The programmes have been developed with the South London & Maudsley NHS Foundation Trust and designed in accordance with the National Institute of Health and Clinical Excellence Schizophrenia Guideline psychological therapy recommendations (NICE, 2003, 2009). The purpose of the programmes is to improve the delivery of cognitive behavioural interventions for people with psychosis. CBTp is a complex therapeutic intervention and requires of independent practitioners an advanced theoretical understanding of cognitive models of psychosis and specialist post-qualification skills in relationship building, assessment, formulation and intervention. Our programmes train students in each of these requirements, enabling them to develop competence then mastery in therapy delivery, and to provide consultancy, training and supervision to others.
The programmes are modular, following a credit framework. Two clinical skills modules build from early therapy activities (Engagement, Assessment and Formulation – Module 1) through to intervention and specialised applications (Intervention & Supervised Practice; Module 2). Two academic modules develop students' critical appraisal of the theory underlying psychological models of psychosis (Theoretical background I: Psychological Models, Module 3) and the evidence base for interventions (Theoretical Background II: Interventions, efficacy & future directions, Module 4). Diploma students complete all four modules; clinical skills certificate students complete Module 1 and Module 2 only; theoretical background certificate students complete Modules 3 and Module 4 only.
Click here for a diagram showing the module structure of the programme.
Case supervision is strongly emphasised on the clinical programmes. Weekly morning supervision sessions take place in small groups (four to five) on the teaching day with all supervision carried out by the programme team. Additional close supervision (listening to audiorecordings of therapy sessions) is a course requirement.
See modules below.
This module is required for the PG Cert and optional for the PG Dip.
The modules aims to provide students with the skills to critically evaluate the evidence base for the interventions. Research from biological, social, cognitive, behavioural and emotional perspectives will be integrated, to enable understanding of the rationale for particular interventions and the justification for the strategies used. Gaps and inconsistencies in the existing knowledge base will be identified, and the research required to advance the field discussed. Knowledge will be applied to clinical cases through workshop teaching.
Teaching will take the form of workshops, supervision, seminars case presentations and research presentations and will cover theory and evidence at the forefront of the field. Students will undertake critical evaluation of the literature, synthesising existing information to generate novel ideas for research relevant to each clinical area. In workshops, clinical applications of theory and elements of practice will be covered, including role play and small group exercises. In seminars, selected research papers representing the latest developments in a particular field will be discussed and evaluated. Research presentations comprise a brief presentation to the seminar group on a particular topic, and are assessed for accuracy of understanding, quality of critique and quality of research ideas, as well as communication and presentation skills. Specialist applications for particular clinical groups are also covered, with each session taught by an expert in the field. Models of learning and supervision, critical reflection on and evaluation of the effectiveness of supervision will also be taught, together with adapting clinical skills - such as flexible and creative problem solving, to supervisory work, and the use of recently developed training manuals and standardised ratings of clinical work as training tools. Effective communication skills for the purposes of supervision and educating clinical teams will be taught. Later sessions will focus on managing a role as a CBT for psychosis therapist within a clinical team or other service, addressing workload, continuing supervision and professional development, creative adaptation of skills to maximise benefits to a particular service, and educating referrers to maximise the use of the service.
At the end of the module, students will be able to use an individualised clinical formulation to identify appropriate targets for intervention; use both research and clinical literature and clinical expertise to devise and flexibly deliver innovative cognitive behavioural interventions, adopting a scientist-practitioner model, and in line with best practice guidelines; evaluate the effectiveness of these interventions and adapt them accordingly; and communicate both interventions and their efficacy in a clear and informative style to both clients and colleagues, in written and verbal form.
They will have a critical understanding of models of supervision and learning, and will be able to draw on these eclectically to develop, deliver and evaluate individualised supervision. They will be aware of issues relating to delivering CBT for psychosis within a service, and able to adopt a problem solving approach to these. They will be able to adapt their skills in communicating about CBT for psychosis to different situations presenting within supervision and within clinical services. Students will be able to reflect on and evaluate their own and others' clinical work, including using standardised ratings to objectively evaluate therapy, and will be aware of professional and ethical considerations in undertaking therapeutic work of this type and the supervision of others in undertaking this work. Academically they will be able to identify opportunities for further research in and development of these specialist fields. They will be able to critically analyse and evaluate scientific papers pertaining to the development and evaluation of CBT for psychosis.
Assessment is by case presentation, research presentation, logbook and supervisor report and audiorecording of clinical practice, each accounting for 25% of the module mark.
This module is required for the PG Cert and optional for the PG Dip.
Small group supervision will focus on developing and enhancing supervision, training and service development skills. Sessions will include listening to audiorecordings of supervision, to improve students’ ability to plan, structure, and evaluate their supervision; reviewing and applying models of supervision and learning; and critically evaluating the evidence base for the effectiveness of clinical supervision. Service contexts and good practice for evaluating service delivery will be discussed. Students will be required to work in a supervisory role, and have the consent of their supervisees to bring supervision recordings to the group.
Assessment is by a written assignments of 2,500 words, analysing supervisory practice or service development issues (25% of module total), a supervisory practice log, including supervisee feedback (25%), and a supervisory practiceobservation assignment (50%).
This module is required for the PG Cert and optional for the PG Dip.
Assessment is by one 5000-word essay (75 per cent of final grade) and a research presentation (25 per cent).
Teaching will take the form of workshops and research seminars and will cover theory and evidence at the forefront of each field presented. Students will undertake critical evaluation of the literature, synthesising existing information to generate novel ideas for research relevant to each clinical area. In workshops, clinical applications of theory and elements of practice will be covered, including role play and small group exercises. In seminars, selected research papers representing the latest developments in a particular field will be discussed and evaluated. Research presentations comprise a brief presentation to the seminar group on a particular topic, and are assessed for accuracy of understanding, quality of critique and quality of research ideas, as well as communication and presentation skills.
At the end of the course, students will have augmented their knowledge in CBT for psychosis and will have an understanding of the development of and evidence base for psychological models of psychosis. They will be able to apply evidence-based ideas flexibly and creatively to thinking and formulating in clinical settings. Academically they will be able to identify opportunities for further research in and development of these specialist fields. They will be able to critically analyse and evaluate scientific papers pertaining to models of CBT for psychosis, and synthesise existing information to generate novel ideas for research projects. They will be able to effectively communicate research findings to colleagues.
This module is required for the PG Cert and optional for the PG Dip.
Assessment is by one 5000-word essay (75 oer cent of final grade) and a research presentation (25 per cent).
Teaching will take the form of workshops and research seminars and will cover theory and evidence at the forefront of each field presented. Students will undertake critical evaluation of the literature, synthesising existing information to generate novel ideas for research relevant to each clinical area. In workshops, clinical applications of theory and elements of practice will be covered, including role play and small group exercises. In seminars, selected research papers representing the latest developments in a particular field will be discussed and evaluated. Research presentations comprise a brief presentation to the seminar group on a particular topic, and are assessed for accuracy of understanding, quality of critique and quality of research ideas, as well as communication and presentation skills.
At the end of the course, students will have augmented their knowledge in CBT for psychosis and will be able to critically analyse and evaluate scientific papers pertaining to practice and efficacy of CBT for psychosis and the practice and efficacy of CBT techniques used in work with other disorders, in the context of a psychotic illness. They will be able to synthesise existing information to generate novel interventions and ideas for research. They will be able to apply evidence-based ideas flexibly and creatively to plan interventions in clinical settings. Academically they will be able to identify opportunities for further research in and development of these specialist fields. They will be able to critically analyse and evaluate scientific papers pertaining to the development and evaluation of CBT for psychosis.
This module is required for the PG Cert and optional for the PG Dip.
Assessment is by two 5000-word case studies (each 25 per cent of the total grade) and two 45-minute audiorecordings (25 per cent each). Students are required to keep a log book.
Engagement: High levels of interpersonal sensitivity, flexibility and clinical skill are required to effectively engage people with psychosis in productive clinical work. Teaching addresses forming and maintaining therapeutic relationships, overcoming challenges to engagement, identifying personal goals for therapy, and socialising clients to a CBT model. Illustrative clinical literature is used, with a critical stance to content. Students progress from beginner level through competent practice to mastery.
Assessment: The skills required to complete a detailed assessment for CBT are covered. Broad initial assessment of problems, difficulties and areas for change progresses to detailed examination of cognitive, emotional, and behavioural maintaining factors, which lead on to an individualised formulation (see next section). The use of standardised rating scales, interview schedules, and the development of personal rating scales is also covered. The practice of evaluating therapy outcome by establishing a baseline then measuring change, and effective methods for achieving this, will be inculcated.
Formulation: Assessment information is used to inform a model of how the person's difficulties are being maintained, and how they developed. Formulations in CBTp are developed with the client, and careful attention will be paid to engaging clients in this process and matching therapeutic style to the pace and perspective of the client. The literature on cognitive models of psychosis and other disorders is used to promote high level skills in both integrating a wide ranging literature, then tailoring that knowledge to develop a formulation suited to particular individual. Formulations emphasise the routes to solve problems and meet the person's goals, and thus inform intervention.
Teaching will take the form of workshops, together with intensive and detailed supervision. Students will critically review and practice techniques used in engagement, and acquire skills in the flexible and creative use of these with clients. Teaching will also cover the critical evaluation of assessment tools and the development of novel and individualised assessments for complex presenting problems. Analysis and synthesis of clinical assessment information and theoretical knowledge to generate individualised formulations for clients and the development of skills in sharing formulations with clients will be taught through supervision and workshops. Reflection on and evaluation of own and others' clinical work, including the use of standardised ratings, and the adoption of a scientist-practitioner model, will be promoted, with reference to guidelines for best practice in evidence-based intervention in CBT for psychosis, moving students towards responsibility for their own professional practice and development. Effectively communicating work to colleagues in written and verbal form will be covered.
At the end of the module, students will be able to competently adopt flexible and creative techniques for engaging clients, and conducting effective assessments, meeting guidelines for best practice in engagement, assessment, and formulation in CBT for psychosis. They will be able to analyse and synthesise clinical assessment information and theoretical knowledge to generate novel and individualised formulations of complex problems, which will inform intervention; establish a baseline from which to assess the effectiveness of interventions; and effectively communicate this information in verbal and written form to both clients and colleagues. Students will be able to adopt a scientist-practitioner approach to engagement, assessment and formulation, and make use of supervision to reflect upon, evaluate and develop both their own work and that of other students. They will be aware of professional and ethical considerations in undertaking this type of therapeutic work and the supervision of others in undertaking this work.
This module is required for the PG Cert and optional for the PG Dip.
Assessment is by a 5000-word case study, an audiorecording of a therapy session, a log-book of clinical practice, and a reflective account of learning through supervision (each 25 per cent of the total grade).
Teaching will take the form of workshops, intensive and detailed supervision, and case presentations and will cover theory and evidence at the forefront of the field in the practice and efficacy of CBT for psychosis and the practice and efficacy of CBT techniques used in work with other disorders, in the context of a psychotic illness. Specialist applications for particular clinical groups are also covered, with each session taught by an expert in the field. Models of learning and supervision, critical reflection on and evaluation of the effectiveness of supervision will also be taught, together with adapting clinical skills - such as flexible and creative problem solving, to supervisory work, and the use of recently developed training manuals and standardised ratings of clinical work as training tools. Effective communication skills for the purposes of supervision and educating clinical teams will be taught. Later sessions will focus on managing a role as a CBT for psychosis therapist within a clinical team or other service, addressing workload, continuing supervision and professional development, creative adaptation of skills to maximise benefits to a particular service, and educating referrers to maximise the use of the service.
At the end of the module, students will be able to use an individualised clinical formulation to identify appropriate targets for intervention; use both research and clinical literature and clinical expertise to devise and flexibly deliver innovative cognitive behavioural interventions, adopting a scientist-practitioner model, and in line with best practice guidelines; evaluate the effectiveness of these interventions and adapt them accordingly; and communicate both interventions and their efficacy in a clear and informative style to both clients and colleagues, in written and verbal form.
They will have a critical understanding of models of supervision and learning, and will be able to draw on these eclectically to develop, deliver and evaluate individualised supervision. They will be aware of issues relating to delivering CBT for psychosis within a service, and able to adopt a problem solving approach to these. They will be able to adapt their skills in communicating about CBT for psychosis to different situations presenting within supervision and within clinical services. Students will be able to reflect on and evaluate their own and others' clinical work, including using standardised ratings to objectively evaluate therapy, and will be aware of professional and ethical considerations in undertaking therapeutic work of this type and the supervision of others in undertaking this work.
All applicants need to demonstrate the ability to work effectively at master's level, and an interest in and enthusiasm for psychological approaches to working with people with psychosis. PG Dip and Clinical PG Cert applicants must also have a recognised professional mental health qualification obtained by a formal examination, with post qualification experience of working with people with severe and enduring mental health problems, and be based in the NHS (or equivalent) with access to suitable clients.
Applications which fulfil the entry requirements will be assessed on an individual basis by the programme leaders. Selected applicants will be invited for interview. Clinical candidates selected for interview will additionally be requested to participate in a short role-play with an actor playing the role of the client and a brief, written case formulation exercise.
Please detail your previous training in, and experience of working with people with psychosis and of providing therapy, both to people with psychosis and in other settings. This should include type of therapy (e.g. CBT or Supportive Counselling), approximate numbers of clients worked with and length of therapy.