Topic 11a: CBT Competence {by 4/23}

There are two VERY short readings due this week (J. Beck – 1 Chapter; Volungis – 1 Chapter).  For this discussion, share at least two main thoughts: (1) How can it be a problem if CBT therapists has a strong aversion to practicing CBT techniques on themselves?  (2) What are some possible indicators to determine if you are receiving quality CBT supervision?  What type of feedback from your supervisor do you think would be most beneficial to your professional development as a CBT therapist?

 

Your original post should be posted by 4/23.  Have your two replies posted no later than 4/25.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

37 Comments (+add yours?)

  1. Monica K Teeven
    Apr 13, 2020 @ 10:35:01

    1. It can be a problem if a CBT therapist has a strong aversion when practicing CBT techniques on themselves because if a therapist does not see the benefit of using these techniques on themselves, the likelihood that your clients will notice this will be high. This can lead clients to feel that their therapist is being ingenuine which will lead to a reduction in their level of hope and motivation for altering their current functioning. This will lead to an unsuccessful outcome for the client.

    2. One indicator is if the CBT supervisor has been fully trained in CBT and is experienced in this theoretical orientation. These supervisors will have a better chance of providing helpful information for becoming fully skilled in CBT. Another possible indicator is if your supervisor says they are familiar with CBT or that their theoretical orientation is not important. Someone being familiar with CBT does not mean they are fully trained in CBT. They may not be able to give you beneficial advice about how to improve your CBT skills. In addition, the theoretical orientation a therapist uses is important, so a supervisor that says that it is not, would be a huge red flag.

    I would want any kind of feedback from my supervisor that would help me become a better therapist. However, I would want my supervisor to provide me with feedback in a way that is constructive, polite, and honest. I would want my supervisor to give me a list of which skills I need to work on and rank them in order of importance. This would allow me to know which areas I need to focus on improving first and after a month or so, I would want my supervisor to reevaluate these skills. In addition, I would want my supervisor to tell me which skills I am doing well on because this will help my level of self-esteem and self-efficacy when attempting to improve my CBT skills.

    Reply

    • Jess Costello
      Apr 13, 2020 @ 13:22:15

      Hi Monica! I loved your last paragraph about the kind of feedback you want from a supervisor. I would also want them to be direct and honest but also polite and telling me what I am doing well in addition to the skills I need to improve. It’s important to balance criticism with compliments to keep us going.

      You also made great points about what to look for in a competent CBT supervisor. I hope that we will be receiving quality supervision as we begin our practicum and internship training, but I also feel that we will be comfortable navigating working with people who have different perspectives. Great work on your blog!

      Reply

    • Ashley Foster
      Apr 15, 2020 @ 21:56:24

      Hi Monica! I like how you mention the clients finding therapists to be ingenuine and those effects on the therapeutic relationship if a therapist has a strong aversion when practicing CBT techniques on themselves. I agree that therapists should fully be able to complete these tasks and be in a good state of mind before working with clients. This cannot only harm the therapeutic relationship, but it may also make the client unsuccessful in session as you mentioned. This could deter the client to future sessions or even coming back to therapy in general. Great job with the post!

      Reply

    • Melanie Sergel
      Apr 17, 2020 @ 20:16:24

      Hi Monica! I also think that if the therapist has a strong aversion when practicing CBT techniques on themselves that they will not see the true benefit on using the techniques. I like that you state that you would like any kind of feedback that would help you become a better therapist. I would also like the feedback to be polite. Receiving this feedback will help us know what we need to work on and if we do not receive honest feedback we will not know what we are doing wrong or right. Good job!

      Reply

    • Taylor O'Rourke
      Apr 21, 2020 @ 11:27:32

      Hi Monica!

      I think you did a fantastic job describing the type of feedback you would want from your supervisor. I think it is super important to have that feedback delivered in a positive, polite manner as you mentioned. Also, I like how you mentioned you would want your areas to work on in a ranked list that would then be up for reevaluation. I agree that this is an objective, concrete way to track your progress as a therapist-in-training over time. Getting feedback is great, but if it is not continuous and revisited over time, I would argue that it is quite useless. I also agree with your point about how the supervisor should make a point to discuss the things you did well because this will definitely help our confidence when we are just beginning sessions on our own.

      Reply

  2. Jess Costello
    Apr 13, 2020 @ 13:19:40

    1. If a CBT therapist doesn’t practice the techniques on themselves, clients will probably notice this and make the interpretations that not only are the techniques a waste of time if even the therapist doesn’t believe in them, but also that the therapist isn’t being genuine by asking the client to do something he or she doesn’t think is useful or is too difficult to incorporate into a daily or weekly routine. Both of these can negatively impact the course of treatment and what the client gets out of therapy, as well as the overall therapeutic relationship between the client and the therapist.

    2. Quality CBT supervision means that my supervisor has been fully trained in CBT and uses this theoretical orientation to guide assessments, treatments, and interventions with their own clients as well as using it to evaluate my work as a trainee. If the supervisor says that theoretical orientation is not important or has no bearing on client outcomes, this is probably a red flag that they are not trained in CBT or an expert on using these techniques and would probably not give the best CBT supervision.

    I would want my supervisor to be both direct and polite when evaluating my performance. I want to know what I am doing well as well as the particular skills I can improve. I would want to know what’s most important to work on in the specific populations we serve in order to improve my functioning as a clinician.

    Reply

    • Melanie Sergel
      Apr 17, 2020 @ 20:11:46

      Hi Jess! I agree with you that if a therapist does not practice the techniques on themselves the client will notice this. The client will then be hesitant to the techniques and like you said, they will think it is a waste of time. I also would like to receive direct and polite feedback from my supervisor. This way we can learn what skills need improvement and we can work on them. Good job on your post!

      Reply

    • Erin Wilbur
      Apr 20, 2020 @ 08:24:46

      Hi Jess!
      You’re definitely right about the poor outcomes a client would have if their therapist didn’t even bother to complete techniques on themselves that they’re asking of a client. If the therapist deems these techniques as a waste of time and doesn’t try to use them in their own life, it is unfair for them to expect a client to do the same. This can also damage rapport with a client, which we know is an important part of effective therapy. A therapist can’t be considered competent if they can’t relate to the work they’re asking of their client, and as a client I wouldn’t want a therapist who has limited understanding of the challenges that could arise when being asked to complete these techniques.

      Reply

  3. Monica K Teeven
    Apr 13, 2020 @ 15:02:14

    Hey Jess! In your response to question 2, you mentioned that you would want to know which skills are more important based on the specific population you are working with. This is a really important factor and this is one of the reasons why I wanted an internship where I can work with adults. I have only ever worked with children and I need to gain more skills and overall experience working with adults. Great job on your post Jess!

    Reply

  4. Jenna Nikolopoulos
    Apr 14, 2020 @ 18:10:13

    1. It can be a problem if CBT therapists have a strong aversion to practicing CBT techniques on themselves because clients will most likely pick up on this, which will cause them to view you as insincere because why would they want to try these techniques on themselves if you won’t even try the techniques on yourself? Clients come to therapy to learn the necessary skills that will help reduce their problems and allow them to function more adaptively in daily life. If therapists don’t believe in these techniques or even think they are useful, the insincerity that clients sense will cause them to lose motivation and hope for change, which will result in them having poor treatment outcomes.

    2. One possible indicator to determine if you are receiving quality CBT supervision is if your supervisor is trained in CBT because the more experienced your supervisor is in CBT, the greater potential you have to learn and master CBT skills. Another indicator is that if your supervisor is able to observe your therapy sessions live (e.g., one-way mirror, video feed), this allows them to continuously assess your therapeutic skills. A third indicator is if you are engaging in group CBT supervision as this can help you develop technical skills and assist in your conceptualization and treatment planning skills.

    I think feedback that is direct and honest and tells me exactly what I am good at and need to work on would be beneficial to my professional development as a CBT therapist because then it would indicate to me what areas in my skillset I need to improve on. I would also want this feedback given to me in a constructive and polite way as it is already nerve-racking enough having to do this on my own for the first time and I would like to know that my supervisor is supportive and open to answering any questions that I may have. I would also want my supervisor to continuously provide me with feedback on my skills to make sure that I’m improving in the areas I need to, and if I’m not, give me advice on what I could do to improve.

    Reply

    • Jess Costello
      Apr 15, 2020 @ 12:04:56

      Hey Jenna! I agree that clients will have trouble agreeing to practice CBT techniques or believe in their effectiveness if they can tell that their own therapist doesn’t even believe in the techniques enough to practice them on their own.

      You also had a great summary of what you want in a competent CBT supervisor who will give you constructive feedback on what you’re doing well as well as what you need to improve to lead your clients to better outcomes. I would also want my supervisor to give me continuous feedback. Good job!

      Reply

    • Ashley Foster
      Apr 15, 2020 @ 22:02:29

      Hi Jenna! I like you point of a quality supervisor giving greater potential for supervisees to learn through observation of live session. As most of us have learned from working in various sites thus far, Live sessions really master our skills. supervisors that are able to observe their supervise is in session can better give feedback and on the other hand, it gives the supervisee the opportunity to see how session should be run. This gives a better understanding to the supervising on what needs to be worked on and how to do so in hopes of being successful and fine tuning their skills. This also strengthens the relationship between the supervisor and the supervisee so greater in-depth, specific feedback can be given. great job with the post!

      Reply

    • Taylor O'Rourke
      Apr 21, 2020 @ 11:35:11

      Hi Jenna!

      I think you really hit on the major points of what makes a good supervisor. We should definitely be looking for someone who has extensive training in CBT and really believes in its techniques; not someone who is just familiar with some skills and does not believe having a set theoretical orientation is really important to clients’ therapeutic outcomes. Also, it is true that the supervisor’s ability to see/listen to sessions is another important factor. I believe this gives them a better look into how our skills are developing and it is an objective way to learn and discuss. Lastly, group supervision is also important as we know, so any worthy supervisor should allow for this type of supervision in some capacity as well.

      Reply

    • Mariah Fraser
      Apr 22, 2020 @ 23:04:25

      Hi Jenna!

      I can relate to one of your responses about hoping that your supervisor is polite as well as constructive because it can be an intimidating experience of providing therapy on your own for the first time. I also hope that I have a good relationship with my supervisor so that I feel comfortable asking questions and still feeling supported by him/her. It’s also important to feel like I’m being given continuous feedback so that I know I’m still heading in the right direction, and I’m aware of any skills that I should focus more or less on.

      Reply

  5. Monica K Teeven
    Apr 15, 2020 @ 10:07:18

    Hi Jenna! An important factor that you mentioned in your blog post that I did not in your response to question 2, was if your supervisor is able to observe your therapy sessions, ideally live through a video feed or a one-way mirror. If your supervisor is not observing your therapy sessions, there is no way they can provide you with constructive feedback. A supervisor who does not provide constructive feedback to you is not only hurting your chances of improving your therapeutic CBT skills, but also the quality of therapy you are providing to your clients. You did a great job on your post!

    Reply

  6. Ashley Foster
    Apr 15, 2020 @ 21:52:18

    1. It can be problematic for a CBT therapist have a strong aversion to practicing CBT techniques on themselves. If the therapist is unwilling to work on problems that they are having, they are less likely to want to use these practices an exercise on their clients. This is problematic as the therapist is taking away treatment from the client that could be beneficial for their success. Furthermore, without practicing these CBT techniques on themselves, they do not get to fully understand what they’re asking of their clients. This can be problematic as the therapist will not be able to give adequate feedback on exercises and understand potential challenges that their client is experiencing on completion.

    2. Some possible indicators that determine on if you are receiving quality CBT supervision include feedback that sharpens the therapist skills while in training. This includes skills such as interventions, assessments, exercises, and theoretical approaches. These techniques should be matching with what we have learned within the classroom structure and are beneficial in strengthening us to be quality CBT therapists. Furthermore, having supervisors that have been in the field and are well known for being quality therapists by other past and present supervisee’s and colleagues who are successful in the field is a sign for success. Having this word of mouth information can better reassure that we are in good hands for our training.

    The type of feedback from our supervisors that are most beneficial for our professional development as a CBT therapist, are such that sharpen our skills and putting our knowledge into practice. As we go into the field and out of the classroom, we should be able to use our knowledge from our professors and our readings and bring them into play. supervisor should have this knowledge and better guide us into using these practices in real life with our clients. also, quality CBT supervisors should be challenging us I’m pushing our skills even when we are unsure in giving us feedback that we can do to better be successful in session. This way we are not going in blind but more of a trial and error on what works for what types of clients and settings and how to be successful in doing so.

    Reply

    • Jenna Nikolopoulos
      Apr 16, 2020 @ 16:01:20

      Hi Ashley! I liked what you said about therapists having an aversion to practicing CBT techniques. Just because the clinician doesn’t see the benefit of using these techniques on themselves, does not mean it won’t be beneficial for the client. When the time and effort is put into these techniques, they can prove to be effective. Also, if a therapist won’t even work on their own problems, how do they expect to help their client work on their problems? Gaining insight through working on yourself is helpful when helping clients do the same because it allows you to guide them in the right direction. Therapists can’t expect clients to understand how to do these techniques and how to gain from them if they don’t understand the techniques themselves.

      Reply

    • Erin Wilbur
      Apr 20, 2020 @ 08:20:22

      Hey Ashley,
      I like your point that a good supervisor should push you to be a better therapist and make better use of your skills, though I’d definitely have to be comfortable with my supervisor first before I would want them to push me. I think a supervisor who acknowledges your skill and tells you what you’re doing right before pushing you to do techniques or use skills you’re less comfortable would be more effective for me. As long as the supervisor understands your needs and accommodates them while also encouraging you to try new things, your relationship will be a success!

      Reply

  7. Melanie Sergel
    Apr 17, 2020 @ 20:08:25

    (1) It can be a problem if CBT therapists have a strong aversion to practicing CBT techniques on themselves for several reasons. It can be a problem because if a therapist does not want to complete the techniques, they will not truly know the benefit it has for the clients. The therapist will also not know what the client emotionally or cognitively went through when completing the techniques. These techniques can be difficult for the client and how can a therapist understand the client’s difficulty if they did not try it themselves. The client will also not see the importance of or be hesitant to the techniques if the client knows the therapist will not try it on themselves.

    (2) One indicator to determine if I am receiving quality CBT supervision is if my supervisor was trained in CBT. Also, not only would they be trained in CBT but are experienced with it. If your supervisor is not trained in CBT or experienced, then there is a high chance that you are not receiving quality CBT supervision. It is also an indicator if the supervisor is using the same techniques that we have learned in class. If they are using very different techniques that I have not heard of or understand then it is possible that it is not high-quality CBT.

    I would like to receive honest feedback from my supervisor. If my supervisor is direct with me then I will know what I have to work on and can learn from it. Receiving honest and direct feedback is not a bad thing, it helps an individual grow and become more experienced. It is also important that the feedback is given politely because I never want to feel like I am stupid. If that is the case where a supervisor rudely gives feedback, it is harder to ask that supervisor questions and discussing how to fix my areas of growth.

    Reply

    • Jenna Nikolopoulos
      Apr 18, 2020 @ 18:30:52

      Hi Mel! I definitely agree with what the kind of feedback you’d want to receive from your supervisor. I think some people are afraid of honest feedback because people want to know that they did well and not the things they didn’t do so well, but receiving honest feedback in this field is important because our skills won’t improve if we don’t know exactly what we need to work on. I also agree that feedback should be given in a polite way because if the supervisor is rude, personally, it would deter me from wanting to reach out and ask about which areas I need to work on because I won’t feel comfortable enough approaching them with my questions or feel like my questions are welcomed.

      Reply

    • Shelby Piekarczyk
      Apr 21, 2020 @ 08:31:03

      Hi Mel,

      I agree that when receiving feedback I would like honest/direct feedback. I believe that without honest and direct feedback we, as trainees, will not fully benefit from supervision. By receiving direct and honest feedback we will gain knowledge and insight on areas that we may lack in as therapist, giving us the opportunity to become more efficient in these areas. This also helps us see areas that we may be unaware we are lacking in. By having honest and direct feedback it will only benefit us as future therapists and help us towards becoming effective CBT therapists.

      Reply

    • Mariah Fraser
      Apr 22, 2020 @ 23:04:02

      Hi Mel!

      I mentioned in a previous reply that it’s important for me to feel comfortable with asking my supervisor questions, because it can be intimidating providing therapy alone for the first couple of times. I would be very hesitant to ask questions if my supervisor communicated in a way that was rude or condescending. After all, I’m there to learn and I’m going to make mistakes, so supportive guidance would be most effective for me. I would get much more out of my supervision if there was mutual respect from both myself and my supervisor.

      Reply

  8. Erin Wilbur
    Apr 20, 2020 @ 08:15:24

    1. It can be a problem if CBT therapists have a strong aversion to practicing these techniques on themselves because it means they will lack insight when using these techniques with clients. CBT therapists who use CBT techniques on themselves have a greater understanding of the challenges clients may face when completing these techniques, as well as what helps them feel better. If therapists don’t first practice these skills on themselves, they may lack empathy and skill while in session, because they don’t have a full understanding of how the techniques benefit someone who is feeling distressed. They may come off as detached or uncaring to a client when explaining or going through the techniques, because they won’t understand the difficulty of completing them. This lowers the level of client care because the client will think the techniques are unimportant if their therapist wouldn’t bother to complete them either, which delays treatment progress and makes CBT less effective.
    2. Some possible indicators to determine if you’re receiving quality CBT supervision include the supervisor asking to observe your sessions, or requiring an audio/video recording if possible, so that they can be sure to get all the details from your session and provide feedback on your responses to your client, which can be lost if you only self-report your sessions. It is also important that your supervisor identifies him or herself as a CBT-oriented therapist, so that you can be sure you’re receiving advice from someone who is trained in the field rather than someone who has not studied it or isn’t familiar with the techniques. Feedback from my supervisor that would be beneficial to my professional development would be someone who is understanding and kind, so I won’t feel embarrassed or afraid to talk with them about messing up or being unsure of what to do. I’d also like someone who is comfortable telling me about their own experiences as a CBT therapist, so that I can learn both what I should be doing and what I should avoid. Lastly, I’d need a supervisor who I’m comfortable asking questions and discussing sessions with, because I won’t be able to learn if I feel uncomfortable asking questions that I’m not confident in answering myself.

    Reply

    • Shelby Piekarczyk
      Apr 21, 2020 @ 08:27:53

      Hi Erin,

      I think you make a great point when you state that therapists who have an aversion to practicing these techniques on themselves with lack insight to these techniques. Just as we have learned in class it is extremely important to complete the techniques on yourself because you truly get a feeling for how much effort one must put in and how to correctly complete each one. Before completing each technique on myself I was unsure how to correctly complete one and how long it would really take me to accurately fill one out. After completing them I learned a lot about myself and ultimately realized how important/ the effort that one must put in to complete each technique. Additionally, I agree that by not completing these techniques yourself this shows to the client that you do not care and that each worksheet is not important. This can greatly harm the client’s motivation within therapy and alter the outcome of treatment. Great job!

      Reply

  9. Renee Gaumond
    Apr 20, 2020 @ 19:36:04

    (1)
    It’d be a problem if a CBT therapist had a strong aversion to practicing CBT techniques on themselves because it may come off as ingenuine to the client if the therapist doesn’t see how the techniques that they want the client to use as helpful to themselves. The client may lose motivation to complete homework if the therapist doesn’t believe that the techniques work. It’s difficult to advocate for a technique that you aren’t willing to take part in. The client could notice that the clinician doesn’t have a lot of faith in the technique, then they might wonder why they should even try it.
    (2)
    Some indicators to determine if you are receiving quality CBT supervision are live viewing sessions and a supervisor with a lot of experience. Supervisors with a lot of experience will be able to teach you more things at better quality since they have spent more years perfecting their own skills as well as exposure to the field itself. Also live supervisions is best because it gives the right context and allows for constant assessment for the skills.
    I think the type of feedback that would be beneficial to my professional development as a CBT therapist would be focusing on areas of improvement and areas of strength. I think if my supervisor were to only focus on the things I did wrong, I would assume that I am doing everything wrong. This might make me overthink my skills and have a negative outlook on my potential. I find it important to know what I do right in order for me to find confidence in what I’m doing while I try to improve my other skills.

    Reply

    • Robert Salvucci
      Apr 22, 2020 @ 22:30:09

      Hi Renee!

      It’s definitely more difficult to advocate for and emotionally be behind approaches that you have not utilized for yourself. This can create an air of being disingenuous and lacking faith in an approach. I like the way you phrased that live feedback allows for the right context for suggestions, as they can be applied in real time. It’s also important to have balanced feedback as well, only focusing on the negative can be demoralizing, and not providing any criticism can come off as flaky and missing an opportunity to learn

      Reply

    • Madison Armstrong
      Apr 24, 2020 @ 13:21:50

      Hi Renee,

      I also would want feedback about my strengths from my supervisor. I think that this type of feedback would be beneficial because it is positive and will help gain confidence and self-efficacy in practicing CBT skills. I would also want to know in which areas I could improve. This type of feedback is also important to receive because as new professionals to this field, we will definitely make some mistakes. It would be helpful to know which areas to work on so we can be effective counselors.

      Reply

  10. Shelby Piekarczyk
    Apr 21, 2020 @ 08:23:55

    1. It can be a problem if a CBT therapist has a strong aversion to practicing CBT techniques on themselves for many reasons. First, if the therapist does not see these techniques as beneficial this could translate to their client, making the client less likely to want to complete each technique. Additionally, this could create a ‘what’s the point’ attitude, decreasing the client’s motivation within therapy. This could also create concern with the therapy of CBT for your client because if the therapist does not believe in the techniques or their importance, the client could feel that something must be wrong with this therapy/ that CBT does not work. This could greatly alter the outcome for the client.

    2. One indicator to determine if I am receiving quality CBT supervision is if my supervisor was trained/ has experience in the field using CBT. Furthermore, when being supervised my supervisor should be full of knowledge and giving me constructive criticism on how to correctly implement the CBT techniques. If my supervisor does not further teach me about the CBT techniques, then it is possible I am not receiving quality CBT supervision. Another indicator that I am not receiving quality CBT supervision is if I am more knowledgeable on the CBT techniques than that of my supervisor. This could show that my supervisor was not trained nor practices CBT, resulting in more CBT supervision.

    The feedback that I would like to receive from my supervisor is direct feedback and constructive criticism. I would like my supervisor to inform me when I may be doing something wrong or an area that I could use improvement. During supervision I want to sharpen my skills and take away as much knowledge as I can. The way this will be possible is with direct/honest feedback on how to better improve myself as a CBT therapist.

    Reply

    • Robert Salvucci
      Apr 22, 2020 @ 22:23:58

      Hey Shelby!

      I definitely agree that being unfamiliar with using techniques on yourself can create a sense of apathy within sessions. As you noted, this can also impact a client’s attitude towards therapy in general, which could significantly decrease their motivation and lead to termination or giving up on trying. I hadn’t thought about the possibility of being more knowledgeable about CBT than my supervisor, but that would certainly be and unfortunate situation XD

      Reply

  11. Taylor O'Rourke
    Apr 21, 2020 @ 11:13:46

    1. How can it be a problem if CBT therapists has a strong aversion to practicing CBT techniques on themselves?

    Being a competent therapist involves practicing CBT skills during sessions, but also practicing the skills on oneself. This can be especially helpful when one is feeling distressed. It is extremely important to have an idea of what it feels like to be on the receiving end of the therapeutic relationship as the client; it provides therapists with greater self-awareness and insight. In turn, this helps build a greater skills competency and sense of empathy when working with clients. Some of the CBT skills therapists can practice on themselves include monitoring daily and weekly activities (i.e., behavioral activation), monitoring/modifying thoughts/emotions (e.g., use a negative automatic thought record), and using exposure techniques for any anxiety that may arise. It can be problematic if CBT therapists have a strong aversion to practicing some of the techniques. This will more than likely be noticed by the therapist’s clients if they think the technique is “stupid” or will not necessarily work on themselves. This comes off as disingenuous to clients and will eventually decrease their motivation and hope for change to occur. This will affect treatment outcomes.

    2. What are some possible indicators to determine if you are receiving quality CBT supervision? What type of feedback from your supervisor do you think would be most beneficial to your professional development as a CBT therapist?

    One possible indicator to determine if you are receiving quality supervision is your supervisor is very experienced in CBT skills. As a trainee, it is better to learn from someone with more experience because this will provide better opportunities to learn and master the skills in the same way they have. Supervisors who are just “familiar” with CBT are not a great option. It is ideal to have the supervisor view the trainee’s sessions live either with a one-way mirror, ear bud, or video feed) that way there is a lot of contextual information provided and the supervisor can continually assess for therapeutic skills. This also allows for self-reflection. Verbal reports are not as useful as video reports because details can often be left out, information could be misinterpreted, and the trainee can attempt to only present themselves positively. Group CBT supervision can be helpful as well because it encompasses conceptualization and treatment planning skills as well as developing technical skills. There is a lot of value in watching other CBT therapists at varying levels conduct sessions as well. Personally, the type of feedback I think would be most beneficial to my professional development as a CBT therapist is mostly constructive criticism with some positive comments integrated as well. I learn the most from hearing what I could do better next time and how maybe something I did would have worked out better if I chose a different skill or technique to use. However, receiving positive feedback will also give me the confidence that I am doing okay and will continue to grow and learn along the way.

    Reply

  12. Robert Salvucci
    Apr 22, 2020 @ 22:15:50

    1. I see a few reasons that an aversion to practicing CBT techniques on oneself can be a problem

    An aversion to practicing these techniques can be an indication that the therapist does not believe CBT to be effective, or that they are unwilling to engage in the difficult self-reflection they are asking of their clients. Having direct experience with the techniques allows therapist to have a stronger sense of what the potential obstacles and benefits are when using these techniques. Seeing benefit from them and regularly practicing them not only increases confidence in the techniques, but is also very likely to foster insight into areas that a therapist can benefit from working on in themselves to become a more effective therapist (as well as a happier, more well-rounded person!). Clients will also likely pick up on a therapist’s hesitation, and the process of CBT will be impacted negatively. Practicing exercises are beneficial for one’s mental health in general and allow one to develop skills as a therapist more effectively.

    2. Quality CBT supervision will consistently reference and reinforce the CBT model, while highlighting strengths and weaknesses. A supervisor should be direct and comprehensive in providing guidance and feedback to a training clinician. They should be well-versed with the theory and techniques that are central to effective CBT. Opportunities to observe CBT work in action are very helpful, as is having a supervisor observe and give feedback on your sessions.

    I would ideally like a supervisor who is direct in giving feedback while being empathic and supporting my curiosity. A mixture of being able to provide guidance while also answering questions I have related to the process. Being too rigid an authoritative can squash my curiosity and desire to learn, while being too open ended can leave me frustrated and looking for definitive answers elsewhere. I hope to have supervision that is both informative and directive while helping me foster my own style.

    Reply

    • Madison Armstrong
      Apr 24, 2020 @ 13:15:08

      Hi Bobby,

      I agree with you that an aversion to practicing CBT techniques on themselves appears that they do not believe CBT to be effective. As we have learned in class CBT entails a lot of self-reflection. As a CBT therapist you want to be able to gain that insight for yourself to be an effective counselor. It is important that the counselor has worked through troublesome areas in their own personal lives and practicing CBT techniques on themselves gives them this opportunity. Practicing techniques will also help them gain confidence and knowledge with using these techniques in practice.

      Reply

  13. Mariah Fraser
    Apr 22, 2020 @ 22:47:29

    1. If a therapist has an aversion to using CBT techniques on herself, that is a problem because it would be noticed by the client. If the therapist doesn’t see the benefit of using these techniques, then she is going to come across as disingenuous. Additionally, instilling a sense of hope to the client is important, and if the therapist has found that specific exercise to be beneficial to her own personal life, then she can provide psychoeducation with a stronger sense of encouragement, as well as empathy due to experiencing the challenges the client may face. Coming across as disingenuous is not only damaging to the client’s motivation and level of hope, but also to the therapeutic alliance because the trust will be lost.

    2. Some indicators of quality CBT supervision would be that the supervisor has confirmed that her theoretical orientation is CBT and has had extensive training and experience, for starters. Additionally, it’s best for the supervisor to observe sessions live through the use of a one-way mirror, video-feed, or an earbud. If this isn’t an option, the next best thing would be to have the sessions video or audio recorded for both the supervisor and supervisee to review.

    3. Building off of the previous answer, I would want to make use of live supervision or recorded sessions because it would help pinpoint the exact skills that I haven’t yet mastered. This form of supervision would provide more contextual information and allow for continuous assessment of therapeutic skills and self-reflection. I would expect constructive feedback that would highlight strengths or positive moments, as well as identify skills that need more work and suggestions as to how to be more effective in those ways. This direct communication would help me become a better therapist who has the ability to provide effective treatment to my clients.

    Reply

    • Tim Keir
      Apr 25, 2020 @ 20:30:48

      Hey Mariah!

      I agree, it will be completely transparent to a client that a therapist has disdain for or inexperience with a technique. Not only will a counselor who hasn’t done it themselves sound disingenuous, but they’ll likely be less confident in general about the process.

      I also agree that the more information the supervisor can observe, the better the advice will be in turn. Hopefully we will be able to find such supervision in the near future. Great post!

      Reply

  14. Madison Armstrong
    Apr 23, 2020 @ 12:46:10

    (1) How can it be a problem if CBT therapists has a strong aversion to practicing CBT techniques on themselves?

    It can be a problem if a CBT therapist has a strong aversion to practicing CBT techniques on themselves for many reasons. If a CBT therapist does not want to practice CBT on themselves, then they may not believe in the benefits of CBT. This can come off as disingenuous to your clients and lead to poor treatment outcomes. As a CBT therapist you want to motivate your client and if you are not motivated yourself, then most people will be able to pick up on that resulting in a lack of motivation from the client. Also, part of CBT is the ability to be empathetic towards your clients. Practicing CBT on yourself, will help you to develop empathy and CBT skills to use with clients.

    (2) What are some possible indicators to determine if you are receiving quality CBT supervision? What type of feedback from your supervisor do you think would be most beneficial to your professional development as a CBT therapist?

    I think that a good indicator that I am receiving quality CBT supervision is that the supervisor is trained in CBT and practices CBT techniques regularly. I think that it would be high-quality supervision if I saw a supervisor using the same techniques that we have learned in the classroom. It would be a strong indicator of quality CBT supervision if the supervisor took an interest in supervision and gave high quality feedback about CBT techniques and their implementation. Although not always possible, another indicator would be that the supervision be taken place live or video recorded to provide the supervisor with more context. I think that the best type of feedback for my professional development as a CBT therapist would be positive and constructive feedback. I think that positive feedback will help to build my confidence and self-efficacy as a CBT therapist. But I also would like my supervisor to provide me specific feedback as to what I can do to improve my skills.

    Reply

    • Tim Keir
      Apr 25, 2020 @ 20:37:48

      Hey Madison!

      It really would be alarming for a client if your counselor was opposed using their own techniques on themselves. I absolutely agree it would dissolve any confidence the client had in the counselor to be doing what is best for you.

      I like that you mentioned having the supervisor be available to properly show you CBT techniques and his enthusiasm for the role. It is not guaranteed that we will receive as supervisors those who are particularly interested in supervising! Hopefully that will not be the case however. Similarly, I am hopeful that our supervisors will be well-versed in CBT and able to teach us properly. Video or live feedback seemed the best for me too, though I understand there would likely be complications in managing that sort of feedback all the time.

      Reply

  15. Tim Keir
    Apr 23, 2020 @ 21:43:51

    1. How can it be a problem if CBT therapists have a strong aversion to practicing CBT techniques on themselves?

    There are so many red flags that come up with the idea of a therapist unwilling to practice the psychological techniques they preach, the same dread that one gets from a skinny cook or a fat personal trainer. If one truly upholds the value of their own expertise, why don’t they follow it in their own lives? How is a client supposed to trust a professional who doesn’t partake in what they peddle?
    There are all sorts of easily imagined justifications that a counselor could take for this sort of stance: “I don’t need it, I’m already emotionally healthy.” “My own experiences don’t tell me anything about the clients’”, etc. etc. Yet for CBT, it seems if one truly does not wish to put themselves through the techniques even after having a firm grasp on the theory, it seems to imply one or both: that they are afraid of examining their own cognitions and behaviors further, or they do not actually and fully believe in the positive outcomes such techniques provide. Neither beliefs seem indicative of a good CBT counselor. Their aversion to experiencing CBT techniques should be examined- ironically a CBT technique like an automatic thought record or anxious patterns record may benefit this process. One must understand themselves before attempting to understand others, and resistance to that concept shows that there is more to unpack.

    2. What are some possible indicators to determine if you are receiving quality CBT supervision? What type of feedback from your supervisor do you think would be most beneficial to your professional development as a CBT therapist?

    The first step to ensuring proper cognitive-behavioral supervision is occurring is ensuring that the supervisor in question is actually qualified to give CBT training. An individual not familiar or only partially aware of CBT strategies won’t have the knowledge to better hone our own CBT skills. On top of that, the way in which the supervision is being given is valuable as well. Giving the supervisor direct observation of your sessions so that practical advice can be given. Either observed live or recorded in video, I would personally prefer that the supervisor can comment on both my words and my body language.
    What I would be looking for in a supervisor are alternative solutions and ideas for situations I suggest. Especially in counseling there will always be subjective decisions and creative solutions to the many problems and goals of clients. In that regard, I want to be exposed to as many different ways that experienced counselors would approach variable situations as possible. Of course I want advice on things like my affect and therapeutic rapport-building, but I would be most interested in hearing the different approaches different counselors would take for organizing sessions and treatments.

    Reply

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Adam M. Volungis, PhD, LMHC

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