Effectiveness of brief training in cognitive behaviour therapy techniques for palliative care practitioners

TLDR

The skills are compatible with national guidelines for psychological support to patients at all stages of cancer. A brief CBT training program of 12 days of teaching plus six months of skills‑building supervision was delivered to 20 palliative care practitioners and their use of the techniques was evaluated with the Cognitive First Aid rating scale. The training led to significant gains in CBT competency (p = 0.001) with high internal consistency (α = 0.93) and inter‑rater reliability, but discontinuation of supervision caused skill loss and reduced confidence, whereas continued supervision maintained and further improved skills (p = 0.007), underscoring the necessity of ongoing supervision for sustained competence.

Abstract

We describe training in CBT techniques for 20 palliative care practitioners delivered as 12 days' equivalent teaching plus skills-building supervision over a six month period. Audiotapes of trainees' interactions with patients during their usual work were rated using a specially devised ‘Cognitive First Aid’ rating scale (CFARS). The CFARS was highly internally consistent (Cronbach's Alpha 0.93) and inter-rater reliability was high. Trainees showed significant gain in CBT skills competency over six months (p=0.001). After initial training, half the trainees were randomised to discontinue supervision; their measured CBT skill dropped as did their self-reported confidence when reassessed six months later, whereas those who continued in supervision gained further skill and maintained confidence (p=0.007). Palliative care practitioners can be trained in CBT skills by a simple and brief training course and supportive, skills-building supervision. These skills are compatible with national guidelines on delivery of psychological support to patients at all stages of cancer. Supervision is necessary to ensure maintenance of skills and confidence to use them.