Critères européens (EABCT)
Les recommandations pour l'accréditation des thérapeutes en TCC proposées par : l'Association Européenne de Thérapie Comportementale et Cognitive European. (Association of Behaviour and Cognitive Therapy : EABCT)
CRITERES EUROPEENS DE FORMATION EN TCC
Compte rendu par Martine Bouvard, Professeure de Psychologie à l'Université de Savoie à Chambéry et Docteur Jean Cottraux directeur du DU de TCC à l'université Lyon 1.
Au cours de l'EABCT, à Manchester en Septembre 2004, nous avons eu une réunion spéciale sur les standards et une autre sur le fonctionnement général. L'EABCT fonctionne maintenant avec un bureau, un site web et des commissions (standards, congrès pour les plus importantes). La commission dirigée par Jaak Beckers s'occupe des standards pour être reconnu thérapeute en TCC.
Le point important pour la formation est le nombre minimum d'heures requises. Il est d'au moins 300 heures, avec 150 sur les processus psychologiques de base. Pour le suivi :10 patients dans trois domaines différents,.quatre cas écrits au moins, 75 heures de supervision en TCC, avec 25 H en « live ». les supervisions sont individuelles ou en petits groupes de quatre.
Il est aussi demandé 100 h de développement personnel, connaissance de soi en individuel ou en petit groupe (une connaissance éclairée de soi plutôt qu'une thérapie). Une partie est incluse dans la formation à la TCC et une autre est un aspect de la supervision.
Il s'agit de simples recommandations : il a été spécifié au cours de la réunion que chaque pays pouvait s'inspirer de ces critères en fonction de ses propres structures universitaires
Le DU de TCC de Lyon 1 sera remplacé par un DIU de TCC qui associera l'université Lyon 1 et de l'université de Savoie à Chambéry. Il est sera mis en place en Septembre 2005 et appliquera, dès lors, ces critères.
EABCT accreditation standards
Proposal from the EABCT working group on training standards, July 2004 voted on at the AGM: September 10, 2004 in Manchester
1:Entry requirements:
Between European countries there are differences in what professionals are allowed to practice psychotherapy. That is also the case for CB therapy, and in different EABCT member associations, even where there are no official government regulations. EABCT recognises the regulations governing each country, but wants to define what we think are the competences of a fully trained cognitive behavioural psychotherapist.
Minimum entry requirements will be:
-All accredited therapists will have an approved basic qualification in an appropriate core profession and be registered with a professional regulatory body.
-They will have sufficient experience in working in a therapeutic role with clients, as defined further in this text.
-They will be using cognitive and/or behaviour therapy in a systematic way as their main, or one of their main therapeutic models.
2:What do we expect CB Psychotherapists will be able to do?
To carry out a broad range of CBT assessment, formulation and interventions independently and in a competent way. To combine techniques, develop new strategies, be creative in designing new protocols or individually tailored interventions. To apply these interventions in therapy, prevention and psycho education, for problems of mental health, education, health in general etc. To provide these interventions for the benefit of all segments of society (children, adults, elderly people, people with handicaps etc.) in the best available format (e.g. individuals, small or large groups). To guide and support other professionals in the application of CB principles.
This means that CB-Psychotherapists need:
a. to be guided by a thorough knowledge and understanding of the basic scientific research and theories in psychology that feed, underlie and challenge the theories and practice of CBT, e.g. learning theories, social psychology, cognitive psychology, theories of memory, theories of motivation.
b. to have and consider knowledge of normal as well as abnormal development across the life span and across different social contexts, including diversity: e.g. sociology, developmental psychology, differential psychology, psychophysiology, behavioural neuroscience, psychopathology of childhood and adulthood.
c. to have and consider a working knowledge of the area in which the therapist practices, e.g. psycho diagnosis, psychiatry, disability, drugs.
d. to be aware of other therapeutic approaches within the therapists area of practice and in related scientific domains, e.g. rehabilitation, physiotherapy, medication
e. to be guided by a sound knowledge of the evidence-based techniques of CBT, their theoretical and scientific basis and their more recent developments. To choose the best available interventions in terms of safety, effectiveness, efficiency and respect for their clients and to abandon less safe, effective, efficient or respecting interventions.
f. to evaluate a client's progress as a result of the interventions carried out by self and others and to use this evaluation to shape their future practice.
g. to have a high level of understanding of the research basis of CBT practice, "high level" meaning: a critical understanding of methodology and results within the wider context of other research.
h. to be aware of and consider ethical and legal issues in therapy, research and training.
i. to have an understanding of their own learning needs and the impact that these have in therapy by developing self-awareness and ability to change.
j. to demonstrate a high level of ability to build, maintain and conclude a therapeutic working relationship, to analyse and understand a clients problems according to CB theory and research, to design an appropriate therapeutic strategy to deal with it and to put this strategy into practice competently.
3:Where and when do CB-psychotherapists develop these competences?
3.1 Some, especially more theoretical, knowledge and general therapeutic skills should be acquired during the core academic training.
3.2 Some of the applied knowledge and of the specific CB therapeutic skills will have to be acquired during a specialised CBT training, e.g. organized by a CBT Association, an Institute, or a University:
3.2.1 The specialised CBT training should be provided directly by recognised behaviour and/or cognitive therapy trainers on a recognised course or an agreed programme of study.
3.2.2 The minimum period of training will not be less than 5 years. This time is measured from the commencement of academic (master level) and professional training to the end of a period of post professional training in cognitive and/or behavioural skills.
3.2.3 Specialist training in a particular model of cognitive and/or behaviour therapy, or in a specialist area of its application may focus on a specific area of interest (e.g.. REBT, CBT with psychosis, CBT with Children,). However, all therapists will have covered a curriculum that will provide a broad-based understanding of the theoretical basis of cognitive and/or behaviour therapies and their application across a range of problems.
3.2.4 Skills training is an essential component of the acquisition of knowledge and experience and will predominantly be developed through supervised clinical practice, skills-based workshops, observation and clinical practice. Skills training should be a significant part of a therapist's total training programme.
3.2.5 Supervisors will be accredited CB therapists with a minimum of 5 years of practice and accepted as such by the EABCT member association.
3.2.6 A record of the training will be kept and this should specify the length of training, the number of taught hours and a record of the lecturers, trainers, and supervisors participating.
3.3 With regard to the above (2, a. to j.) mentioned competences this means:
a. To be guided by a thorough knowledge and understanding of the basic scientific research and theories in psychology that feed, underlie and challenge the theories and practice of CBT, e.g. learning theories, social psychology, cognitive psychology, theories of memory, theories of motivation.
Will be acquired during:
- Core academic training (bachelor and master level: 1st and 2nd cycle)
b. To have and consider knowledge of normal as well as abnormal development across the life span and across different social contexts, including diversity:
Will be acquired during:
- core academic training
c. To have and consider a working knowledge of the area in which the therapist practices:
Will be acquired during:
- core academic training
d. To be aware of other therapeutic approaches within the therapists area of practice and in related scientific domains:
Will be acquired during:
- core academic training
e. To be guided by a sound knowledge of the evidence-based techniques of CBT, their theoretical and scientific basis and their more recent developments. To choose the best available interventions in terms of safety, effectiveness, efficiency and respect for their clients and to abandon less safe, effective, efficient or respecting interventions.
Will be acquired during:
- core academic training
- specialised CBT training
- seminars and workshops, certified by the local CBT association
The number of theoretical hours and skills training provided in the specific CBT training on these subjects should be at least 300, 150 of which on basic psychological processes. Supervision is not included in this number. (souligné par moi)
f. To evaluate a client's progress as a result of interventions carried out by self and others and to use this evaluation to shape their future practice.
Will be acquired during:
- core academic training and
- specialised CBT training
g. To have a high level of understanding of the research basis of CBT practice, "high level" meaning: a critical understanding of methodology and results within the wider context of other research.
Will be acquired during:
- core academic training and/or
- specialised CBT training if necessary: this competence should be assessed as an entry requirement; if the candidate has not proven to be proficient in research skills, the CBT training centre can either allow him to do CBT training and provide the necessary research skills, or not allow him to do CBT training until he has proven to be proficient in research skills, if the CBT centre is not interested in providing such skills.
h. To be aware of and consider ethical and legal issues in therapy, research and training:
Will be acquired during:
- core academic training or
- specialised CBT training. If this competence has not been included in the core academic training, the CBT training centre should provide this competence, in subjects/ workshops and supervision
i. To have an understanding of their own learning needs and the impact that these have in therapy by developing self-awareness and ability to change:
Will be acquired during:
- core academic training and
- specialised CBT training.
100 h. of personal development/self-awareness should be provided in individual or small group settings. Personal development is not to be understood as personal therapy but as "awareness": learning about themselves, especially as therapists. Part, but not all, of it can be included in pre-CBT training; part of it can also be incorporated as an aspect of supervision.
j. To demonstrate a high level of ability to build, maintain and conclude a therapeutic working relationship, to analyse and understand a clients problem according to CB theory and research, to design an appropriate therapeutic strategy to deal with it and to put this strategy into practice competently.
Will be acquired during:
- academic training at master level (called differently in different countries: 2nd cycle of academic training),
- specialised CBT training and
- supervision
Combined these should contain at least:
o 300 h. of supervised assessment and therapy, with a minimum of 10 clients in, at least, three different problem-areas
o 75 h. of supervision in CBT, in the course of the specialised, post-academic CBT-training, while they work as professional CB therapists. Supervision is given, as mentioned before, by a recognised CBT supervisor. At least 25 hours should be in close supervision, meaning: based on "live" material (audio- or videotapes, one-way screenŠ). Supervision is done individually or in small groups of not more than 4 people.
o Supervised practice will be assessed with at least four case studies written upo Furthermore, an understanding of evidence-based practice should be evaluated by the production of an extended case study that critically discusses the research evidence, a relevant research dissertation, a research paper written as first author or an equivalent proof of competence.July '04, Jaak Beckers, Training coordinator of EABCT