Module Directory

The module is undertaken in all three terms of year one of the DClinPsych. It lays the foundation of clinical skills needed to work with adults and older people in the NHS and private and voluntary sector. This includes both generic clinical skills and specific skills in two major approaches cognitive behaviour therapy (CBT) and psychodynamic therapy. The module combines a range of approaches to facilitate trainees development of knowledge, understanding and skills in relation to CBT and psychodynamic therapy.

The aims of the module are outlined below, according to the different teaching strands that comprise the module:

Clinical Skills (Year 1)

The Clinical skills teaching strand aims to lay the foundations for trainees to develop some of the key generic therapeutic competencies relevant across different therapeutic modalities. In doing so it aims to help prepare trainees for starting supervised practice on their training placements (HS761). It runs in conjunction with teaching provided on modules HS762 and HS764.

Objectives include:

• To understand how to foster and maintain a good therapeutic alliance with clients


• To gain an understanding of the cycle of hypothesis testing, formulation, action planning and evaluation as part of the therapeutic process.


• To have a conceptual understanding of assessment processes, measurement and testing


• To understand how to make use of clinical supervision


• To gain a clear understanding of how to manage risk, in keeping with professional and ethical guidelines


• To increase awareness of how the personal and professional interact in clinical work and to reflect critically on one’s own positionality within the therapeutic encounter

Cognitive Behavioural Therapy (CBT)

The CBT skills teaching strand aims at providing trainees with foundational CBT skills, to prepare them for more complex applications on placement. The syllabus is anchored to the competency framework for Cognitive Behavioural Therapy (CBT) developed by Roth & Pilling (2007) and downloadable at www.ucl.ac.uk/CORE/.

Objectives include:

• To critically reflect on the contextual origins of CBT and underlying assumptions of the model, with a focus on positive practices to promote inclusivity and sensitivity to the experiences of people in different communities.


• To develop understanding and skills in CBT-based assessment and formulation processes.


• To understand the core competencies required for CBT practice, with reference to the Revised Cognitive Therapy Scale (CTS-R) developed by James, Blackburn & Reichelt (2001) and UCL competency framework (see above)


• To develop awareness of, and competencies in, CBT basic skills (e.g., agenda setting, structuring sessions, setting homework)


• To develop awareness of, and competencies in, CBT specific skills (e.g., use of thought diaries, Socratic questioning, collaborative case conceptualisation, and behavioural experiments)


• To develop awareness of disorder-specific models and interventions to inform and enable effective treatment planning, using a CBT framework.

Psychodynamic Psychotherapy

The psychodynamic psychotherapy teaching strand aims to lay the foundations for developing understanding of core psychoanalytic ideas, and for developing some of the foundational competencies that allow for the establishment of the frame for psychoanalytic/ psychodynamic therapy interventions.

This module is not intended to train clinical psychologists to work as analytic psychotherapists, but rather to help them to acquire knowledge that can inform their generic practice. The module therefore provides a contribution to the development of the knowledge base underpinning a sub-section of the ‘basic competencies’.  Specific techniques are discussed at an introductory level to raise awareness of the model of therapeutic action underpinning analytic approaches, but the module does not set out to provide trainees with the full range of competences in this specialist domain. The module lays the foundations for developing basic competences (over the course of the DClinPsych training) and  would need to be further supported by specialist clinical placements in the third year of training and further training post-qualification in order to reach competency in these various domains.

Objectives include:

• Developing knowledge of the basic principles of psychoanalytic/ psychodynamic theory and therapies in the following three areas:
  
  
  
  • knowledge of the core principles of psychoanalytic/ psychodynamic therapy
  
  
  • knowledge of the developmental theory
  
  
  • knowledge of a psychoanalytic/ psychodynamic model of the mind.
  
  
  
  


• Introducing Psychoanalytic assessment and formulations and developing the ability to assess the likely suitability of psychoanalytic/ psychodynamic therapy.


• To develop the ability to engage the client in the therapeutic work.


• To develop the ability to formulate: a dynamic formulation accounts for the developmental origins of the client’s difficulties, the underlying unconscious conflicts, the defences associated with their management and the recurring interpersonal patterns and expectations of others.


• Establishing and managing the therapeutic frame and boundaries


• Developing the ability to identify and manage difficulties in the therapeutic relationship
  
  Applying psychoanalytic models to understand dynamics within institutions, organisations, societal phenomena and issues related to culture and race.

Clinical skills (Year 1)

By the end of this module, trainees will be able to:

• use their understanding of the theoretical frameworks relevant to core competencies of assessment, formulation, intervention and evaluation to design and implement flexible and sophisticated psychological responses to a range of service user, staff and organisational referrals and problems in different settings.


• take into account biological, social and psychological factors in order to adapt the cyclical model of clinical thinking and action to accommodate the complexities of unique circumstances.


• conduct clinical assessments drawing on a range of different sources of information


• understand the nature, purpose and meaning of professional communications.


• consistently create ethically sound and professional competent and effective written communications.


• formulate clinical presentations


• evaluate the impact of a clinical intervention


• use clinical supervision effectively to reflect on their clinical competencies and professional development

Cognitive behaviour therapy

By the end of this module, trainees will:

• Have a thorough understanding of CBT competences and frameworks


• Be able to relate their own generic and specific CBT competences to their ongoing clinical practice


• Have fundamental competences in relation to CBT in line with competency frameworks (such as the UCL competency framework and the Revised Cognitive Therapy Scale)


• Have skills and knowledge relating to CBT assessment, formulation, intervention and evaluation and apply this flexibly to meet individual need


• Be proficient in applying CBT change methods appropriate to particular presenting problems and based on a collaborative case conceptualisation


• Understand the nature of behavioural experiments and demonstrate competency in using behavioural experiments across a wide range of presentations and problems


• Have a foundation in extending CBT to clients with complex presentations


• Have an awareness of transcultural CBT and apply this to their clinical practice


• Consider issues of difference and diversity when using CBT in their clinical practice


• Have an awareness of critiques of CBT

Psychodynamic

By the end of this module, trainees will have:

• Acquired a basic orientation to the broad areas of difference and overlap within psychoanalytic theory and practice.


• Acquire knowledge of the affective and interpersonal focus of the therapy.


• The ability to apply the understanding of the dynamic interplay between external and internal reality to the beginning stages of therapeutic interaction


• An understanding of unconscious processes and object-relations


• An understanding of Freud’s and Klein’s understanding of the development of the mind.


• An understanding of the relationship between the internal world and notions of psychological health versus illness (i.e. how do external events impact on the mind).


• An understanding of the core features of the analytic attitude.


• An understanding of the important features of the therapeutic frame and its management.


• An understanding of and ability to work with in practice, constructs such as ‘projection’, ‘projective identification’, ‘enactment’ and ‘transference’


• The skills required for closely tracking therapeutic processes (i.e. attending closely to micro-processes in the therapeutic relationship so as gain a detailed understanding of the client’s internal world of relationships and conflicts).


• Skills relating to adopting a primarily receptive (i.e. non-directive) stance


• An understanding of the relationship between therapist and patient as a source of information about the patient’s difficulties and of the difficulties that may arise in this relationship.


• To encourage the development of reflective practice through an applied case study.


• To acquire knowledge of the indications and contraindications for a psychodynamic approach


• To recognise the main differences between a psychiatric and a psychoanalytic formulation of psychiatric difficulties.


• To develop awareness of the contribution of analytic ideas to working in the NHS.


• To encourage a more systematic consideration of the unconscious meaning of endings in therapeutic practice.

To develop confidence in addressing the affective meaning of endings with patients

Clinical Skills (taught across year 1)

• Communication and Listening skills


• Developing the therapeutic alliance


• Psychological formulation


• Measuring outcomes


• Assessing risk


• Reflecting on the personal/professional interface


• Use of supervision


• Leadership skills


• OSCE assessment (practice)

Cognitive-Behavioural Therapy (across year 1)

• Context and principles of CBT


• Competency frameworks and measures


• Assessment and formulation


• The process of guided discovery


• The therapeutic relationship within CBT


• Working with beliefs (cognitive approaches)


• Behavioural experiments


• Working with Depression


• Working with anxiety and OCD


• Working with addictions


• Working with psychosis

Psychodynamic Psychotherapy (taught across year 1)

• Introduction to the psychoanalytic frame


• Psychodynamic perspectives on psychopathology


• Dreams (and the importance of the internal world)


• Object relations and transference


• Psychodynamic perspectives on narcissism


• Assessment and formulation


• Defences


• Psychodynamic perspectives on issues of race and culture


• Reflective Practice


• Brief psychoanalytic approaches


• Therapeutic endings

Overview:

Teaching for HS765 is delivered mainly in the format of in-person lectures, led by both internal course staff and invited external lecturers with clinical expertise in the subject being taught. There are also opportunities for some learning sessions to be peer-led.

Lectures are designed to be interactive, and to employ opportunities for experiential role play, skills practice, group discussion and case material to support theoretical teaching with clinical applications.

The taught curriculum is supplemented by additional study time (in the wider DCP programme timetabling) for trainees to engage in self-directed learning, including reflecting on lecture materials and with reference to suggested readings.

Lecture/classroom-based:

Additional lecture resources and copies of teaching slides are made available on the trainee accessible BOX folder (module tutors are responsible for keeping these updated)

Timetable information is provided at least once per term, and details about where lectures are held automatically appear in students University outlook calendars which they are encouraged to look at regularly (in case of late room changes).

Independent study:

Self-directed study is essential. Study days are timetabled into the overall programme planning, to offer additional time for self-directed reading and learning to complement teaching and facilitate theory-practice links.

Suggested readings are provided via the Module-linked TALIS reading list.

Further lecture resources are supplied in the trainee accessible folder on BOX.

Practice-based:

The HS765 module does not comprise practice-based components.

However, HS765 is complemented and supported by supervised clinical practice on placements as part of HS761. These run across the course of the first year of training.

Tutorial/seminar-based:

The HS765 module does not comprise tutorials or seminars.

However, HS765 is complemented and supported by clinical seminars and reflective groups that run as part of module HS764 - these offer opportunities to discuss and reflect on the personal/professional interface in clinical work and in making theory-practice links in practice.

Skills-based and simulated practice:

The assessment for HS765 is an ‘Objective Structured Clinical Exam’ (OSCE) which takes place at the very end of the first year of training.

Built into the HS765 module timetable is a scheduled ‘OSCE practice’ day.

Other:

Additional support and resources:

The Module and teaching strand leads are accessible to discuss learning issues and needs arising from the curriculum and teaching for this Module if needed.

Trainees are invited to give regular feedback on the lectures provided, and at the end of the Module.

Trainees also have access to a personal tutor through their three years of training, for additional support and guidance with the academic and practice requirements of the DClinPysch training, as needed.