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​Supervision and Consultation Services

Supervision toward ACT Certification
Intensive, individual supervision is available to therapists who wish to hone CBT skills to the highest level: using independent judgment and critical thinking to appropriately and effectively deliver CBT interventions. An entire therapy session, audio-recorded, is reviewed each week by the supervisor and rated on the Cognitive Therapy Rating Scale (CTRS). Supervision sessions are held in person or by audio/video conferencing. Proficiency is determined by standard scores on the CTRS. Trainees are awarded a certificate once proficiency is reached. 

In  supervision, clinicians submit audio-recordings of actual therapy sessions each week which are rated on the Cognitive Therapy Rating Scale (CTRS). The CTRS is the rating instrument used by the Academy of Cognitive Therapy -- the international credentialing institution for CT, as well as all of the major training institutes across the country, such as the Beck Institute.

Supervision is the preferred option for clinicians who would like to become certified in CT. Noah Clyman is a member of the Academy's Credentialing Committee, and helps clinicians enhance their skills with conceptualization and application of CBT techniques so that they are well-prepared to submit the required work sample and case write-up.

To learn more about the requirements for certification, please review the Academy of Cognitive Therapy Candidate Handbook,  here. 
Consultation
Group and individual consultation is available to therapists who desire guidance and feedback as they begin to utilize newly learned concepts. Less intense than Supervision, therapists discuss and problem-solve challenges they encounter as they implement new CBT skills. For Consultation, the submission of taped therapy sessions is not required. 
Supervision FAQs 
Find answers to some commonly asked questions about supervision here. 

What is the structure of supervision?

Participants initially set goals for their supervision experience. Noah believes that we learn best from a combination of modeling, observation, and direct practice.To model effective structure and to maximize participants’ learning, Noah organizes supervision sessions in the same way that CBT therapy sessions are structured: conduct a brief check-in, collaboratively set the agenda, establish a “bridge” from the previous supervision session to the current one, discuss the case (including conceptualization, direct teaching, guided discovery, and role-playing), discuss other topics or patients (if time allows), create an “action plan” to follow up the supervision session, and elicit feedback on how the session went.

*To enhance the learning experience, Noah provides the option for participants to submit a tape-recording of an actual therapy session each week (once the appropriate written consents have been obtained by the patient). Noah will review the entire recording prior to the supervision session, rate it according to the Cognitive Therapy Rating Scale (CTRS) and develop a plan for that session, based on therapeutic priorities and on the participant’s level of skill and overall goals.The opportunity to get direct feedback on taped therapy sessions is particularly valuable as it allows participants to get recommendations based on what actually happened in the session, not just what they remember at the time of our meeting.

This process provides an excellent opportunity to reduce performance-anxiety and get feedback, practice, and skills-acquisition prior to applying for certification, as the Academy requires that participants achieve passing scores on the CTRS to get certified.

Objectives for Supervision

1-Cognitive Conceptualization: To improve competency in conceptualizing clinical conditions, personality disorders, and therapeutic processes (e.g. transference) from a cognitive perspective

 2-Cognitive Skills: To improve CT strategies, techniques, and cognitive restructuring tools including:
  • "Collaborative empiricism", "guided discovery", and the effective use of "Socratic questioning" to facilitate therapeutic change
  • Identifying, evaluating, and responding to relevant automatic thoughts and images
  • Developing “reality (behavioral) experiments” to test & change underlying maladaptive beliefs
  • Implementing appropriate homework assignments to facilitate change
  • Intervening with core beliefs (schemas) and relevant cognitive-emotional-interpersonal processes relevant to personality disorders
  • Appropriate use of other cognitive techniques and strategies (e.g., restructuring early memorie


3-Developmental History & Cognition: To better understand the developmental origins (familial, social, experiential) of belief systems as related to conceptualization and treatment.

4-Theoretical Integration: To more effectively integrate cognitive therapy with psychodynamic, humanistic, behavioral or other therapy approaches.

5-Transference Issues: To increase sensitivity and skill with use of cognitive therapy approaches in response to transference reactions in the therapeutic relationship. 

6-Short-term Treatment Efficiency: To maximize treatment efficiency and effectiveness especially when time limits are imposed by managed care or client finances, with emphases on specifying treatment goals, setting session agendas, homework, and overall treatment structure.

Preparation for Certification by the Academy of Cognitive Therapy

Participants will:
  • Develop an individualized conceptualization of the client based on the cognitive model;
  • Plan treatment based on this conceptualization;
  • Conceptualize and solve therapeutic relationship problems;
  • Use the conceptualization to plan treatment in sessions and across sessions;
  • Learn how to structure the therapy session;
  • Learn to effectively employ a wide range of techniques (at both intellectual and emotional levels) to meet therapeutic goals;
  • Conceptualize and solve therapeutic relationship problems;
  • Identify key beliefs and strategies associated with several personality disorders;
  • Educate clients about their cognitive profile and core beliefs;
  • Use specialized cognitive and behavioral interventions to modify beliefs;
  • Enhance treatment compliance and overcome obstacles in treatment;
  • Learn how to monitor and measure patient progress;
  • Use the Cognitive Therapy Rating Scale to assess competency
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