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Therapy process research has made surprisingly little headway during the past 25 years, which has been attributed to a range of methodological and conceptual problems. As a result, appeals have been made for fresh approaches to psychotherapy process research. Here we provide an experiential learning model as one promising way to crystallize conceptualizations of competence in therapy and to advance research. The model provides an integrative account of the moderators and mediators believed to explain the way that therapy achieves its outcomes. Its breadth takes it beyond the scope of its closest rival, the assimilation model. By way of illustration, the theoretical components of the experiential metaphor were operationalized and mapped onto an existing competence scale, the Cognitive Therapy Scale.

Training in cognitive therapy includes a grounding in relevant empirical research, and the development of a range of clinical skills. It is recognized that this training will need to be continually updated in line with new developments. Several postgraduate training courses in cognitive therapy or cognitive behaviour therapy exist in the United Kingdom. Such courses are expensive in terms of both direct and indirect costs. A postal survey was employed to investigate the effects of the one-year post-qualification course in cognitive therapy at the Newcastle Cognitive Therapy Centre on trainees who had attended the course. The questionnaire examined trainees’ views about the course, of their current clinical skills in cognitive therapy and their use of cognitive therapy since leaving the course. Finally, continuing professional development, on-going supervision and further training in cognitive therapy were examined.

Psychiatrists, who are still performing the executive roles in many areas of mental health, make up 6.5% (N=184) of the British Association for Behavioural and Cognitive Psychotherapies (BABCP) membership. Considering that there are currently 4577 practising psychiatrists in the U.K. (Consultants, Senior Registrars, Specialist Registrars, Associate Specialists and Staff grades), the above figure is put into perspective. The equivalent figure for clinical psychologists is 40.9% (N=1162) of BABCP membership, taken from a national total of 3734 qualified professionals. Viewed in this context, the present review examines the profile of cognitive therapy (CT) in British psychiatry during the last three decades. As a measure of this, it was decided to survey the number of articles on cognitive therapy appearing in two key psychiatric journals widely circulated in Britain: The British Journal of Psychiatry and Current Opinion in Psychiatry.