This article is part of our introductory series on cognitive-behaviour therapy.
There are unfortunately very few CBT therapists in South Africa. A study by Möller and Van Tonder (1999) suggested that only about 6% of South African clinical psychologists could be regarded as CBT therapists. As of the time of this study, only 20% of clinical psychologists had had any training in CBT, only 5% used CBT more than 50% of the time, and only 4% regularly consulted CBT journals or literature.
As of 2011, no formal minimum training standards are provided for CBT therapists in South Africa and there is no formal national CBT organisation or training standards committee. It may thus be most helpful to consider psychotherapists as belonging to one of four categories with respect to their proficiency and experience in using CBT:
- No experience or interest in the use of CBT as a therapeutic model.
- Some interest in and experience with the use of CBT.
- Primarily uses CBT as a therapeutic approach and has significant experience in using CBT, has attended international conferences and workshops in CBT but does not have any specific international certification as a CBT therapist.
- Internationally-certified CBT therapists, with specific qualifications based on supervised practice by an international training standards committee
It is most probably wise when seeking a therapist who provides CBT to try and assess which of the above-mentioned categories they may fall into. Many therapists will report that they use CBT, but few have actually had specific supervised training in the model and many do not provide cutting-edge treatments for specific disorders.
In addition, it would also be important to check whether or not the therapist has specific experience in your area of concern. For instance, an individual may have plenty of experience in working with anxiety or depression, but little experience or expertise in treating tic disorders, insomnia or psychosis, for example. Below is a list of reasonable questions that one could ask a therapist prior to making an appointment or during an initial appointment aimed at assessing their experience with CBT.
Have you received any training in CBT?
Training could vary from an introduction during a masters programme to an internationally-certified qualification.
Did your training include individual supervision of case material from an experienced or internationally-certified CBT therapist?
It is important to distinguish between theoretical training and practical, supervised training that includes individual supervision in the use of CBT in working with clients.
Does your CBT training include international certification from an international training standards committee?
Typical international certification is from the Beck Institute or the Albert Ellis Institute. Other training centres in the USA and the UK also exist.
How many years’ experience do you have in practising CBT?
We all start with little experience and build our knowledge base. It would be wise not to doubt a well-trained and supervised CBT therapist with one or two years’ experience. It, however, goes without saying that those therapists with greater practical experience bring the expertise accumulated from this experience to helping you.
In what way do you use CBT in your practice?
Many people will tell you that they integrate CBT in to their practice. This typically would entail using skills or techniques from more than one theoretical orientation at the same time. This approach is known as eclecticism. This is not unethical nor an unacceptable practice. Should you look for a CBT therapist specifically, this is obviously not the type of service provided by a therapist with an eclectic approach. Therapists will also tell you that they use different theoretical approaches to treat different clients and problems. This is also an acceptable approach. It would, however, be important to determine if the therapist is sufficiently trained in CBT and if the therapist would suggest CBT for your specific problem.
Ask if the therapist has training in the CBT treatment of your specific disorder.
It important to know that the therapist has disorder-specific training in the condition that you require help with.
Ask the CBT therapist to explain the specific treatment to be employed to treat your specific condition.
Inform yourself via recognised CBT websites about the latest treatments available and the researchers responsible for the development of this treatment. You will find a list of helpful links to international CBT training and research facilities on our website (www.cognitive-behavioural-therapy.co.za) .
Written by Bradley Drake and Jaco Rossouw, Centre for Cognitive-Behaviour Therapy, Cape Town, South-Africa. For further details visit: www.cognitive-behaviour-therapy.co.za. (September 2011)
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