Topic 9: CBT Competence & Myths {by 5/3}

There are two short readings due this week (J. Beck – 1 Chapter; Wright et al. – 1 Chapter).  For this discussion, share at least two main thoughts: (1) Once you graduate from Assumption College with your degree (and later get licensed) what can you do to maintain and improve your competence as a cognitive-behavioral therapist? (2) Name at least one CBT stereotype/myth/criticism you have heard from other people/professionals. What are your thoughts when you hear such comments? Your original post should be posted by the beginning of class 5/3.  Replies are not required for this blog.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

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10 Comments (+add yours?)

  1. Tori Bryant
    May 01, 2018 @ 20:39:14

    1) Once I graduate from Assumption College and get licensed, I hope to do maintain and improve my competence as a CBT therapist in many ways. In the early stages of my counseling career, I would hope to have a helpful and insightful supervisor who I could rely on as a mentor and guide. I feel that having someone to process and receive concrete and constructive feedback from will be imperative for my development. I would also try to develop healthy, professional relationships with my co-workers in order to have support systems and also gauge where I am at in a healthy form of comparison. Reading relevant and up to date articles will also assist me in staying in touch with how the field is progressing and new findings in CBT research. Conferences with fellow professionals in the field will assist me in processing and learning techniques. It will be important that I also do the activities I am asking my clients will do so that I can make accurate recommendations as to what interventions to use, I can understand what they may find difficult about the various tasks I ask them to complete for homework, and observe where I can find trends and patterns within the records they fill out. Being in touch with social justice issues will be imperative to ensure I am understanding what could be influencing my clients in their day-to-day lives.
    2) I have heard that CBT is too scientific and un-feeling. My first reaction is that I understand where that comes from because CBT is based off of evidence and scientific methods; however, that is not the entire picture. CBT therapists need to relay the evidence and findings to their clients with a lot of empathy and care. In order to uncover the evidence found in CBT sessions, there has to be a therapeutic alliance that is founded upon collaborative empiricism, which requires the client to trust the therapist. When people say CBT is un-feeling, it is clear to me that they have only chosen to see a part of what really transpires in those sessions.

    Reply

  2. Teresa DiTommaso
    May 01, 2018 @ 23:50:25

    1. Although there were many different strategies to maintain and improve competence that both Wright and Beck addressed, I feel as if there are only a few that I could see myself actually doing. For example, I would love to go to the different conferences on CBT, but unless my place of employment is paying me to attend, it will probably be a rare occurrence. Therefore, I think it is important to identify which steps one will take on a practical level. Aside from supervisor and feedback, the number one way I will improve my competence in CBT moving forward is through reading different books and articles that have been written on the subject. There is always new research out there and I know that reading a book about CBT is something I can see myself doing and trying out new techniques or being exposed to new ideas as a result. In addition, attending continuing education classes would also be a positive way I could see myself improving and maintaining competence. Not only are certain continuing education classes required for continued licensure, but my lens as an academic would make me feel comfortable attending classes and workshops.
    2. The most prominent stereotype or criticism that I have heard about CBT is that there is little room for a therapeutic relationship or emotion and that it is too skilled-based and not based enough in the client’s interest. As we have all been studying for this semester and others, that is simply not true. I can definitely see how outside professionals and psychologists may see CBT as rigid and not enough about the emotions of the client because that is what I thought at first too. My worries that there was not enough focus on emotions and the client were very swiftly dismissed entering this program and completing this course.

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  3. Stephanie Mourad
    May 02, 2018 @ 22:24:30

    1. An option is to practice cognitive-behavioral interventions regularly and to take advantage of postgraduate education opportunities. Attending workshops, viewing videotapes of accomplished CBT therapists, and going to educational retreats or camps can be used to build basic competency. These experiences can play a useful role in helping clinicians maintain their CBT skills and develop new areas of expertise. Readings in CBT also can help you learn new ways to apply methods and expand knowledge of CBT. Attending ongoing seminars or CBT supervision groups provide stimulating and collegial forum for learning.

    2. One criticism that I have heard is that CBT is not effective at all and I disagree with this because CBT is a collaborative process. The client and the therapist come up with treatment goals together that are effective and appropriate towards the client. The goals are created together so that the client understands the role that he or she is doing and understanding of what is being worked towards. Clients are also expected to do work outside of the session so clients are not sent home without having to work on something or testing a treatment goal.

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  4. Lexie Ford-Clottey
    May 03, 2018 @ 00:23:41

    1. After graduating from Assumption College and later becoming licensed, it is important for me as a cognitive-behavioral therapist to both maintain and improve my competence in order to provide the best possible service to clients. Starting off as a new therapist, I think the best way I can improve my competence is through supervision. Accurate and effective feedback from supervisors can help me better understand what I should work on while also highlighting some of my strengths. Supportive and knowledgeable supervisors can serve as great support networks as I further my career, in which I can exchange knowledge with these individuals or seek advice when needed. Since the field of psychology is constantly changing and expanding, new research is something I should always be aware of, especially when providing psychoeducation to clients. By reading books, articles, or attending workshops I am able to stay current with CBT techniques as well as gain new ideas I could utilize in sessions. I also find it important for me to familiarize myself with the assignments and techniques I may be asking my clients to do in order to gain insight to the obstacles/challenges they may face. For example, by doing my own Thought Record or Core Belief Worksheet I gain greater self-awareness, while also considering the client perspective at the same time.

    2. One criticism I have heard about CBT is that therapy should not be like school, in which many people don’t like the idea that this therapeutic approach emphasizes the importance of homework. I think giving clients assignments to work on outside of sessions is an integral part of the change process, which allows clients the opportunity to track their own progress. I also think homework serves as another way for clients to practice and strengthen the goals they have established for themselves in therapy.

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  5. Abbey Lake
    May 03, 2018 @ 09:09:29

    1.) Once I graduate from Assumption College and get licensed I will maintain and improve my competence as a cognitive-behavioral therapist in a number of ways. I expect to continue to gain experience with cognitive behavioral techniques by practicing techniques on myself before doing so with clients. Beck (2011) discusses the importance of this and how doing this will help you as a therapist to be able to apply techniques in a successful way and identify any potential obstacles that your clients may face. I learned throughout this course that it is very important to remember to consider the client’s role and experience in therapy and to try to uncover any potential obstacles that the client may face so that you are prepared to set the client up for success. I think it is also important for a therapist to be mindful of his/her own cognitions and to continuously strive for self-awareness. I think that especially as a beginning therapist it will be important for me to develop professional relationships with my colleagues and to utilize these relationships for support when needed. Especially as a beginning therapist, in order to improve my skill set I think that it is exceptionally important to rely on my supervisor as a mentor and to take any constructive criticism and apply it as best as I can during therapy. I will also be sure to keep up with reading about new research and techniques and take continuing education courses in order to improve and maintain competence.

    2.) One CBT criticism that I have heard from other people is that “CBT ignores emotions”. I strongly disagree with this statement and I think that this misconception is due to the fact that CBT is heavily based on science and scientific methods. However, CBT works to teach clients the skills that they need in order to improve their emotional state by using such methods that are scientifically proven. CBT uses techniques such as thought records, as one example, to identify the link between a client’s thoughts and emotions.

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  6. Cassie McGrath
    May 03, 2018 @ 09:14:40

    1. After graduating form Assumption there is a lot that I can do to ensure that I continue to grow as a CBT therapist. The first thing that I should be doing is receiving supervision that is CBT based. This will allow for me to discuss my current CBT approaches with a client and also allow for alternative approaches to my current CBT treatment plan. It is important to speak with a supervisor about what is going on in therapy as you may be missing something that someone else picks up on that may be an important piece of the puzzle. In addition, as a continuing therapist it is important to remember that although your formal education is completed there is still room for continuing education classes. As a therapist you should continue to take courses and lectures about CBT to stay up to date with techniques.I also think that viewing how other’s do CBT is important. I think that as a therapist it is easy to get stuck in a singular approach and making sure that there is exposure to other techniques and approaches is important to make sure the clinician is able to provide the best level of care.

    2. I have heard that CBT is to strict in regimen. I do not fully agree with this because the therapist is able to conduct the sessions in a way that is most beneficial to the client. I can see how someone would feel that CBT is strict because it is a lot of work and requires more than just talk therapy. There is more that goes into the CBT process than just the therapeutic relationship and theory. I think that CBT is just not what most individuals envision when they think about a therapy session and what that would look like (blame TV and movies for that).

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  7. Aleksa Golloshi
    May 03, 2018 @ 12:26:48

    1. There are many things I can do to maintain and improve my competency as a therapist once I graduate with my degree. Personally practicing the skills that I am using in sessions with my clients with help me understand what it is like to receive these techniques. This can provide me with great insight on how to use the skills with clients, as well as provide me with self-awareness. Additionally, practicing these skills will build my competency to use the skills and will add to my empathy when working with a client. Another technique I can utilize that’ll help maintain my competency as a therapist is to see a CBT therapist myself. This will help me realize what worked and benefited me, as well as what I think did not personally work. Receiving CBT supervision is also another vital component that’ll help me maintain my competency as a therapist. The more experienced my supervisor is the greater of a chance I have to learn from my supervisor and master CBT skills. Partaking in group CBT supervision will also be beneficial to me because it’ll help me develop my technical skills as well as aid in my conceptualization and treatment plan skills.

    2. A myth I’ve heard regarding CBT is that CBT only treats symptoms and not the whole person. CBT focuses on so many aspects of a person’s life, with the symptoms they’re experiencing being only one aspect. Core beliefs and automatic thoughts are aspects that the person holds that might contribute to the maladaptive behavior they are engaging in so by targeting these symptoms and maladaptive thoughts the whole client is being treated, not just solely their symptoms.

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  8. Sarah Mombourquette
    May 03, 2018 @ 14:11:31

    I would hope to have high quality supervision in order to maintain and improve my competence as a CBT therapist. By communicating regularly with my supervisor, I will be able to discuss ideas about moving forward with clients and to reflect on my mistakes with a more experienced clinician. Similarly, discussions with colleagues about what has or has not been beneficial to them will allow me to explore new avenues of CBT work. The next thing that I could do to maintain and improve my skills would be to attend workshops and lectures that discuss CBT approaches to various disorders in the area that I hope to pursue. By following up on CBT within specific populations, I will be able to learn more in depth about the ways specific interventions are helpful. I believe that the most beneficial thing for me personally would be to read existing and new literature on CBT specific to the population that I am hoping to work with. I believe that I will only be able to maintain and improve my competence if I am willing to do the research on it.

    I have often heard that people view CBT as too “scientific and cold.” This idea alludes to the understanding that CBT therapists cannot be empathetic and sensitive towards their clients. I will say that one of the main reasons that I chose to pursue CBT is because it is scientific and evidence-based. I would not have felt comfortable promoting treatment that was not statistically proven to be effective. In fact, I would even go so far as to say that it could be considered manipulative and exploitative to ask a vulnerable individual to pay you for something that has no basis in fact. Therefore, I disagree with the view that CBT therapists cannot be empathetic towards clients. I believe that in order to achieve the most effective results, you need to be willing to do research. Because CBT therapists’ practices have a basis in evidence, they are doing what will be most effective for the client. Therefore, empathy and sensitivity, in my opinion, are the foundational pillars from which CBT therapists make their decisions.

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  9. Allexys Burbo
    May 03, 2018 @ 14:23:00

    (1) In order to maintain and improve my competence as a cognitive-behavioral therapist after graduating, I anticipate staying up-to-date on evidence-based practices within the field. While the literature helps maintain written records of research attributed to CBT, it is important to put these skills into practice at every given opportunity. In staying up to date on the literature, attending workshops/trainings, and integrating evidence-based skills in therapy, I will demonstrate an intentional effort to reinforce the CBT skills learned during my time in this program. Similar to the notion that the collaborative nature of CBT serves as integral to the therapeutic process and achieving positive outcomes, observation and feedback from colleagues and other experienced professionals within the field will also prove helpful for improving competence and tuning skills. Just as the clinician functions as a support network for helping the client achieve successful therapeutic outcomes, the relationships provided by the professional network of colleagues and supervisors also function in this way – that is they offer perspective for improving/growing as a clinician.

    (2) Of all the stereotypes/myths/criticisms about CBT, the one that I have encountered most is that this type of therapy disregards emotion entirely and focuses primarily on dimensions of thought and altering behavior. While the name would suggest an adherence to only cognitive/behavioral attributions, the identification of emotion is often an initial and integral component of the therapeutic process. Given that the emotional experience of the individual is often the most readily available to the client (as emotional responses are the easiest to elicit and almost always at the forefront of awareness), integration of this aspect is integral to the therapeutic process and eliciting positive therapeutic outcomes – that is, emotion identity functions as the building block to uncovering other unconscious processes (i.e., automatic thoughts and core beliefs). In this instance, clients learn that through modification of their thoughts, the intensity of their emotions will be moderated. From this perspective, regard for the emotional experience of the individual is credited as a key aspect of CBT.

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  10. Louis D'Angelo
    May 03, 2018 @ 14:52:02

    1. After graduation and obtaining a license it is important to understand that education never truly ends. To maintain and increase therapeutic competencies, a clinician would continually be educating themselves by reading new landmark studies as well as participate in conferences and presentations in the field. Evaluating competencies in therapeutic work is also important for maintaining competencies. This can be done by practicing intervention strategies on oneself as well as self-evaluating and supervisor evaluations on taped sessions in the field. Therapeutic competency is then assessed using the cognitive therapy scale as well as the cognitive-behavioral therapy supervision checklist. Continually educating and monitoring both the use of assessment tools as well as competencies in therapy are great ways to maintain and increase therapeutic proficiency.

    2. One myth that I had heard in education of cognitive behavioral therapy is that the client’s past is not focused on and not considered. This is particularly a concerning believe because I believe that any effective therapy should consider aspects of the clints past if only to provide a strong therapeutic alliance and more in depth knowledge of the clint. As further education shows me, while CBT dose work on problems that the client is experiencing here and now, the clints past is a crucial aspect of CBT as it is necessary in understanding the development of core beliefs and the resulting automatic thoughts that are from those beliefs in the present. So this idea is indeed a myth because a client’s past is important in understanding why cognitive distortions develop and understanding this could help in restructuring these cognitions.

    Reply

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Adam M. Volungis, PhD, LMHC

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