Use of self-practice/self-reflection (SP/SR) exercises for competency-based training and assessment in CBT

Abstract

With the increased demand for psychological services, and particularly for cognitive behavioural therapy (CBT), it is vital that teaching programs offer effective training that produce skilled and competent clinicians. This paper reviews the limitations of traditional approaches to training within the field of psychology, in terms of the promotion of a breadth of declarative knowledge at the expense of a deep and nuanced understanding of cognitive behavioural theory and clinical competence. It also reviews issues with existing strategies for competency-based assessment of trainees learning CBT. To date, many of these appear to assess a range of competencies concurrently and to test trainees within complex environments. Such methods may fail to provide an opportunity for the assessment of specific areas of competence and/or confound the assessment itself. It may also result in the public being exposed to trainees who are yet to develop competence. Based on recent research in training methods within psychology at large, and in relation to CBT specifically, a model of competency-based training and assessment is presented to address these issues. This model extends the existing research on the use of the experiential self-practice/self-reflection (SP/SR) framework for training in CBT. It proposes that the use of discrete exercises within a SP/SR training program promotes a more in-depth and nuanced appreciation of cognitive behavioural knowledge and skills and increased clinical competence. Furthermore, such exercises are proposed to provide an avenue for assessing clinical competence in specific skills prior to the commencement of direct client services. Key learning aims (1) To review literature on training for the development of clinical competence. (2) To review literature examining methods of assessing competence. (3) To propose the use of experiential training through a SP/SR framework as a method for providing both competency-based training and assessment.