There has been a rapid expansion in competence-based therapies in response to growing demands for evidence-based practice, greater openness and accountability. The changes have been accompanied by a new theoretical and empirical base for therapist training and practice. Out of this rapidly changing therapeutic world emerged Counselling for Depression (CfD). This competence-based integrated model of person-centred and emotion-focused therapy is intended to standardise counselling work, particularly for therapists working in an Improving Access to Psychological Therapies (IAPT) agency, in the treatment of depressed clients. The change has not been without its critics. Concern has been expressed about the suitability of one model for all modalities. The history of competence based vocational education and training since the 1980s suggests that an uncritical adoption of the competence based approach can have unintended consequences.
This thesis explores competence, in the context of CfD, and the implications for training, practice and assessment based on the perceptions of therapists, trainers and supervisors. Nineteen participants involved in CfD training, from across England, were interviewed for their perceptions of CfD as a manualised, evidence-based framework of integrated person-centred and emotion-focused competences. The interviews were audio recorded and the resulting transcripts analysed using Template Analysis. Therapists were relieved that CfD had become available and thereby secured their jobs as IAPT therapists. Participants unfamiliar with emotion-focused therapy saw CfD training as an opportunity to enhance their practice. The CfD competence-framework provided participants with the means of explaining what they actually do. However, significant tensions emerged concerning the CfD competence framework, the integrative therapy, the CfD training programme and the CfD method of assessing competence. The implications for participants, the competence framework, training, therapeutic practice and assessment are discussed and several recommendations proposed.
Available under License Creative Commons Attribution Non-commercial No Derivatives.
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