EPIC:
How did the Beck team prepare you and your agency to start CBT?
Gina:
I can see different layers in the Beck Team. They started with the patient plan. The team was promoting the values of CBT in our agency. They tailored it to our community, to our agency, to our clinicians and our supervision of clinical work. They see it from a systemic view. This opened me, the other clinicians and other administrators to be creative [with the work]. They helped us to see the challenges we had and how to come across them in order to implement CBT. We sat together to review a common goal and plan. We were planning for us and for the community. That bridged the process. We were pulling so many things together so people were going to love it and not be afraid. We reviewed the CBT supervision model very carefully. Michael taught us in a very simple manner how to understand the values of CBT as a movement and as an initiative. This helped to bring a lot of passion to the project.
EPIC:
What was most helpful in this “readiness” stage of CBT Implementation?
Gina:
The supervision plan was great because the trainers were in tune with us. The implementation was also key to our work. It helped the Beck trainers to understand how we work and how we were to move forward.
EPIC:
When did you and the Beck team know you were ready to start training in CBT and practicing it?
Gina:
Doris and myself had been trained in CBT before so we already knew kind of what to do. Doris had been a CBT supervisor before. I also used CBT as a therapist. We created a culture of non-judgement and that had the core values of CBT in our agency so that everyone was ready. We made sure that every therapist and the front desk staff understood what CBT was. We created a culture around the principles of CBT in our agency. After we created this culture therapists could choose to be trained in CBT with a working knowledge of CBT.
EPIC: What did you think about CBT at first? Were there parts of CBT you were skeptical about?
Gina:
I always liked to learn. I always want to learn everything that makes me a better person and makes me more skillful in helping other people. I heard someone else talking about it and I said, “I want to sound like that.” She was using Socratic questions and I loved what she was teaching me in doing this. I then started CBT training and supervision. Our members in the Latin community have so many things that they bring to session. But when you have an agenda it makes it easier and less stressful. It helps to organize you and the patient. You help the patient to be more successful. You take away a lot of guilt from the patient who would normally feel that they are burdening you. They see themselves as the problem. It helps them to prioritize. It also helps us as therapists to prioritize.
Dorothy:
I knew Dr. Beck is well known so I wanted to go hear about it [The Beck Community Initiative]. I think I was thinking of it as more behavioral but then when I went to the information session I realized “this is right up my alley!” I liked how it helped people to restructure their cognitions and knew I was interested. I felt like I needed to apologize to Dr. Beck after I understood what it was.
EPIC:
What would you say to someone who is skeptical about CBT? Staff or member?
Gina:
We have to be very creative and sell CBT. We need to be like a salesperson selling a product. We need to develop our skills in selling CBT. The certificate is not the most important thing, it’s that you are creating a culture that includes personal growth and family growth. It’s the culture you are building in yourself and the people. You are helping the community by using CBT.
Dorothy:
I think when some people have their master’s you can’t tell them nothing. But I am someone who acknowledges there is a continuum of change and there is always something to learn. You can take an easy way and say you are eclectic. People tell me that I am psycho-dynamic and I didn’t believe them but I strongly believe things happen by osmosis. I have training in contextual family therapy (Bosmnyi-Nagye) and CBT weaves well with it. [They are] different interventions but producing the same results. A father is trying to change the history of his family so that his kids will be there for their kids if and when they have them. We are changing how the family thinks. I don’t say I am looking to do cognitive structuring with you. I am showing them. CBT gives me the guidance of an evidence-based structure. I can use guided discovery to support a person to realize that things are holding them from moving forward in life.
