Training Standards OF EABCT

Introduction

The training standards as you can read them further on in this section are the present result of a work in progress that is not yet finished. The present working group on training consists of: Thomas Kalpakoglu (Greece), Thomas Heidenreich (Germany), Maie Kreegipuu (Estonia), Olivera Zikic (Serbia), Jaak Beckers (chairman) (Belgium).

In some of the member associations only psychologists or psychiatrists are accepted as members, other associations also accept other professionals.

The working group proposes therefore to consider the accreditation in EABCT, through the member associations, as a strict cognitive/behavioural accreditation, that does not define a profession, but an extra training for someone who already has a diploma in a relevant profession. That way somebody becomes: “a cognitive/behavioural clinical psychologist”, “a cognitive/behavioural psychiatrist”, “a cognitive/behavioural nurse”, “a cognitive/behavioural social worker”, “a cognitive/behavioural school psychologist”, etc.

The accreditation by EABCT than states that this person has completed an adequate training to ensure that he or she has the proficiency to apply CBT principles in their job as a clinical psychologist, a psychiatrist, a nurse, a social worker.

An implication is that the associations, as monitored by the accreditation committee of EABCT, will have to ensure that people get the training that is adapted to their initial knowledge on the one hand, but also to their specific needs to work as a clinical psychologist, a nurse etc.

One of the tasks of the working group is to define these specific training needs for different professions.
The text as published here states the general principles that we think should apply to training in cognitive and/or behaviour therapy, for different professionals, in the member associations of EABCT.

 

EABCT standards for the training and accreditation of
Behavioural and Cognitive Therapists

B:
LENGTH OF TRAINING

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The period of training will include both basic professional training that prepares a person for work in psychotherapy in general and a period of specialist training and experience relevant to behaviour and/or cognitive therapy.

The competencies to become an effective cognitive and/or behaviour therapist are usually developed in two stages. Firstly, there are those competencies in generic therapeutic skills and the understanding of psychopathology that form part of a clinicians core professional training. Secondly, there is the development of knowledge about the cognitive and behavioural model and specific competencies in behavioural and cognitive therapeutic skills that are usually developed as part of a post-professional qualification period of training. Sometimes the latter skills may be developed during a professional training course but it is unlikely that this will be to a level that meets EABCT's Minimum Training Standards

The minimum period of training recognised by EABCT as sufficient to develop the Minimum Training Standards will not normally be less than 5 years. This time is measured from the commencement of professional training to the end of a period of post professional training in cognitive and/or behavioural therapy skills

This is a minimum standard and does not preclude a national association requiring a longer period of time to attain the training standards recognised by its own requirements.

 

C:
THEORETICAL AND SKILLS TRAINING & COMPETENCES

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The period of training (core professional training and specific post-qualification training) will include the acquisition of a critical understanding of the relevance of studies of human development, psychopathology, psychology, social issues and evidence-based practice.

Specialist training may be in a particular model of behaviour and/or cognitive therapy, or in a particular field (e.g. CBT with psychosis, CBT with Children,). However, all therapists will have covered a curriculum that will provide a broad-based understanding of the theoretical basis of cognitive and/or behaviour therapies and their application across a range of problems.

Theoretical knowledge and skills will have been acquired through structured teaching and self-directed study. The minimum number of hours study required for the behavioural/cognitive elements of training is 450 hours of which 200 hours should be provided directly by recognised cognitive and/or behaviour therapy trainers on a recognised course or an agreed programme of study within the member association or country.

Skills training is an essential component of the acquisition of knowledge and experience and will predominantly be developed through supervised clinical practice (see D below), skills-based workshops, observation and clinical practice. Skills training should be a significant part of a therapist's total training programme.

Therapists should achieve the skills to be able to understand and interpret research relevant to the outcome and effectiveness of behaviour and/or cognitive therapy.

Acquired competences necessary to practice CBT will include:

C.6.1 Ability to assess, understand and formulate a client’s problem(s) according to CBT model(s):
  • To demonstrate effective interviewing and listening skills using appropriate verbal and non-verbal communication.
  • To make use of appropriate behavioural and cognitive assessment methods (questionnaires, rating scales, observational techniques) and understand their validity and reliability.
  • To understand the problem(s) presented in relation to cognitive-behavioural formulations.
  • To summarise, compare and contrast the behavioural-cognitive theoretical frameworks with different types of therapies to ensure that the appropriate model of intervention is applied.
C.6.2 Ability to apply an appropriate range of cognitive and/or behavioural interventions:
  • To demonstrate a broad knowledge and skills in implementing a range of B/C interventions that are effective and evidence-based.
  • To be informed by and draw upon relevant information from the fields of psychology and other disciplines that have contributed to the knowledge base of C/BT.
  • To have sufficient knowledge on normal and abnormal behaviour (e.g., psychopathology), developmental and social contexts which are relevant to the area in which the practitioner works.
  • To work in a collaborative way with clients explaining at all points during therapy the relevance of the interventions used and seeking consent.
  • To make use of appropriate evaluation methods (questionnaires, rating scales, observational techniques) to assess the impact of the interventions undertaken.
C.6.3 To build, maintain and conclude a therapeutic working relationship
  • To set and maintain appropriate professional boundaries
  • To be able to effectively assess the risk of harm to patient, therapist or others
  • To be aware of and consider ethical and legal principles as applied to therapeutic relationships
  • To have an understanding of the impact that their own cognitive, emotional and behavioural characteristics (personal development) can have on their work, and to have the willingness and ability to change, making appropriate use of supervision and feedback

Possible methods to assess therapists’ competences include:

  • Direct observation of therapy-sessions by a supervisor
  • Video recording of sessions
  • Audio recording of sessions
  • Rating scales on relevant competences
  • Discussion during supervision
  • Written and oral presentation of case reports
  • Peer-review
  • Self-assessment
  • Training log-books
  • Papers accepted by scientific journals
  • Feedback from clients
  • Examination

Possible learning methods to acquire therapists’ competences include:

  • Theoretical lessons
  • Reading
  • E-learning
  • Supervised clinical practice
  • Peer-group supervision
  • Supervision sessions
  • Observation and modelling
  • Role play
  • Discussion with other professionals
  • Attendance and presentations at conferences
  • Participation in skills-training workshops
  • Research
  • Evidence-based reviews
  • Case presentations

Additional competences will be needed for practitioners undertaking supervision, training of other therapists and research.

D:
SUPERVISED CLINICAL PRACTICE

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Therapists will have conducted 200 hours of supervised assessment and therapy during training.

All therapists will have received supervision during the period of training for both assessment and therapy, carried out by a competent cognitive and/or behaviour therapist. Supervision will consist of regular feedback and discussion. Close supervision should be used as part of this process and will involve the use of live, audio or video materials.

A minimum of 8 clients will be treated during the period of training from assessment to completion or termination of treatment before a therapist is regarded as having completed their training. These cases will cover at least 3 types of problems and 3 cases will have been closely supervised as defined above.

Details of supervised clinical practice and case mix will be recorded in a training record.

 

E:
PERSONAL THERAPY / DEVELOPMENT

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E.3		 The requirement of personal therapy/personal development is regulated in some European countries and therapists will have to meet these requirements where appropriate.

All therapists must ensure that they can identify and manage appropriately their personal involvement in the process of cognitive and/or behaviour therapy.

Therapists must have developed an ability to recognise when they should seek other professional advice.

 

F:
ACCREDITATION OF COGNITIVE AND/OR BEHAVIOUR THERAPISTS

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Therapists who fulfil the Minimum Training Standards, maintain an agreed level of continuing professional development in cognitive and/or behaviour therapy, receive regular clinical supervision and meet any additional national or legal requirements pertaining to the country in which they wish to practice, should be accredited by their national association or national regulatory body as a cognitive and/or behavioural therapist.

Associations should have, or be developing, procedures for accrediting therapists at a level which demonstrates that they have reached a higher level of competence and expertise that enables them to provide supervision or training to others or be recognised as a senior practitioner in the area of behaviour and/or cognitive therapy.

Supervisors and senior practitioners will normally have 5 years of therapeutic practice after meeting the minimum training standards and have received further training to equip them as trainers/supervisors.

 

G:
ASSESSING CORE TRAINING STANDARDS

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Therapists are expected to demonstrate an understanding of the theoretical aspects of cognitive and/or behavioural therapy and its application by the production of either a formal assessment essay, exam or research project.

An understanding of evidenced based practice should be evaluated by (i) the production of an extended case study that critically discusses the research evidence or (ii) a relevant research dissertation, or (iii) a research paper written as first author.

Supervised practice will be subjected to formal assessment with at least two case studies written up (2000 – 4000 words).

The above assessments are usually required in most formally recognised cognitive and/or behaviour therapy training programmes. For candidates who are not pursuing a training route through such a course it is important that they agree an independent programme of study and assessment with a competent therapist approved by their national association.

A record of training must be kept and this should specify the length of study, number of taught hours and a record of the lecturers, tutors or mentors participating in a therapists training.

 

H:
TRAINING PROGRAMMES

 H.1 EABCT supports the development of structured and accredited training programmes in each country that will provide trainees with a level of training and supervision to enable them to attain these minimum standards and any higher level of competence required by their national association or country.

 

 

Procedure to get accreditation:
  1. Within EABCT, an accreditation committee is formed. The committee has 4 members (representatives or non-representatives), the chair of them being the training coordinator of EABCT. The evaluation of a Member Associations application is done by at least 3 of the committee members that have no concern in that MA.

  2. A Member Association (MA) that wants its members to be able to receive the EABCT certificate has to have accreditation criteria, an accreditation procedure and a procedure to reaccredit members in its own association.

  3. To hold the EABCT certificate an individual candidate has to be an accredited member of his/her own MA.

  4. The MA submits its accreditation criteria and procedure to the EABCT committee. It provides all the necessary information in writing e.g.:
    - when was the association founded
    - what is the number of accredited members
    - what are the entry/admission criteria
    - what institute(s) or organisations give the specialised CBT training, what are the qualifications of trainers and supervisors;
    - what is the length and the content of the training program; what are the modalities of supervision and personal development; what are the evaluation
     procedures;
    - what are the criteria and the procedure to reaccredit members;
    - etc.

  5. Once a MA meets the EABCT criteria, the MA can recommend its members for accreditation by EABCT.

  6. When a member of the MA wants the EABCT accreditation he/she contacts his/her own MA.