Application of a self-practice self-reflection (SP/SR) framework to clinical training programmes for those learning cognitive behavioural therapy (CBT) have demonstrated positive outcomes. These programmes have typically resulted in reports of enhanced learning, improved clinical skills, heightened empathy, improved interpersonal skills, increased self-awareness, and self-development for those undertaking such training. However, the utility of specific activities within this framework for enhancing trainees’ learning still requires exploration. This study sought to explore the use of a low frustration tolerance (LFT) exercise to enhance trainee’s learning around issues relating to frustration and discomfort tolerance. It also further explored the possible application of SP/SR as a form of competency-based assessment. The study was based on 41 student trainees that engaged in a self-directed LFT exercise. Written reflections on these exercises were then thematically analysed. From a competency basis, the exercise provided an approach for observing the trainee’s competency with formulation skills, intervention planning, and self-reflective capacity. Participants reported both personal and professional development outcomes from the exercise. These included a ‘deepened’ understanding of cognitive behavioural principles related to their experiences, both in terms of principles relating to maintenance of dysfunction and to creating change. Increased self-awareness and learning outcomes relating to the development of interpersonal skills were also commonly reported by trainees.

Research on self-practice/self-reflection (SP/SR) programmes in training cognitive behavioural therapy (CBT) have shown promising outcomes over the past decade. To date, the SP/SR framework research has generally focused on entire programmes and has rarely assessed the utility of specific exercises as teaching tools. This study aimed to determine the utility of an exposure intervention known as a shame attack in helping to facilitate CBT training in a clinical psychology programe when delivered in a SP/SR framework. It also sought to examine the potential for the exercise to be used as a form of competency-based assessment. Forty-one student trainees engaged in self-directed shame attack exercises and provided written reflections on their experiences. The reflections were then studied via thematic analysis. The results indicate that the exercise provides an avenue for competency-based assessment of trainee therapists’ conceptual knowledge, formulation skills and intervention planning. It also promoted learning outcomes relating to a ‘deeper’ and more nuanced appreciation of CBT theory and practice. The shame attack exercise provided for personal development and the opportunity to experience typical client challenges with engaging in exposure interventions, which have the potential for enhancing empathy and cognitive behavioural skills.

Evidence exists that the effectiveness of psychotherapy depends more on therapists’ variables than on their theoretical orientation or the techniques they use. Nevertheless, relatively little is known regarding the process of cognitive behavioural psychotherapists’ development. The purpose of the study was to explore how beginning cognitive behavioural therapy (CBT) practitioners develop, considering various professional and personal influences. Eight in-depth interviews with beginning therapists were conducted, and the Grounded Theory Method was used for data analysis. The developmental process was conceptualized as Gaining Professional Confidence, and three phases of this process were identified: (1) Externally Based Confidence in CBT Methods, (2) Internalized Confidence in CBT Methods, and (3) Therapists’ Self-Confidence. The results indicate that trainees’ self-reflection on their personal qualities, values, attitudes and preferences should be given more attention in CBT training, as this plays a crucial role in their overall professional development.