CBTp Competence Standards
The position of the NACBTPN is that competence in provision of CBTp is attained through rigorous training, consultation and/or supervision, inclusive of the following elements:
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Training consistent with needs of learners, as assessed by an initial formal assessment of these needs (although this may not be possible in some settings where training is offered to diverse groups of learners from multiple settings)
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Recognition that awareness of learning needs is crucial in order to determine the level of training in CBTp that would be required to reach either
i. competence in CBTp, or
ii. competence in CBTp-informed care
and recognition that each of these levels of competence require significantly different levels of training and skill development
3. Inclusion of longitudinal, formal, consultation and/or supervision of CBTp clients
4. Recognition that in order to achieve a level of competence, all learners ought to be evaluated and assessed for adherence to CBTp. Evaluation ought to include consideration of CBTp intervention skills as well abilities in case formulation and treatment planning.
North American Policies that Support
CBTp Delivery
Policy
The Substance Abuse and Mental Health Services Administration (SAMHSA) convened a one-day expert panel meeting in 2019 in which subject matter experts and persons with lived experience from across the U.S. and Canada examined the key areas of need for redressing the inaccessibility of CBT for psychosis. As a product of this meeting, two documents addressing the importance of the routine availability of Cognitive Behavioral Therapy for psychosis (CBTp) in the United States were issued:
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The first is a CBTp implementation guide published in May 2021 by SAMHSA. This document represents the first federally-issued declaration that CBTp should be offered as the standard of care in behavioral health settings, and that CBTp-informed care, at a minimum, should be offered to individuals with psychotic disorders across forensic, correctional, primary care, and educational settings.
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The second, more extensive document - The Position Statement on the Routine Administration of Cognitive Behavioral Therapy for Psychosis as the Standard of Care for Individuals Seeking Treatment for Psychosis – is intended to supplement the SAMHSA guide. Published by the National Association of State Mental Health Program Directors, the position statement details a rationale for sustainable CBTp implementation and delivers key recommendations to support broad intra- and inter-organizational adoption for individuals who have or are at risk of developing a psychotic disorder.
CBTp Websites
Books, Articles & Handouts
COVID-19 CBTp Materials
Cultural Considerations when Applying CBT to Racial and Ethnic Minorities
This practice brief, prepared by Jessica Maura, PhD and Sarah Kopelovich, PhD, is intended to help clinicians —particularly those who administer Cognitive Behavioral Therapy for individuals with serious mental illness—to enhance their cultural awareness and incorporate culturally-relevant practices into their formulation and treatment approach."
The Importance of Human Relationships, Ethics and Recovery-Oriented Values
This research brief captures the methodology and key findings of a review paper published by Drs. Alison Brabban , Rory Byrne, Eleanor Longden, and Anthony Morrison on service user perceptions of CBTp. The brief includes the top 10 strategies to ensure ethical and competent delivery of CBTp.
Values-based CBTp
CBT for Psychosis
Other evidence-based interventions using CBTp principles or techniques for psychotic symptoms
The attached list is not exhaustive but covers various interventions that use CBTp techniques, principles, or target cognitive biases, in order to help people with their psychotic symptoms. We will attempt to keep this list up-to-date as new interventions are studied and empirically supported. Other interventions using CBT strategies have been developed and validated with people with psychotic disorders but do not specifically target psychotic symptoms and are therefore not presented here (e.g. CBT for trauma, CBT for supported employment, CBT for social anxiety, CBT for sleep).
Not all of the interventions listed have received the same empirical support – some have been extensively studied in several randomized-controlled trials (and even meta-analyses) whereas others have only been studied in one or two clinical trials, but with promising results. As a Network, we do not wish to promote or favor any specific intervention above another.