University of Exeter Doctorate in Clinical Psychology

Individual Accreditation with the British Association for Behavioural and Cognitive Psychotherapies (BABCP): Support Pack

Contents

1. Overview of BABCP accreditation process

2. Guide to enhancing eligibility for BABCP accreditation whilst on the programme

3. Notes on making a BABCP application

4. Timeline

Appendices

I. Self-study hours record

II. CBT case record

III. Supervisor verification form

IV. Exeter DClinPsy case presentation marking criteria

V. BABCP case study marking criteria

1 1. Overview of the BABCP accreditation process

BABCP offers accreditation for Cognitive Behavioural Psychotherapists, Supervisors, Trainers and Psychological Wellbeing practitioners. BABCP also accredits CBT training courses at two levels. To become a BABCP accredited CB therapist some people attend a CBT training programme that is itself accredited by BABCP. In general these are post-graduate diploma or Masters programmes, including the high-intensity IAPT programmes. If you graduate successfully from one of these programmes you must still submit an application to BABCP, but much of your training is taken for granted, thus the evidence you must supply is substantially reduced.

Our programme has taken the decision that, at least at present, we will not be applying for programme level accreditation with BABCP. This is because we judged that some of the adjustments necessary would compromise other important aspects of our particular training course. Instead we support those trainees who wish to to apply for BABCP accreditation on an individual basis. This means that the trainee is required to evidence various aspects of their CBT training and experience. To help you with this, we made adjustments to our programme and paperwork so that i) we maximise the amount of CBT training and experience that we can reasonably deliver; ii) this training and experience is easily and clearly evidenced; iii) we support those interested in BABCP accreditation by providing advice on the process, and on negotiating DClinPsy training in a way that maximises CBT experience, and by offering additional services to enhance eligibility (such as marking additional case reports). This means that responsibility for demonstrating a portfolio of training and clinical practice in CBT that is commensurate with what is required by BABCP lies with the individual (and can draw from experiences across his / her career to date), however our programme will help trainees to gain and evidence a considerable proportion of the experiences required.

If this is your first application to BABCP you must submit an application for provisional accreditation. After one year you can apply for full accreditation. It is worth noting that BABCP require you to have been practicing in your core profession for one year before applying for provisional accreditation: for many trainees this will mean waiting until one year post qualification from the DClinPsy. Nevertheless, we can help you to put together a portfolio of experience in anticipation of an application.

For those trainees who already have provisional or full BABCP accreditation we offer support in progressing / maintaining accredited status.

For further information see: http://www.babcp.com/Accreditation/Accreditation.aspx

2 2. Guide to enhancing eligibility for BABCP accreditation whilst on the programme

2.1 Teaching

In your application you will be asked to provide details and evidence of the teaching on CBT that you have received as part of your core professional training. As this teaching is consistent across trainees, the programme will provide you with a yearly list of the CBT relevant teaching that you have received.

What should I do?

 At the end of year 3 you will receive a list of the all CBT relevant teaching sessions provided to your cohort across the programme. You can use this to complete your application form.

2.2 Self-study

BABCP require that you complete 450 hours of specialist CBT training, at least 200 of which must be directly taught; the remainder can be prescribed self-study. On this programme you may accrue these hours as part of your study for assessments (such as CPRs, PBLs, MRP), as well as as part of locality packs and on clinical placement. This element will vary from trainee to trainee, however the programme will provide you will evidence of the locality CBT self study hours.

What should I do?

 As above, you will receive a list of all the CBT-relevant teaching you have received, which will include locality packs: this can be signed by the CBT lead.

 To evidence self-study on clinical placement, record this in your clinical log, where it is signed off by your supervisor.

 To evidence other CBT-relevant self-study (for assessments), record this in the self-study record form in this pack, and then once each line is complete, seek signature from the person indicated.

2.3 Clinical Practice

You will need to provide details of any specific behavioural and/or cognitive placements on your DClinPsy or supervised clinical practice.

BABCP requires you to have a minimum of 200 hours of CBT Clinical Practice, supervised by an appropriate CBT Clinical Supervisor (someone who is BABCP accredited as a CBT practitioner or supervisor, or would meet the BABCP practitioner accreditation requirements if they were to apply), totalling at least 40 hours of Clinical Supervision. You must have seen a minimum of 8 CBT cases, covering at least 3 different problem types. Three of these must have been “closely supervised” (see: http://www.babcp.com/files/Accreditation/CBP/Provisional/Close-Supervision-Guidelines-V2- 071015.pdf) which involves use of an appropriate competency rating instrument such as the Cognitive Therapy Scale (CTS-R), The supervisor should judge the therapy delivered to be “of a reasonable standard” (see Close Supervision Guidelines for definitions of this).

What should I do?

3  Complete your clinical log books, making sure you explicitly record CBT assessment, therapy, supervision, study and any additional training in CBT received on placement. Your supervisor signs off your log book.

 Across your training, work with your appraiser and clinical tutor to ensure that you see a minimum of 8 CBT cases, covering at least 3 different problem types. Use the CBT case record form in the appendix to record the work you have done.

 Use live material and the Cognitive Therapy Scale – Revised (CTS-R) regularly during supervision. This can be used towards the “live observation” requirement of the DClinPsy programme. Ensure that you use live material and this tool (or an equivalent) for your three “closely supervised” cases, for which your supervisor must listen / watch at least one whole session per client.

 Work with your appraiser, CBT lead and academic tutor to think about how you might develop four CBT case studies. The programme expects that no more than two Clinical Practice Reports (CPRs) would be focused on CBT therapeutic work. In addition to this you can write up additional case reports to be marked by the programme, and / or present up to 2 cases at the optional CBT case presentation workshop that takes place at the end of year 3. You will have the opportunity to attend BABCP case report “clinics” to discuss these further prior to investing time and effort in writing additional reports. For each additional case report or presentation you produce you will need to obtain client consent (as you do for CPRs) plus supervisor verification (see appendix).

 On the BABCP application form you must obtain signatures of the supervisor for the three cases which received live supervision, as well as signatures of the assessors of the four case reports. You can ask supervisors to sign this aspect of your form at the end of the placement, or at any time afterwards. If you have trouble obtaining a signature the programme can help you to find an alternative. The programme will arrange for assessors to sign your form when it is ready.

 BABCP expect you to wait one year post qualification before applying. However if you are planning to apply sooner that this (for example, if you already have a core profession), work with your appraiser and clinical tutor to ensure that in your final year you are practicing CBT and having regular (at least monthly) CBT supervision, and that you document details of every supervision session including date, no. supervisees present, duration, content, method. In addition, over 50% of your work and other psychotherapeutic-related working activities must be cognitive behavioural.

2.4 Additional points for those on the CBT route:

 Work with your appraiser, clinical tutor, and the clinical lead to seek out a portfolio of placement experiences that give you sufficient exposure to CBT to meet BABCP requirements. This will be done as part of appraisal meetings, and also in consultation with the CBT lead.

4  Where necessary the programme can arrange to supplement supervisory arrangements on placement with in-house supervision provided by a member of the programme team.

2.5 Letter of support

It is not necessary to provide a letter from your DClinPsy programme attesting to the CB training and experience you have gained on the programme, however the programme will supply such a letter if you wish.

2.6 For those seeking to move from provisional to full BABCP accreditation, or seeking re- accreditation

BABCP require that you are currently practicing CBT as more than 50% of your psychotherapeutic workload (including direct client contact and indirect psychotherapeutic activities). You must have a minimum of two client contacts a week or equivalent. You must have been receiving CBT supervision at least monthly over the past 12 months from a BABCP accredited therapist or equivalent, and supervision should regularly involve the use of live material and preferably a competency rating instrument. You must obtain a reference from your current CBT supervisor and from your previous supervisor if your current one has been in place for less than 6 months. You must submit a log book of CBT CPD activity, totalling at least 30 hours.

What should I do?

 Record evidence of your CBT practice and supervision in the clinical log books. Use the BABCP full accreditation application form to guide you as to keeping a detailed record of the content of supervision.

 Ensure that CBT supervision regularly includes live material and competency rating.

 Clinical supervisors providing CBT supervision can be approached to provide the necessary references.

 Work with your appraiser, clinical tutor and the clinical lead to seek out placements that will provide the necessary CBT experience.

 Where necessary the programme can arrange to supplement supervisory arrangements on placement with in-house supervision provided by a member of the programme team.

 The programme can supply you with a list of the teaching you have received so far, signed by the CBT lead and cross referenced against your attendance record, when you need to submit your application.

5 3. Notes on making a BABCP application

Criterion One: Core Professional Training

. You will need to state details of Undergraduate Psychology Degree and your Postgraduate Clinical Psychology Doctorate.

. You will also need to record your membership of the BPS.

Evidence required for this section: degree certificates and BPS pin number.

Evidence provided by the programme: not applicable

Criterion Two: Professional Accountability and Practice

. Professional Accountability: You will need to demonstrate one year of professional practice since qualifying as a Clinical Psychologist where you have been accountable to a senior Clinical Psychologist / member of a “relevant Core Profession”.

. Current Professional Practice: You will need to give details of your last year of practice showing that more than 50% of your clinical practice and other psychotherapeutic related working activities must be Cognitive Behavioural Practice (CBP).

. Cognitive Behavioural Practice: You will need to provide a breakdown of your CBP time across clinical practice, supervision, teaching and training etc.

Evidence required for this section: details only. Will be supported by references.

Evidence provided by the programme: for those making an application / re-application less than one year post qualification from the DClinPsy, programme clinical log books could be used as evidence for this section.

Criterion Three: Specialist Behavioural and/or Cognitive Training

In this section you will have to evidence how you meet the Minimum Training Standards for the Practice of CBT. As the University of Exeter Doctorate in Clinical Psychology is not level 2 accredited you will need to complete all sections of this criterion. To do so it will be useful if you can keep all the records and evidence below up to date throughout the course.

The BABCP requires:

. A minimum of 450 hours of specialist CBP training overall.

. 200 hours taught by recognised CBP trainers.

. Half of the overall CBP training must focus on CBP skills development

6 . A minimum of 200 hours of CBP Clinical Practice (supervised by appropriate CBP Clinical Supervisor, totalling at least 40 hours of Clinical Supervision).

. A minimum of 8 cases undertaken during training, covering at least 3 different problem types.

. Four of these cases should have been written up and assessed as case studies (2000-4000 words): up to two may be presented and examined in an alternative format e.g. live case report with written support such as a summary/PowerPoint.

. Three of these cases must have been closely supervised, using live (in-vivo, video, audio) assessment.

. Personal Development: There is also a requirement to evidence that you have and can ensure appropriate personal involvement in CBP and can recognise the need for and utilise additional professional advice and support.

Criterion 3a: Taught C/BP Components of your Core Professional Training

As stated above the BABCP requires:

. A minimum of 450 hours of specialist CBP training overall.

. 200 hours taught by recognised CBP trainers.

. Half of the overall CBP training must focus on CBP skills development

You will need to list details of behavioural and cognitive theoretical and skills components from the DClin. We have produced an outline of the relevant sessions and will provide you with a list of these in summer of year 3 with the details about each required by BABCP. At the time of writing the number of taught hours is around 200 and over half focuses on skills development.

Evidence required for this section:

. Course curriculum plus teaching received must be recorded on the application form session by session.

Evidence provided by the programme:

. Session by session record of teaching for your cohort at the end of year 3.

Criterion 3b: C/BP Placements or Supervised Practice during your Core Professional Training

You will need to provide details of any specific behavioural and/or cognitive placements on your DClinPsy or supervised clinical practice.

7 . Course curriculum plus evidence of placement activity; on the application form you are asked to record placement duration, no. clinical hours, no. taught skills development hours, placement supervisor, and type of evidence.

. Course curriculum (as above) plus clinical log books: the latter records clinical CBT hours and CBT-relevant on-placement training, and can be supplied as the evidence of C/BP placement activity.

Criterion 3c: Taught C/BP Recognised Specialist Training

This refers to any other significant formal C/BP training you have done outside the DClin. It is not a requirement to enter information here.

Dates Qualification Awarding No. of hours No. of hours Evidence Body/Institutio taught theory taught skills n curriculum of training & certificates of any qualifications

. Certificates and evidence of the curriculum.

. Not relevant

Criterion 3d: Self-directed Study Prescribed in C/BP Components of Core Training and C/BP Specialist Training

Here you must list hours spent on CBT study as prescribed by your training programme. Currently we prescribe 134 study days (828 hours in total), plus any study necessary on placement. However only a proportion of these hours will be spent on CBT-relevant study. In addition we currently include 23.5 hours of locality study on CBT-relevant topics.

. Evidence of prescribed self-directed study.

. Table of self-directed academic and research study, to be completed by trainee and signed by designated members of staff.

8 . Clinical log books which include trainee record of CBT study hours, signed by placement supervisor.

Criterion 3e: Other C/BP CPD Training and Experience

This would include any other training you have done outside the core requirements of the DClin including short courses, workshops, conferences (e.g. attendance at BABCP conference), research projects, SIGs etc. You may wish to include any relevant clinical training courses you had the opportunity to attend whilst on placement.

Dates Title and Trainer / Organising No. of No. of Evidence type of Lecturer / Body hours hours activity Placement taught taught Supervisor theory skills e.g. certificates, placement records, agendas or minutes

. Not stated on application form

. Not relevant

Criterion 3f: Supervised Clinical Practice in Behavioural and/or Cognitive Psychotherapy in Training

As stated above the BABCP requires:

. A minimum of 200 hours of CBP Clinical Practice (supervised by appropriate CBP Clinical Supervisor, totalling at least 40 hours of Clinical Supervision).

. A minimum of 8 cases undertaken during training, covering at least 3 different problem types.

. Four of these cases should have been written up and assessed as case studies (2000-4000 words): up to two may be presented and examined in an alternative format e.g. live case report with written support such as a summary/PowerPoint.

. Three of these cases must have been closely supervised, using live (in-vivo, video, audio) assessment.

. Signatures of supervisors and, for those written up as case reports, signatures of assessors.

9 . Signatures as above. This is supported by a) clinical log books, and b) assessed CPRs / case reports / case presentations that have been signed off by supervisors and CBT lead.

Criterion Four: C/CP Clinical Supervision

Here you will need to complete a CBP Clinical Supervision record for the 12 months prior to application evidencing a minimum of one hour per month, not only in group settings i.e. with some opportunity for individual supervision. Supervision must be with a BABCP accredited practitioner (or someone who is eligible for accreditation). Supervision must include live supervision and competency assessment using formal measures such as the CTS-R.

Evidence required for this section: details only. Will be supported by references.

Evidence provided by the programme: for those making an application / re-application less than one year post qualification from the DClinPsy, programme clinical log books could be used as evidence for this section.

Criterion Five: Evidence of Sustained Commitment

Here you simply sign a declaration that you are committed to CDP and clinical supervision.

10 4. Timeline

Year 1 Year 2 Year 3 Post qualification Oct- Jan- Apr - July-Sept Oct-Dec Jan-Mar Apr - Oct- Jan- Apr - July- Dec Mar June June Dec Mar June Sept Work with at least 8 CBT cases, covering 3 problem types, using live material and competence rating Get supervisor and appraiser signatures for 8 cases, if not already done Record self-study hours and have these signed off

Write up to 2 CPRs on CBT assessment and intervention Write up additional cases, and have these and relevant CPRs marked / signed off by programme List of CBT teaching received emailed to yr 3 Case Case presentation report workshop(s) clinic(s) Discuss accumulation of CBT casework and case reports in appraisals; plan future CBT experience Ensure monthly CBT supervision over 12 months before application, as well as that over 50% of work is cognitive behavioural

11 Appendix I

UNIVERSITY OF EXETER DOCTORATE IN CLINICAL PSYCHOLOGY

Record of CBT Self-Study Hours

Programme Details of self-directed Total Hours Verified by Tutor / supervisor component study activity hours dedicated Signature & PRINT to CBT Problem Based Researching CBT Academic Tutor Learning (PBL) perspective on PBL case studies Small-scale Service- Researching CBT relevant SSRP supervisor related Research material for SSRP Project (SSRP) Major research Researching CBT relevant Thesis project (MRP) material for supervisor Clinical Practice Researching CBT Academic tutor Report (CPR) elements of CPR reports Professional issues Researching CBT Academic lead essay elements of professional issues essay Guided self-study Completing learning 23.5 23.5 CBT curriculum sessions packs on the theory and practice of CBT CBT study as part CBT study as part of Clinical of clinical clinical placement supervisor: placement recorded in logs of clinical activity

12 Appendix II

Record of CBT cases to constitute 8 training cases

Client ID Problem type Therapy hours Case report? Client consent Supervisor Live Competency Times brought (CPR / obtained for verification of supervision rating done? to supervision additional case report / case report / used? report / presentation? presentation? presentation): (on standard (on form given 4 needed in CPR consent in Appendix X) total form)

13 Appendix III

University of Exeter Doctoral Programme in Clinical Psychology

Additional Case Report: Supervisor’s Verification

Name of Trainee: ______

Title:

Total Word Count:

“I certify that the work reported in this assessment took place as described and note below any constraints or circumstances which may have affected the conduct of the work described”

I confirm that I have seen the signed consent form (or have evidence that appropriate verbal consent has been given) of the client with whom the clinical work was conducted, in which he/she had given written consent for the release of the material for supervision and assessment for educational purposes.

Or (please delete as appropriate)

I confirm that the client was deemed to lack capacity to give consent for the release of the material for supervision and assessment for educational purposes, but that careful consideration was given by those who know the client well, who agree that in their judgement recorded material may be released for supervision and assessment for educational purposes.

Signed by supervisor: ______Date: ______

Name of supervisor: ______

Statement of academic probity and professional practice (delete as appropriate): For individual work : “I certify that all material in this assignment / assessment which is not my own work has been identified and properly attributed. I have conducted the work in line with BABCP and BPS DCP Professional Practice Guidelines.” For group work: “This assignment has been prepared in accordance with the instructions of the course convenor. In those sections of the assignment which are required to be prepared independently, I certify that all material which is not my own work has been identified and properly attributed. I have conducted the work in line with BABCP and BPS DCP Professional Practice Guidelines.”

Signed (trainee): ______

14 Appendix IV DClinPsy CBT Case Presentation Guidelines

The DClinPsy programme offers an optional case presentation session for those interested in compiling their portfolio of experience for individual level accreditation with BABCP. This takes place in the summer of the final year. BABCP require applicants to have completed four case reports of their cognitive behavioural practice; up to two of these can be in the form of a case presentation.

The purpose of the case presentation is to demonstrate your grasp of the application of cognitive theory to clinical practice and to demonstrate your skills in assessment, formulation and treatment.

In keeping with the BABCP case study marking criteria, you will be assessed on the following dimensions:

*Assessment Should include: . Reason for referral and for seeking treatment at this point. . Presenting problem(s), diagnosis and co-morbidity. . Relevant background/personal information, including development of the problem, predisposing and precipitating information, and current social circumstances. . Risk assessment. . Identified treatment goals for therapy (focus on SMART goals). . Issues relating to engagement and the therapeutic alliance. . Use of the relevant model to guide assessment, formulation and intervention (if it is not used, reasons for this should be given). . A cognitive behavioural assessment of the presenting problem(s), including a description of identified situations/triggers, cognitions, emotions, physical symptoms and behaviours. . Socialisation to the model and suitability for CBT. . Scores on relevant outcome and assessment measures. *Conceptualisation / Formulation . Where a particular model has been used to guide formulation this should be referenced and accurately described. . There should be a description of the case conceptualisation and clarified, where possible, by a diagrammatic representation of the conceptualisation. . Ensure that the arrows on any diagrammatic formulations should make sense, flow accurately and reflect both the theory and actual experience of the client. . The formulation should link and explain the presence of maintenance factors of the presenting problem(s) and where relevant the development of the problem. . The formulation should relate to the client’s goals and flow from the assessment. . Ensure a focus on collaboration with explicit client contribution. *Intervention The intervention(s) should: . Relate to the client’s identified goals. . Directly relate to and flow from the case conceptualisation. . Include reference to relevant NICE guideline(s) if applicable . Have a clear and explicit rationale. . Be described in enough detail so that it is clear what was done, but a blow-by-blow account of each session is not needed. *Link of theory to practice This is covered to some extent in previous areas. Throughout the presentation you should relate the clinical work carried out to relevant cognitive-behavioural theory and relevant models. You should use theory to guide your assessment, formulation and intervention plan and guide your thinking about this case. You should refer to and make use of the relevant literature pertaining to this case. *Critical evaluation/outcome . You need to evaluate the interventions as applied and the outcome of the case. 15 . You need to demonstrate that evaluation is not something that is done just at the end but throughout the course of therapy so that you know you are on track. . You should re-administer and report on all measures that were used at assessment and if not explain why not. . Outcomes should relate to the goals of therapy. . You should critically evaluate the outcome to date; why you think the changes made have been made? Or if no changes again why this may be? Where possible relate this to current cognitive theory and or the formulation and model. . Where a case is not complete you need to present the current outcome in relation to the goals. Awareness of professional issues (including confidentiality) Your work should demonstrate good professional awareness, e.g. awareness of: . Issues of risk . Ethical issues . Power dynamics . Issues of diversity and difference and its impact on the therapeutic relationship. . Client confidentiality: anonymised biographical data must be used throughout the presentation, i.e. change any names and identifying information and make it clear that this has been done. Structure and style of presentation Marks will be awarded for a well-structured and well-presented case presentation. Use of PowerPoint is encouraged. The case presentation should flow in a logical manner and any slides/hand-outs provided should be relevant and aid the marker. Be mindful of your use of language, both regarding the use of colloquialisms and jargon. Where appropriate you may make use of diagrams, tables and bullet points in the presentation to clarify information.

Please provide a copy of your presentation to the programme.

A possible structure could be based on the marking criteria e.g.: Introduction to the presentation, reason for referral, presenting problem(s), assessment, formulation, intervention and critical evaluation/discussion. Theory to practice links, self-reflectivity and professional issues could be covered throughout the presentation.

Your case presentation should be clearly presented and you may wish to consider practising your presentation beforehand where possible. References References should be given throughout the presentation and provided on a slide at the end. For simplicity of visual presentation, references in the presentation slides can be shortened to ‘et al.’. Reference section at the end MUST conform to APA guidelines. Please check and double check references in terms of accuracy, consistency and ensuring that all references in the presentation slides/text are referred to in the reference section. Spelling, grammar, typographical errors You will be marked down for typographical, grammatical and spelling errors on any slides/hand-outs you provide. If you have problems in this area please use the study skills department. Length of Presentation The case presentation should be a maximum of 20 minutes’ duration. A further 5 minutes can be spent on questions by the panel for clarification purposes only. No follow-on questions will be permitted; therefore all relevant clinical information will be required within the case presentation. The presentation will be halted at 20 minutes and information not presented will not receive credit.

Assessment of the case presentation

You will receive written feedback on your presentation, and feedback as to whether it would be likely to be awarded a “pass” on a postgraduate Cognitive Behavioural Therapy training programme. As a guide, if more than one of the highlighted areas (*) above does not reach pass 16 standard, this is likely to result in the presentation overall not being judged to be of “pass” standard. In this case, you are invited to complete a written submission relating to the failed areas. The programme will allow a maximum of 1 written submission per presentation.

17 Appendix V Case Study Marking Criteria Introduction On the application form for Accreditation, Criterion Three - Specialist Behavioural and/or Cognitive Training - section 3f: Supervised Clinical Practice in Behavioural and/or Cognitive Psychotherapy in Training states: The Minimum Training Standards require that psychotherapists will have conducted 200 hours of CBP clinical practice, appropriately supervised during training, and will have treated a minimum of 8 clients, covering at least 3 different problem types. Each client should have been seen from assessment to completion, and for at least 5 sessions (although most should have been significantly longer).Of these cases, 4 will have been written up and assessed as case studies (2000 – 4000 words), and 3 will have been closely supervised using live (in-vivo,video, audio) assessment. Normally, where the main C/BP Training has taken place in a formal academic setting, the assessment and evaluation of these written submissions is by the course tutors and award boards of the institution. Some applicants however,may find that their formal training has included insufficient numbers of equivalent academic case studies. In such cases, the applicant is required to supplement their formal training by completing and submitting evidence of further equivalent academic case studies as part of their application. This document establishes standards and criteria for the assessment of written case studies where the assessment takes place outside the regulations of an academic body. A Suitable Assessor When selecting an assessor to mark an academic case study for the purposes of BABCP Accreditation, the assessor should be Fully Accredited with the BABCP, or be a Cognitive and/or Behavioural Psychotherapist who meets the BABCP criteria for Accreditation. In addition, they should be experienced at working within post graduate academic settings, providing assessments for post-graduate level academic work, and with recent experience as a Lecturer or Tutor on an academic post-graduate CBP training course or equivalent.The assessor may, however, currently be independent of an academic institution. General Standards Most Cognitive Behavioural Psychotherapist professional positions, both in the NHS and other organisations are graded in remuneration and status terms at a professional level, suggesting a requirement of post-holders to be trained to identifiable standards. Most C/BP training is also at post-graduate Diploma or Masters Degree level.Therefore those assessing written case studies should set a general standard of contents, writing style, layout, structure, graphics and presentation that is commensurate with post-graduate academic work. In addition to the above, because CBP practice emphasises evidence-based treatment, the written case studies should demonstrate a professional ability to not only show a theoretical and research based rationale for a particular approach to a client’s treatment, but also show a knowledge of alternative CBP methods and present an argument as to why these were not used. Marking Criteria These criteria are provided as guidance for assessors of written case studies for the purposes of practitioner accreditation. All areas need to be adequately addressed and given equal weighting. It is strongly recommended that assessors give robust feedback when marking case studies and that they look for a reflective element with a view to reinforcing new learning, as would be done if the report were marked as part of an academic university programme. Assessment Evidence of structured assessment, including the following: • anonymous biographical data 18 • current social circumstances • current presenting problem(s) • diagnosis • co-morbidity • reason for seeking treatment at this point • definition of current problem • current coping • development of the problem • previous treatments • relevant personal history • risk assessment • use of appropriate standardised psychometric measures and idiographic measures • identified treatment goals • socialisation to the model • suitability for CBT Literature Review • detailed description, explanation and critical evaluation of the CBT model(s) underpinning the interventions • reasons for choice of model • theoretical framework underpinning the model • evidence base from clinical outcome studies • evidence base from exploratory or experimental studies • model’s strengths and weaknesses • adaptations to the model needed for the case • challenges to treatment delivery Case Formulation • evidence of individualised formulation at maintenance or cross-sectional level in keeping with model of disorder/generic model • explanation of links between elements in maintenance cycle • diagrams of maintenance cycles (and longitudinal formulation, if appropriate) • identification of a trigger or critical incident/explanation of onset of problems (precipitating factors) • underlying beliefs/assumptions (predisposing cognitive vulnerability factors) and explanation of links between these and maintenance cycles • explanation of how past events may have contributed to/reinforced the beliefs • indication of missing data • coherent, parsimonious formulation developed collaboratively over treatment with explicit patient contribution Course of Therapy and Treatment Outcome • theoretical aims of treatment according to the disorder-specific model used • treatment plan explicitly linked to formulation • clear identification and description of the main phases of treatment and detail on at least two specific change processes, including the cognitive and behavioural interventions utilised and the rationale for their use • excerpts of therapy dialogue • examples of written materials used • justification of any deviation from the model • what the patient learned 19 • therapeutic alliance (interpersonal process) • how difficulties in treatment and ruptures to the therapeutic relationship are understood in terms of the formulation, and how these are managed in session • use of clinical supervision • continued refinement of formulation (if necessary) • treatment outcome in relation to identified changes in problems • progress towards treatment goals • changes in psychometric and idiographic measures • changes to patient’s general functioning • patient’s evaluation of therapy • relapse management plan Discussion • reflection on the therapy and the outcome of treatment • therapist and patient factors that helped or hindered therapy • aspects of treatment that were useful or not so useful • role of the therapeutic relationship • what therapist may have done differently given another chance • the likelihood of treatment gains being sustained over time • broader implications for the model or evidence base. Structure, Presentation, References • overall presentation • coherent structure • flow to sequence of sections • clarity of communication, grammar and spelling • clarity of expression • use of diagrams, tables and/or figures • quality of referencing in text and in reference list • limited, judicious use of appendices (if used at all)