PYMDEP-Theory and Practice for Depression

Module Provider: Psychology
Number of credits: 40 [20 ECTS credits]
Level:7
Terms in which taught: Summer & Autumn Terms
Pre-requisites:
Non-modular pre-requisites:
Co-requisites: PYMFUN Fundamentals of Evidence-Based Treatments (CBT) and PYMANX Theory and Practice for Anxiety Disorders
Modules excluded:
Current from: 2020/1

Email: elliot.rose@reading.ac.uk

Type of module:

Summary module description:

This module will cover the evidence-base for CBT assessment and treatment for depression.

Aims:

1. To develop practical competency in evidence-based Cognitive Behavioural Therapy for depression


2. To develop critical knowledge of the theoretical and research literature for cognitive and behavioural models of depression.

Assessable learning outcomes:

1. Understand the evidence base for CBT assessment and treatment strategies for depression.


2. Be familiar with NICE Guidance for working with depression and be able to deliver the recommended interventions.

Achieving the learning outcomes listed below will ensure that students have developed the required competences related to depressive presentations listed in the competency framework (Roth and Pilling 2007- see http://www.ucl.ac.uk/cl inical-psychology/CORE/competence_frameworks.htm). Overall it is expected that the students will attain the specific competences set out in the IAPT high intensity curriculum (http://www.iapt.nhs.uk/silo/files/national-curriculum-for-high-intensity-cognitive-behavioural-therapy-courses.pdf). 

At the end of the course students will be able to de monstrate the following:     

1. A critical understanding of the phenomenology, diagnostic classifications and epidemiological characteristics of depressive disorders


2. Assess patients with depression, taking into account clinical manifestations, co-morbidity, past history, present life situation, course and outcome of depression in suitability for CBT


3. Assess risk factors associated with depression and the integ ration of risk management within treatment plans


4. Assess suicidal risk and implement practical strategies for managing suicidality


5. Prioritise problem areas, problem solving and identifying solutions 


6. Construct both cognitive and behavioural development and maintenance formulations in cases of depression


7. Develop cognitive and behavioural treatment plans for depression


8. Critically evaluate a range of evidence based interventions in depression


9. Derive cognitive or behavioural models with clients taking into account individual needs and preferences


10. Work with co-morbid presentations of depression and taking personal responsibility for clinical decision making in complex and unpredictable situations


11. Demonstrate self-direction and originality in tackling and solving therapeutic problems with depression including use of client support networks


12. Manage ending therapy and plan for long term maintenance of gains with evidence of a relapse prevention plan


13. Begin to practise as “scientist practitioners” continuing to advance their knowledge and understanding to develop new skills with depression to a high level


14. Demonstrate insightful knowledge of CBT and an ability to identify own values and beliefs in working with depression and CBT’s application to their own lives


15. Make best use of supervision with depressive disorders on the course 


16. Sensitively adapt CBT for depression, and ensure equitable access of CBT to diverse cultures and value


17. Demonstrate a working knowledge of the principles and practice, and competency in delivering high intensity psychological therapy for depression within a stepped care system

Additional outcomes:

1. Students will gain confidence in the assessment and treatment of clients with depression


2. Academically, students will develop skills in critical appraisal of research and develop theory-practice links


3. Reflective practice will be integrated as part of all training within the module

Outline content:

The module will comprise in-class teaching, clinical skills practice/supervised clinical practice, supervision in-service and independent study.  Teaching and supervision is delivered by experienced BABCP accredited therapists. The following will be covered:

• Phenomenology, diagnostic classification and epidemiological characteristics of depression


• Common factors linked to predisposition and precipitation, course and outcome of depression
  
• Current evidence based pharmacological and psychological treatments for depression to include role of combined treatment


• Theory and development of cognitive and behavioural models for depression
  
  Assessment and formulation of CBT with depression, including specific associated problems


• Risk assessment, risk management, suicide risk, mental state examination, personal and medical history


• Application and suitability for CBT with depression (to include contraindications such as substance misuse) and awareness of referral pathways for unsuitable cases


• Role of co-morbid disorders such as anxiety, PTSD, plus personality disorders and substance abuse


• Clinical process for CBT with depression using a cognitive or behavioural activation model (formulation, rationale, active treatment, relapse prevention)


• Clinical process for CBT with chronic, recurrent depression


• Use of standard and idiosyncratic clinical measures to monitor CBT process and outcome in depression


• The role of the therapeutic relationship in CBT with depression


• Relapse prevention


• Linking theory with practice, clinical trials and outcome studies


• Application of theory to practice in individual cases


• Theories and experimental studies of process in depression


• Development of therapeutic competency in the application of cognitive and behavioural interventions with depression


• Experiential learning illustrating how both cognitive and behavioural strategies with depression can be applied to students’ own experiences


• Values, culture and diversity (access, ethical, professional and cultural considerations)


• Effective use of supervision to help students identify own values and beliefs in working with people with depression to enhance and regu late good practice


• An overview of the principles of the stepped care system, knowledge of low intensity interventions with depression and the role of high intensity psychological therapy within that framework

Brief description of teaching and learning methods:

1. Experiential and skills based workshops providing students with a strong foundation in the clinical procedures of CBT, and addressing the most up-to-date research developments.


2. Skills based competences will be developed through small group experiential work and role plays in workshops, group supervision by course members and individual/group supervision in the place of work.


3. On-going clinical supervision provided by members of the course team and a t the place of work.


4. Self-directed study to include general reading for each course and preparatory reading for each session. DVD/video library and web based resources will be available in order that students can borrow and study examples of clinical therapy sessions and clinical demonstrations of specific techniques.

Case management and problem based learning will be facilitated through a combination of course and work-based supervision.

Contact hours:

Teaching contact hours: average minimum of 100 hours; the total minimum teaching contact hours summed across Modules PYMFUN, PYMANX and PYMDEP (including clinical skills and supervision) is over 300 hours.

Supervision contact hours: average minimum of 12 hours in University and 12 hours in the service.  The total minimum supervision contact hours summed across Modules P YMFUN, PYMANX and PYMDEP is 70 hours

Total contact hours: Minimum of 400, to include lectures and clinical skills, supervision and guided independent study.

Summative assessment- Examinations:

Summative assessment- Coursework and in-class tests:

1. An extended case report of a client with depression.  The extended case report should include a critical discussion of the theory and relevant literature that informed the clinical intervention, the assessment measures used, the outcome and a balanced evaluation of the intervention chosen and possible alternatives.


2. A recording of a CBT therapy session with a patient with depression. The recording is rated by a member of the course team and self-rated by the student using the CTS-R.  The recording will be of a different client to those submitted for PYMFUN and PYMANX and linked to the extended case report (item 1 above).

The assessments will be weighted equally. All assessments are assessed using a standardised measure and must pass at 50% with no autofail criteria.

3. Portfolio elements including content relevant to all modules.  This includes audit of cases, clinical log, training log, supervisor reports and report. The KSA portfolio produced by students following the KSA route sits in the portfolio and must be signed off as complete for the portfolio to be marked.

This assessment is marked as Pass/Fail. 

Formative assessment methods:
In addition to the three summative assessments for this module, the student will be required to submit:

1. The Module 3 University Supervisor Report must be passed and placed inside the Accreditation Portfolio. Any student who fails the final University Supervisor Report must submit a recording of a treatment session demonstrating skill in the areas of deficit identified by the supervisor. Once such a recording is deemed to pass on the CTS-R, and an appendix added to the report and placed inside the accreditation portfolio, it can be submitted for final marking. The recording can be resubmitted on one occasion.

Penalties for late submission:
Penalties for late submission on this module are in accordance with the University policy. Please refer to page 5 of the Postgraduate Guide to Assessment for further information: http://www.reading.ac.uk/internal/exams/student/exa-guidePG.aspx

Assessment requirements for a pass:

50% in each piece of assessed work for 1 and 2.  The Portfolio must be marked as a pass. A minimum of 80% attendance is required.

Reassessment arrangements:

Students who do not obtain the required pass mark in the summative assessed work will be given the opportunity to resubmit, on one further occasion, any individual assessment that has been failed. The re-sit grade cannot exceed 50%. If a student does not complete the required attendance they are expected to catch up on missed teaching hours by watching a recording of the session and submitting a 1500 word reflective piece on the topic.  If attendance falls below 80% for any module it will not be possible to make up the missed teaching hours in the current year. Arrangements can be made for students to attend missed teaching in the following year in order to pass the module but this would delay completion of the Diploma.

Completion of studies is dependent on employment within an IAPT Service and ongoing access to an IAPT appropriate clinical caseload. Students must successfully pass all modules of the training programme. Therefore a student’s studies may be terminated if they are no longer working in an IAPT service, no longer have access to an ongoing IAPT appropriate caseload, or fail coursework at second attempt

Additional Costs (specified where applicable):
1) Required text books:
2) Specialist equipment or materials:
3) Specialist clothing, footwear or headgear:
4) Printing and binding:
5) Computers and devices with a particular specification:
6) Travel, accommodation and subsistence:

Last updated: 21 May 2020