition.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beck, J. (1995). Cognitive Therapy: basics and beyond. New York: Guilford Press.Google Scholar
Beck, J. (2005). Cognitive Therapy for Challenging Problems. New York: Guilford Press.Google Scholar
Beck, A. T., Rush, A. J., Shaw, B. F. and Emery, G. (1979). Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Bennett-Levy, J. (2002). Cognitive Therapy in Three Dimensions: mapping the impact of self-practice and self-reflection (SP/SR) in the training of cognitive therapists. Unpublished doctoral dissertation, Southern Cross University, Lismore, NSW Australia.Google Scholar
Bennett-Levy, J. (2006). Therapist skills: a cognitive model for their acquisition and refinement. Behavioural and Cognitive Psychotherapy, 34, 5778.CrossRefGoogle Scholar
Bennett-Levy, J. and Beedie, A. (2007). The ups and downs of cognitive therapy training: what happens to trainees’ perception of their competence during a cognitive therapy training course? Behavioural and Cognitive Psychotherapy, 35, 6175.CrossRefGoogle Scholar
Bennett-Levy, J., Lee, N., Travers, K., Pohlman, S. and Hamernik, E. (2003). Cognitive therapy from the inside: enhancing therapist skills through practicing what we preach. Behavioural and Cognitive Psychotherapy, 31, 143158.Google Scholar
Bennett-Levy, J., McManus, F., Westling, B. and Fennell, M. (2009). Acquiring and refining CBT skills and competencies: which training methods are perceived to be the most effective? Behavioural and Cognitive Psychotherapy, 37, 571583CrossRefGoogle Scholar
Bennett-Levy, J. and Thwaites, R. (2007). Self and self-reflection in the therapeutic relationship: a conceptual map and practical strategies for the training, supervision and self-supervision of interpersonal skills. In Gilbert, P., and Leahy, R. (Eds.), The Therapeutic Relationship in the Cognitive Behavioural Psychotherapies (pp. 255281). London: Routledge.Google Scholar
Bennett-Levy, J., Turner, F., Beaty, T., Smith, M., Paterson, B. and Farmer, S. (2001). The value of self-practice of cognitive therapy techniques and self-reflection in the training of cognitive therapists. Behavioural and Cognitive Psychotherapy, 29, 203220.CrossRefGoogle Scholar
Blackburn, I., James, I., Milne, D., Baker, C., Standart, S., Garland, A. and Reichelt, F. (2001). The revised Cognitive Therapy Scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431446.CrossRefGoogle Scholar
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77101.Google Scholar
Dobson, K. S. and Shaw, B. F. (1993). The training of cognitive therapists: what have we learned from treatment manuals. Psychotherapy, 30, 573577.Google Scholar
Eells, T. (1997). Handbook of Psychotherapy Case Formulation. New York: Guilford Press.Google Scholar
Eells, T. D. (2007). Handbook of Psychotherapy Case Formulation (2nd ed.). New York: Guilford Press.Google Scholar
Eifert, G. H. (1996). More theory-driven and less diagnosis-based behaviour therapy. Journal of Behaviour Therapy and Experimental Psychiatry, 27, 7586.Google Scholar
Epstein, S. (1994). Integration of the cognitive and the psychodynamic unconscious. American Psychologist, 49, 709724.CrossRefGoogle ScholarPubMed
Farrand, P., Perry, J. and Linsley, S. (2010). Enhancing self-practice/self-reflection (SP/SR) approach to cognitive behaviour training through the use of reflective blogs. Behavioural and Cognitive Psychotherapy, 38, 473477.Google Scholar
Fothergill, C. and Kuyken, W. (2002). Quality of cognitive therapy case formulation rating-scale (Unpublished).Google Scholar
Goleman, D. (1996). Emotional Intelligence. London: Bloomsbury.Google Scholar
Greenberger, D. and Padesky, C. A. (1995). Mind over Mood: a cognitive therapy treatment manual for clients. New York: Guilford Press.Google Scholar
Haarhoff, B. (2008). The Map, the Navigator, and the Explorer: evaluating the content and quality of CBT case conceptualizations and the role of self-practice/self-reflection as a training intervention., Unpublished doctoral dissertation, Massey University, Auckland, New Zealand.Google Scholar
Haarhoff, B. A. and Stenhouse, L. M. (2004). Practice makes perfect: practicing cognitive behaviour therapy techniques and training. New Zealand Clinical Psychologist, 4, 2630.Google Scholar
Kendjelic, E. and Eells, T. (2007). Generic psychotherapy case formulation training improves formulation quality. Psychotherapy: Theory Research, Practice, Training. 44, 6677.Google Scholar
Kennedy-Merrick, S., Haarhoff, B., Stenhouse, L., Merrick, P. and Kazantzis, N. (2008). Training cognitive behaviour therapy practitioners in New Zealand: from university to clinical practice. New Zealand Journal of Psychology, 37, 817.Google Scholar
Kuyken, W., Padesky, C. and Dudley, R. (2009). Collaborative Case Conceptualization. New York: Guilford Press.Google Scholar
Leahy, R. (2001). Overcoming Resistance in Cognitive Therapy. New York: Guilford Press.Google Scholar
Leahy, R. (2003). Cognitive Therapy Techniques: a practitioner's guide. New York: Guilford Press.Google Scholar
Leahy, R. (2007). Schematic mismatch in the therapy relationship. In Gilbert, P. and Leahy, R. (Eds.), The Therapeutic Relationship in the Cognitive Behavioural Psychotherapies (pp. 229254). London: Routledge.Google Scholar
Mathieson, F., Barnfield, T. and Beaumont, G. (2009). Are we as good as we think we are? Self-assessment versus other forms of assessment and competence in psychotherapy. The Cognitive Behaviour Therapist, 2, 4350.Google Scholar
Milne, D. L., Baker, C., Blackburn, I. M., James, I. and Reichelt, K. (1999). Effectiveness of cognitive therapy training. Journal of Behaviour Therapy and Experimental Psychiatry, 30, 8192.CrossRefGoogle ScholarPubMed
Myles, P. J. and Milne, D. L. (2004). Outcome evaluation of a brief shared learning programme in cognitive behavioural therapy. Behavioural and Cognitive Psychotherapy, 32, 177188.Google Scholar
Nezu, A., Nezu, C., Friedman, S. and Hayes, S. (1997). Case formulation in behavior therapy: problem solving and functional analytic strategies. In Eells, T. (Ed.), Handbook of Psychotherapy Case Formulation (pp. 368401.). New York: Guilford Press.Google Scholar
Padesky, C.A. (1996). Developing cognitive therapist competency: teaching and supervision models. In Salkovskis, P. (Ed.), Frontiers of Cognitive Therapy (pp. 266292). New York: Guilford Press.Google Scholar
Padesky, C. A. and Mooney, K. A. (1990). Clinical tip presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 2829.Google Scholar
Persons, J. and Tompkins, M. (1997). Cognitive-behavioral case formulation. In Eells, T. (Ed.), Handbook of Psychotherapy Case Formulation (pp. 314339.). New York: Guilford Press.Google Scholar
Persons, J. B. and Tompkins, M. A. (2007). Cognitive-behavioural case formulation. In , Eells. T. (Ed.), Handbook of Pychotherapy Case Formulation (pp. 290316). New York: Guilford Press.Google Scholar
Rudd, M. and Joiner, T. (1997). Countertransference and the therapeutic relationship: a cognitive perspective. Journal of Cognitive Psychotherapy: An International Quarterly, 11, 231249.CrossRefGoogle Scholar
Safran, J. and Segal, Z. (1996). Interpersonal Process in Cognitive Therapy. Northvale: Jason Aronson Inc.Google Scholar
Young, J. E. (1995). Young Compensation Inventory. New York: Cognitive Therapy Centre of New York.Google Scholar
Young, J. and Beck, A. T. (1980). Cognitive Therapy Scale: Rating Manual. Unpublished.Google Scholar
Young, J. E. and Brown, G. (1990). Young Schema Questionnaire. New York: Cognitive Therapy Centre of New York.Google Scholar
Young, J., Klosko, J. and Weishaar, M. (2003). Schema Therapy: a practitioner's guide. New York: Guilford Press.Google Scholar
Young, J. E. and Rygh, J. (1994). Young-Rygh Avoidance Inventory. New York: Cognitive Therapy Centre of New York.Google Scholar
Submit a response

Comments

No Comments have been published for this article.