Hello and welcome to our 10 year celebration! It’s great to see so many colleagues, students
and ex-students both from within and outside of CNWL. I want to start by thanking Sarah
Corrie, Charlotte Green, Jane Rogers, Mike Waddington and Ursula Barbieri for organising
this event including such lovely CBT cup-cakes.
So… it’s been 10 years of CBT training. How did that happen? I think we and CNWL have a
lot to celebrate and to be proud of in relation to the establishment and success of the CBT
training programme. I’d like to tell you a little bit about how we came about and what it is
we do, and why, in my view, we are not done yet and why I predict there will be a 20 year
celebratory event…possibly featuring even nicer cakes… please make a note in your diary
now..
Our CBT programme actually began in 2003. The initiation of the CNWL CBT course was led
by Philip Tata, John Green and Jose Wood in collaboration with Rod Holland from West
London Mental Health Trust. Gary Brown from Royal Holloway was employed to develop
the programme and to become its first programme director. It’s a testament to Gary’s
knowledge and expertise in both CBT and programme design that the original structure that
he developed has proven to be such a solid foundation, allowing us to evolve the
programme over time in a way that is responsive to developments in professional practice
and accreditation requirements, as well as developments in CBT itself.
The original agenda for the development of the programme was, and remains, that of
increasing the availability of evidence based psychological therapies within the trust and
more widely. The development strategy was to effectively ‘grown our own’ supervisors and
trainers as well as to form and maintain strong relationships with external experts and
training providers. We have been highly successful on both fronts.
I recently looked through the list of names of those enrolled in the first few intakes of our
Post Graduate Diploma. The names are very familiar as many of these people have gone on
to be clinical leads within IAPT services in CNWL or senior clinicians in secondary care
services. Additionally, many of these, such as Louise Payne and Rita Woo have gone on to be
lecturers and supervisors on our course and continue to be heavily involved with the
programme. We have also managed to form good relationships with many CBT experts both
nationally and internationally and who continue to enrich our courses by coming here to
teach.
Our original intake consisted of 18 students from within CNWL and West London. As of
today, if we include those people currently enrolled on one of our two Post Graduate
Diploma courses, we will have trained over 440 people in CBT. An early success for us was
establishing our courses as fully accredited programmes with the British Association for
Behavioural and Cognitive Psychotherapies. This has meant that those who train with us are
fully prepared to become accredited CBT therapists. To give you some sense of impact then
I understand that at present there are just over 700 fully accredited CBT therapists in the
Greater London area. Obviously, many of our ex-students have moved beyond greater
London and even internationally however I think you would agree that our contribution
here is pretty respectable.
Who are these people who have come to us for training? From the beginning, our trainees
have been from multiple professional backgrounds including Nursing, Occupational Therapy,
Social Work, Psychiatry, Clinical and Counselling Psychology and others. Having this rich mix
of professionals together has always created an exciting context for training. Being an old
fashioned behaviourist at heart, I have always believed in the project of making the tools
and understanding of the behavioural and cognitive therapies as widely available as
possible, rather than having this concentrated in the hands of a special exclusive elite. That
our training and supervision is largely delivered by psychology has also in my view
evidenced the extra value psychology can bring in increasing patient access to evidence
based therapies both as front line therapists as well as supervisors, trainers and managers.
And, of course, it is very true to state that it is largely through my interactions with our
trainees, and the many challenging questions and clinical dilemmas they have presented
that has supported me to develop as a Trainer and supervisor. Just as our patients teach us
how to become effective therapists, if we have ears to listen, our supervisees and students
teach us to become more effective trainers and supervisors.
And then came IAPT! : Increasing Access to Psychological Therapies. The biggest
development in CBT training in the known universe since time began. Due to our success in
establishing our Accredited Post Graduate Diploma we were able to successfully bid to
provide training in High Intensity CBT from the first year of the programme in 2008 and each
year since. We became one of only two courses within London to provide this training, the
other being The Institute of Psychiatry. It’s been a great source of satisfaction for me that
we have also been able to work in a highly collaborative fashion with the Staff of the IOP,
Sheena Liness and Suzanne Byrne in particular, in delivering this demanding programme
across London and that we continue to do so as we seek to ensure the long term
sustainability of the High Intensity workforce.
We have successfully trained therapists from IAPT services across greater London. To give
you some idea of the scale of this, our last intake involved working with 13 separate IAPT
services across greater London. Our current intake is even larger, as we have now
established a relationship with services in Hertfordshire and the East of England. Far from
drawing to a close, our current intake is the second largest we have had and indications are
that we may have more commissions next year. All of this of course has raised the profile of
CNWL as an established provider of training in evidence based psychological therapies.
The IAPT programme has also supported us in developing new innovative trainings. For me
the most exciting of these has been the training we have developed in Behavioural Couples
Therapy.
For those of you who may be unaware, The High Intensity Training programme has
concentrated on individually focused disorder specific models, primary those with an
evidence base for anxiety and depression. However, there is a wide range of research which
confirms that one of the biggest factors affecting individual well-being, as well as response
to individual therapies, is the quality of people’s couple relationships. Where patients
present with a distressed couple relationship it can often be more effective to work directly
with the couple on their relationship. Doing so can be effective both at resolving individual
forms of psychopathology but also in improving couple satisfaction and well-being. Again
through the initiative of Philip Tata, we have established a collaborative relationship with
Professor Don Baucom of the University of North Carolina. Don is one of the principle
originators of this form of therapy. My team and I have had the pleasure of working with
Don to design and deliver a 12 month training programme in BCT which we have so far
delivered to three cohorts of students as part of the IAPT ‘other modalities of therapy’
initiative. We have so far trained 75 therapists in BCT and are due to train a further 27 IAPT
staff this December. Many of these have gone on to join the newly established Couple
Therapy Interest group in the BABCP which has in turn lead to further training activities and
conference presentation nationally. Our previous graduates have also gone on to
successfully stablish BCT in their services. We know this because we have kept in touch with
them and have conducted several audits of their practice. We have gathered data that
shows that these people are providing a service which does reach the couples that we are
targeting, and they are providing the therapy in a way that leads to a reduction in couple
distress and improvements in couple satisfaction. We have been able to present this data
and this programme at both National and International conferences as this is in many
respects a unique programme that is worthy of further investment and research.
I would like to see BCT made much more available within CNWL as it has the potential to
help not only couples where there is depression and anxiety but also where there is physical
health and other problems and where relationship distress can function to hamper
recovery.
So, what started as a small, part time concern, with 18 students and a few staff, has grown
into a full time concern with a range of training programmes and initiatives. I believe we
have created a team of creative and committed people who have achieved a great deal.
Some of these people have ‘grown up’ so to speak in the programme by first doing the
training and then going on to be supervisors and lecturers and to write papers and conduct
research. So I am going to turn the floor over to others now but before I do I just want to
reiterate that we are not done yet. The original agenda of providing access for CNWL staff to
training in evidence based therapies remains an important one. We have established a wellregarded and effective programme for achieving this and I look forward to taking this
project forward with you into its next decade.
Thank you.