- 06 August 2020
- 15 min read
How I Made Cognitive Behavioural Therapy My CareerSubscribe To Advice
Charlotte Rhian Lowe explains everything you need to know about becoming a Cognitive Behavioural Therapist.
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When Did I Decide I Wanted A Job As A Cognitive Behavioural Therapist?
I always knew I wanted to work within a caring environment, even writing on my personal statement at school that I wanted to become a Counsellor or Psychologist.
I initially went down the Psychology route by completing my BSc and MSc in Psychology, receiving a first-class honors and a masters degree with distinction.
It was whilst undertaking these degrees that I was initially introduced to Cognitive Behavioural Therapy (CBT), progressing to work as an Assistant Psychologist in two services which offered CBT.
This furthered my knowledge and understanding of this individual therapeutic approach, and provided me with first-hand experience of witnessing the benefits CBT can have on an individual’s life.
During my time working as an Assistant Psychologist at Lancashire Traumatic Stress Service (LTSS), I had a CBT research article published which enabled me to obtain a more in-depth understanding of this therapy.
My research explored service-users’ experiences of receiving trauma-focused CBT after suffering from post-traumatic stress disorder.
What Qualifications Does A Cognitive Behavioural Therapist Need?
I believe a Cognitive Behavioural Therapist would need to gain experience in the field of mental health, which could be through either paid or voluntary employment.
To obtain the relevant experience, for many years I carried out voluntary work in a variety of services; MIND, Barnardo’s, Youth Offending Team, Prince’s Trust and Bipolar UK.
I began working voluntarily from the age of eighteen and whilst studying Psychology at college. There are also plenty of opportunities to acquire paid employment, and in the early stages of my career I worked as a Support Worker and a Nursing Assistant on the psychiatric wards.
The next step to a career as a Cognitive Behavioural Therapist would be to undertake a degree in a relevant subject area; Mental Health Nursing, Social Work, Art Therapy, Occupational Therapy, Psychology or Psychotherapy.
It is essential individuals read up on CBT to ensure it is an area of interest they wish to pursue.
In addition, following the completion of their professional degree, it would be wise to obtain some work experience in a service offering CBT. This would further an individual’s knowledge of CBT, and confirm it is the career path they wish to take.
I also completed an online diploma in CBT which provided me with a secure knowledge base for this therapeutic approach before embarking on my career.
The final step to becoming a qualified Cognitive Behavioural Therapist would be to complete a post graduate diploma in CBT.
This can be carried out over a year on a full-time basis or over two years on a part-time basis.
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Finding A Job As A Qualified Cognitive Behavioural Therapist
You would be unable to find or apply for a job as a Cognitive Behavioural Therapist with no experience as experience is vital to practice effectively as a Cognitive Behavioural Therapist.
Please see the qualifications section for details on obtaining relevant mental health experience.
Additionally, to successfully qualify as a Cognitive Behavioural Therapist trainees are required to complete many clinical and supervision hours involving direct contact with clients.
What Was Your First Job In The Industry Like?
For me personally, my career starting as a Cognitive Behavioural Therapist was more of a gradual process and therefore it is difficult for me to recall my first day on the job.
As I was already very much aware of the CBT approach and related principles, I did utilise these when working therapeutically with students in school.
This meant that I was fortunate to already be working in an environment which allowed me to effectively make use of CBT techniques prior to beginning the CBT training.
Although I do not remember a specific first day, I do remember my initial period of working as a Cognitive Behavioural Therapist.
As is typical of a newly qualified trainee, I felt apprehensive about beginning my new role, but this soon diminished and I began to feel more confident.
Like any job, it was about practising the skills I had acquired on the course, learning from any mistakes made and asking for help where necessary.
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What To Expect From Your Job
Cognitive Behavioural Therapists can work in many different settings, but generally the role they carry out is very similar.
Practising as a Cognitive Behavioural Therapist involves working with clients suffering from mental health difficulties by carrying out mental health assessments, developing a formulation of a client’s difficulties to then subsequently deliver CBT.
Therapy involves working with clients to help them change the way they think and act, with the aim of improving the way they feel.
Some of the day to day tasks I expect to face during my job as a Cognitive Behavioural Therapist include:
• Carrying out mental health assessments,
• Developing formulations of my client’s problems,
• Identifying goals to work on during therapy,
• Setting ‘homework’ tasks for the clients to complete between sessions,
• Involving a client’s family wherever possible,
• Providing advice and training to other health professionals,
• Running therapeutic groups,
• Writing reports and maintaining accurate records.
There is therefore an eclectic range of tasks to complete, and no one working day is the same as another.
Working In The Private Sector
There are many private organisations which recruit Cognitive Behavioural Therapists, and examples include private hospitals or occupational therapy services.
Similarly, there are several agencies which frequently recruit Cognitive Behavioural Therapists, such as TPP Recruitment or Pulse. However, often they only offer short-term contracts of between 3-12 months which is not always practical for some people.
There is also the possibility of setting up in private practice by working independently with clients as a Cognitive Behavioural Therapist.
Although setting up privately allows individuals to work much more flexibly, there are also some challenges to this.
No guarantee exists as to whether practitioners will refer enough clients, and the number of clients will fluctuate at times.
When setting up privately, initially it is therefore sensible for individuals to maintain another job which provides them with a steady income to cover their living costs.
Working In The NHS since the introduction of the Improving Access to Psychological Therapies (IAPT) programme in 2008, there have been an increased number of opportunities to work as a Cognitive Behavioural Therapist within the NHS.
Similarly, since a lot more money has recently been invested into CBT, the amount of jobs available will continue to rise.
The IAPT service was established to increase provision of evidence-based treatments for common mental health problems, with it now being estimated that approximately 900,000 adults access this service each year. Although I have never worked as a Cognitive Behavioural Therapist in the NHS, I know many people who have done so or still do.
Furthermore, I have worked as an Assistant Psychologist within the NHS so I have experienced many of the same frustrations faced by Cognitive Behavioural Therapists.
The Importance Of Supervision Whilst Practising As A Cognitive Behavioural Therapist
Receiving supervision from an accredited supervisor is an essential component in the practice of CBT, as well as during training.
The aim of supervision is to support and develop practitioners, and therapists subsequently learn new skills and techniques from their supervisors. Supervision can be delivered face-to-face, within a group setting, online or over the phone. However, it is recommended for CBT therapists to make use of audio and video recordings of their sessions during supervision, therefore face to face contact with a supervisor is preferred.
Supervision offers a safe environment for CBT therapists to discuss any concerns, casework or other professional issues in a structured way. Supervision sessions can make use of the Cognitive Therapy Scale Revised (CTS-R), which is a 12-item scale with each item reflecting one important competence in CBT.
Competencies range from agenda and homework, to more complex CBT competencies, such as eliciting negative thoughts and emotions. Audio and video recordings are used to determine whether the trainee meets the competencies listed.
For accreditation purposes, the British Association for Behavioural and Cognitive Psychotherapists (BABCP) require trainees to make use of the CTS-R during their CBT training.
The amount of supervision sessions required will depend on a therapist’s workload, and the number of clients they have on their caseload.
Why Do I Enjoy Cognitive Behavioural Therapy?
There is still so much more to be discovered. A large number of individuals do not benefit from CBT, so research is continuously being carried out in this area.
I feel excited by the ‘third-wave’ of CBT which incorporates mindfulness and more compassionate based approaches.
I have an interest in compassionate based approaches and have found these to be helpful when standard CBT protocols are not proving effective on their own.
Another branch of CBT which I am excited about, is the increased recognition of the benefits of this evidence based treatment for children and young people.
Since 2011, the Children and Young People’s Improving Access to Psychological Therapies Programme (CYP-IAPT) has been delivered by NHS England with the aim of improving existing Child & Adolescent Mental Health Services (CAMHS) working in the community.
This programme has recently been extended further so many more Cognitive Behavioural Therapists are set to be trained.
What Kind Of Person Is A Cognitive Behavioural Therapist?
I believe a Cognitive Behavioural Therapist needs to be a ‘people person’ and enjoy working with others.
It is vital that they are caring and wish to make a positive difference to the lives of others, ideally feeling passionate towards mental health.
I consider there to be a need for a Cognitive Behavioural Therapist to exhibit several key qualities:
• Good interpersonal and listening skills.
What Are The Career Opportunities For An Experienced Therapist?
There is the possibility for a CBT to go on to supervise other CBT practitioners. This would involve them completing an accredited supervision course attached to a relevant university.
There is also the option for an experienced Cognitive Behavioural Therapist to specialise in teaching or research in CBT.
This would involve them being employed by a college or university and it is likely they would be required to supervise student’s research projects in addition to carrying out their own research.
As already mentioned, experienced Cognitive Behavioural Therapists also have the option of setting up privately and working independently with clients.
• Experience in the field of Mental Health.
• Degree in a relevant area: Mental Health Nursing, Social Work, Psychology, Psychotherapy, Occupational Therapy or Art Therapy.
• Accredited Post Graduate Diploma in CBT.
• Exceptional communication skills
• Strong interpersonal and counselling skills
• Excellent listening skills
• Skills in assessment and formulation
• Empathy and the ability to deal with people in distress
• Problem solving and decision making skills
• Ability to maintain confidentiality
• Soft Skills
• Report writing and presentation skills
• ICT skills for recording information
• Good time management and organisational skills
Cognitive Behavioural Therapists working within the NHS can expect to receive a salary of between £26,500 and £41,500 per annum. A similar rate of pay is usually paid when working as a Cognitive Behavioural Therapist in a private organisation.
I believe it is necessary for an individual to highlight any mental health experience they may have from working with different client groups in a variety of settings.
It would be wise to focus on any therapeutic experience they may have, and discuss how this may be related to CBT.
As well as an individual focusing on their experiences and qualifications, I think it is important for them to discuss their qualities as a person and how these are deemed necessary for the role of a Cognitive Behavioural Therapist.
Note from Mat, Content Editor at Healthjobs.co.uk: As you can see in the comments below, we have had a lot of people read this looking for even more specific information. So, we've asked Charlotte if she could address them in full. Here are those questions, together with Charlotte's response.
"I am an aspiring CBT. I want to set up my own service. However, I do not have a postgraduate degree so I wanted to know if this would this affect my prospects of setting up my own service?" - Joel Hylton
Thank you for your question Joel.
To practice as a cognitive behavioural therapist, you would need to have completed a post-graduate diploma in CBT, along with a previous degree in psychology or a mental health related field.
This would be in addition to carrying out the relevant clinical hours and gaining enough experience of working directly with clients.
You would therefore require a postgraduate degree to be able to set up your own private practice.
If you do not have a prior qualification in a mental health related field, your experience may still count for something if you work or carry out voluntary work in a service whereby counselling skills are used.
There are two main routes into training as a cognitive-behavioural therapist and these are described in the answer to the question asked below by Sarah.
I hope this helps and good luck with setting up your service in the future.
"I have a First Class Degree in Psychology and Counselling. I am aware of so many routes to get to where I hope to be but would really value knowing what the most suitable option would be" - Sarah Pustkowski
Firstly, well done on receiving a First-Class Honours as that is a great achievement.
There are two main routes into CBT and the most suitable option would depend on several factors.
Would you like to work with adults or children and young people?
Would you like to work with clients struggling from mild to moderate difficulties or more complex problems?
Do you have the money to fund further study?
One option would be to carry out a postgraduate diploma in CBT (course providers are listed on the BABCP website), however you would need to fund this yourself.
A different route would be to train through the Improving Access to Psychological Therapies (IAPT) initiative.
This was set up to help improve access to mental healthcare within the NHS and provides a cost-effective way to train as a CBT therapist because it is funded by the government and trainees earn a salary.
Via this route you could train to become a low intensity worker or psychological wellbeing practitioner (PWP), working primarily with adult clients struggling with mild anxiety and depression.
Alternatively, you could train to become a high intensity CBT therapist and support people experiencing more complex problems.
If you specifically want to work with children and young people, you could go down the Children and Young People’s Access to Psychological Therapies (CYPIAPT) route instead.
More recently, Education Mental Health Practitioner (EMHP) roles have been developed which provide an opportunity for individuals to be trained to deliver evidence-based early intervention for children and young people in educational settings.
Again, you will need to have a degree in psychology or a mental health related field to be able to apply for these roles.
The training is funded, full-time, lasts for a year and involves university study as well as employment in a Mental Health Support Team trailblazer site.
Whichever route you choose, the emotional investment in the training is substantial and for most CBT training courses you will need to attend therapy yourself throughout your course.
Good luck with your studies.
"I have graduated Bcs Psychology and am looking to go down the CBT route. Where I live there is a limited amount of masters courses available and I'm looking into doing a Cognitive Behavioural Therapy PGDip. Do you think it would be worthwhile doing this now or doing a general Psychology Msc first? - Sally Laycock
Thank you for your question Sally.
I think if you are wanting to go down the CBT route then you would not need to complete a MSc in Psychology.
Although this is something which I did, when I undertook my masters it was at a time in my career when I had not decided whether to pursue a career in CBT or not.
I would therefore not have needed to complete my masters if I had known at this time which direction I wanted to take.
If you have already made that decision to go down the CBT route, then I would definitely recommend completing a post graduate diploma in CBT instead: this will not only save you time, but also a lot of expense!
Good luck with your training whichever route you choose to take.
Let me know in the comments your thoughts on becoming a Cognative Behavioural Therapist and what I've said - let's chat there!
Oh, and please Like this article to let me know you enjoyed it - thank you!