The aim of this review was to ascertain whether an examination of the theory of structural dissociation of the personality (TSDP) and its treatment may lead to recommendations in the treatment of dissociative identity disorder (DID) and other trauma-related disorders utilizing CBT. An analysis of the neurobiology of trauma will aid this process. The literature review considers a variety of literature on TSDP. Several themes were identified which suggested that dissociation refers to a structural dividedness of the personality and that there is a psychobiological pathway for all trauma-related disorders. Additionally the role of bottom-up vs. top-down processing was explored. Recommendations for the treatment of trauma-related disorders using CBT have been made.

There are theoretical challenges in distinguishing obsessions from overvalued ideas (OVIs) and delusions. The latter can be defined by its rigid nature and unusual content, but obsessions and OVIs are also reported with such characteristics. Clinically, what are the implications when this distinction is not entirely clear? In this case study, these issues are explored with a man who presented with commonly reported symptoms of obsessive compulsive disorder (OCD) and a belief about transforming into a giant fly. Clinically meaningful gains were made following a course of 17 sessions of CBT, providing some additional support for the effectiveness of CBT for abnormal beliefs within OCD.

Competencies for psychiatric training have been developed that reflect what psychiatrists have to be able to do in order to function in their role. Although the need for a formally delivered psychotherapy experience is assumed and associated competencies are represented in the curriculum, it is not clear which competencies thereby achieved can be translated into generic practice. This paper reports the outcomes of a workshop held at an academic regional meeting of the Royal College of Psychiatrists. Potential competencies to be achieved following training and experience in CBT were presented. Small group review of the frameworks and subsequent feedback demonstrated broad support for requirements of CBT knowledge and attitudinal competencies that could inform day-to-day practice, within a generic psychotherapeutic skills framework. New competencies that were related to CBT and considered meaningful in daily psychiatric practice emerged. Further development of these ideas from the workshop in this paper leads to a set of coherent competencies that would be helpful in non-CBT specialist practice and are congruent with the context of generic psychiatric practice. These enable models of training other than the delivery of a single ‘brief’ psychotherapy case to be considered.