CBTp Competence Standards
While the NACBTp Network is not a certifying organization, we recognize the need to identify clear expectations and performance metrics for clinicians who wish to provide competent and adherent CBT for psychosis. CBT certification indicates to service users and families, employers, and other clinicians that the individual is a skilled cognitive therapist. In addition, the NACBTp recognizes that the identification of core competencies enhances transparency in both the provision of high-quality clinical services as well as in CBTp training. The NACBTp offers Competence Standards for formulation-based CBTp as well as CBTp-informed care.
North American Policies that Support
In 2019, the Substance Abuse and Mental Health Services Administration (SAMHSA) convened a one-day expert panel meeting in which mental health administrators, experts in CBTp, and people 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:
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.
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.
COVID-19 Articles and Resources
Cultural Considerations when Applying CBT to Racial and Ethnic Minorities
This practice brief, prepared by Drs. Jessica Maura and Sarah Kopelovich for the Northwest Mental Health Technology Transfer Center, is intended to help clinicians enhance their cultural awareness and incorporate culturally-relevant practices into a cognitive behavioral formulation and treatment approach.
The Importance of Human Relationships, Ethics and Recovery-Oriented Values
This research brief, prepared by Drs. Jessica Maura and Sarah Kopelovich for the Northwest Mental Health Technology Transfer Center, 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.
CBTp Briefs and Tip Sheets
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. The NACBTp Steering Committee, in partnership with the Research Work Group, will maintain this list as new empirical support emerges. 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 disturbance).
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 demonstrate promising findings. As a Network, we do not to promote or favor any specific intervention above another.
CBT Smartphone Applications
The app aims to stop the cycles of depression. Record feelings and stop to think the best course of action.
The app uses CBT to help deal with emotions through three different phases, Catch it, Check it, and Change it. The mood is added to a user diary and short recommendation is provided.
Web‐based cognitive training intended for all types of users as it targets five categories of cognition: Memory, Attention, Speed, People Skills, and Intelligence. The program contains 19 exercises that address each category and adapt to users’ skill level.
For adults aimed to improve overall well‐being and happiness, with influences from positive psychology, cognitive behavioral therapy and mindfulness. Each activity intends to strengthen one of the five happiness skills: savor, thankful, aspire, give, or empathize.
Adventure‐style game to document and cope with stressors. Type a response within the game and the app recommends strategies for dealing with it. The social feature allows users to connect anonymously with other people of the same age group (13+).
Teaches a skill called “diaphragmatic breathing” to help feel more relaxed. Diaphragmatic breathing, also known as “belly breathing,” is a common relaxation skill utilized in a variety of treatments for anxiety and PTSD.