How to Become a More Effective CBT Therapist explores effective ways for therapists to move beyond competence to metacompetence , remaining true to the core principles of CBT while adapting therapeutic techniques to address the everyday challenges of real-world clinical work.

About the Editors ix About the Contributors x Foreword by David M. Clark xv Foreword by Tony Roth xvii I The Foundations 1 1 Mastering Metacompetence: The Science and Art of Cognitive Behavioural Therapy 3 Adrian Whittington and Nick Grey 2 The Central Pillars of CBT 17 David Westbrook 3 Developing and Maintaining a Working Alliance in CBT 31 Helen Kennerley 4 Working with Diversity in CBT 44 Sharif El-Leithy II Handling Complexity 63 5 Working with Co-Morbid Depression and Anxiety Disorders: A Multiple Diagnostic Approach 65 Adrian Whittington 6 Collaborative Case Conceptualization: Three Principles and Five Steps for Working with Complex Cases 83 Robert Kidney and Willem Kuyken 7 Transdiagnostic Approaches for Anxiety Disorders 104 Freda McManus and Roz Shafran 8 When and How to Talk about the Past in CBT 120 Gillian Butler 9 “Is it Them or is it Me?” Transference and Countertransference in CBT 132 Stirling Moorey 10 What To Do When CBT Isn’t Working? 146 Michael Worrell III Adapting for Specific Client Groups 161 11 CBT with People with Long-Term Medical Conditions 163 Jane Hutton, Myra S. Hunter, Stephanie Jarrett and Nicole de Zoysa 12 CBT with People with Personality Disorders 178 Kate M. Davidson 13 CBT with People with Psychosis 191 Louise Johns, Suzanne Jolley, Nadine Keen and Emmanuelle Peters 14 CBT with Older People 208 Steve Boddington 15 CBT with People with Intellectual Disabilities 225 Biza Stenfert Kroese IV Mastering Metacompetence 239 16 Using Self-Practice and Self-Reflection (SP/SR) to Enhance CBT Competence and Metacompetence 241 Richard Thwaites, James Bennett-Levy, Melanie Davis and Anna Chaddock 17 Using Outcome Measures and Feedback to Enhance Therapy and Empower Patients 255 Sheena Liness 18 Making CBT Supervision More Effective 269 Nick Grey, Alicia Deale, Suzanne Byrne and Sheena Liness 19 Take Control of your Training for Competence and Metacompetence 284 Adrian Whittington An Afterword about Therapist Style 300 Simon Darnley and Nick Grey Index 306

CBT has been shown to be effective in helping many people with a wide range of difficulties. A key strength is its empirical basis, and much effort has gone into training therapists to adhere closely to the specific treatment protocols used in research trials. However, real-world therapists need to make moment-to-moment decisions about the direction therapy should take with individual clients. How to Become a More Effective CBT Therapist explores effective ways for therapists to move beyond competence to “metacompetence”, remaining true to the core principles of CBT while adapting therapeutic techniques to address the everyday challenges of real-world clinical work. This innovative text explores how to: Work most effectively with fundamental therapeutic factors such as the working alliance and diversity;Tackle complexities such as co-morbidity, interpersonal dynamics and lack of progress in therapy;Adapt CBT when working with older people, individuals with long-term conditions (LTCs), intellectual disabilities, personality disorders and psychosis;Develop as a therapist through feedback, supervision, self-practice and training. Based firmly on foundations of the current evidence and richly illustrated with case studies and therapy transcripts, this practical guide will help therapists navigate complexities of clinical practice and develop as skilled practitioners of CBT.

“A much needed and timely book, written and edited by a splendid array of top-quality CBT therapists and researchers, and aptly dedicated to David Westbrook whose own work exemplified the sophisticated integration of theory and real-world practice we find here. Practical, scientifically sound, and broad in scope – an invaluable route map for continuing therapist growth and development.” Melanie Fennell, Ph.D., Founder, Oxford Cognitive Therapy Centre and Clinical Research Associate, Oxford University Department of Psychiatry