CBSST Implementation & Training

The primary goal of CBSST is to use cognitive behavioral therapy (CBT) and social skills training (SST) psychosocial interventions to systematically help consumers with serious mental illness achieve their personal recovery goals. SST involves learning communication and problem-solving skills, and CBT involves learning to catch, check and change unhelpful thoughts that interfere with successful goal-directed skill performance in the community.

Training Series:
In this training series, the theoretical rationale for using these interventions to improve functioning in schizophrenia will be discussed, the evidence for the efficacy of these interventions will be reviewed, and practical training on how to deliver these interventions will be provided. 1) An Overview workshop will provide a review of research evidence supporting the efficacy of CBT and SST in consumers with serious mental illness (SMI), basic knowledge about core CBT and SST skill components, and an understanding of how to deliver CBSST with high fidelity; 2)  The Skills Practice workshop will provide practical training involving video demonstrations and role play practice of core CBSST goal-setting, thought-challenging, problem-solving and communication skills and their application to common problems (e.g., making friends and renewing family relationships, transportation, working/volunteering, taking a class, assertiveness, substance abuse, etc.); and 3) ongoing supervision will provide an opportunity for participants to discuss their challenges and successes in providing CBSST to consumers and receive feedback and guidance.

Implementation Costs:

Cognitive Behavioral Social Skills Training (CBSST) for Schizophrenia: A Practical Treatment Guide (Guilford Press). The consumer manual is included in the book.

Training Workshops:
On-site CBSST training workshops are available. Depending upon the number of attendees, a second trainer is recommended to provide additional coaching to attendees during role plays and practice of the skills.

On-site and remote consultation is available. We highly recommend consultation following the training workshop to facilitate the development of skills and improve the implementation of CBSST in your organization.

Quality Control:
To ensure high-fidelity implementation of CBSST, we offer CTS-Psy ratings of session recordings. These ratings great assist in monitoring the progression of skill development in providers and demonstrating the level at which CBSST is being delivered in your organization.

* Please note that the purpose of consultation training and fidelity ratings are to improve provider skills, adherence to the CBSST model and overcome implementation barriers. Consultation is not for treatment planning or advice about the care of any individual clients.  The treatment of clients at the agency is entirely the responsibility of the agency and providers at the agency.

Clinician Qualifications: 
No specific credentials are required to deliver CBSST, but clinicians must be able to work with consumers with serious mental illness and be hopeful and supportive of their living, learning, working and socializing recovery goals.

Example of CBSST Implementation Timeline:

Phase I (3 months): Preparation and CBSST Workshop Training
a. Planning meeting with administrators who make a commitment to integrate CBSST
b. Identify CBSST Team leader(s) and clinical staff who will initially deliver CBSST and participate in 2-day workshop
c. 2-Day CBSST training workshop including information and practical experiential learning exercises (role plays; video demonstrations)

Phase II (6 months): CBSST Skills Development
a. CBSST team leader advocates for implementation of CBSST and schedules and conducts weekly CBSST group consultation together with outside expert CBSST consultant
b. Providers practice CBSST with limited caseload and protected supervision time
c. CBSST team leader communicates with leadership about obstacles to implementation of CBSST
d. CBSST team leader observes CBSST providers in sessions at least once every month and provides feedback in supervision to improve fidelity (use of standardized fidelity rating scales can facilitate this process)

Phase III (ongoing): Consolidation and Sustained Practice
a. Focus on strengthening CBSST skills in weekly supervision by local CBSST team leader as outside expert CBSST consultant phases out
b. CBSST team leader observes clinicians in sessions at least once every 6 months
c. Consider starting CBSST alumni group of consumers who can act as role models and peer coaches/providers in groups and in the community

CBSST Supervision
1.Supervision Goals
  a. Monitor and track CBSST delivery:
    i. Module/Session #
    ii. At-Home Practice
    iii. Goal Progress
    iv. Consumer’s level of participation and key thoughts
  b. Learn and practice skills (role plays)
  c. Evaluate and improve competence and CBSST fidelity at the facility (feedback fidelity ratings) 
  d. Support clinicians implementing CBSST
  e. Brainstorm and problem-solve about obstacles to CBSST implementation 
2. Supervision Structure:
  a. Recommend weekly 1-hour protected time for group supervision to ensure fidelity and support sustainability
  b. Structured agenda to guide meetings (attached):
    i. Initial focus on recruiting consumers 
    ii. Ongoing focus on clinician competence and CBSST fidelity
    iii. Initially lead by outside consultant; then by in-house CBSST team leader

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