Practitioner Training - Couple Therapy for Depression

Based on NICE guidelines, Couple Therapy for Depression is a brief integrative-behavioural treatment for depression for couples where one or both partners are experiencing relationship distress and depression. It has been developed by identifying best practice in a range of behavioural, systemic, psychodynamic, cognitive and emotionally focussed couple therapies evidenced in RCT effectiveness trials. Couple Therapy for Depression focuses on the relational aspects of depression and on factors that reduce stress and increase support within the couple, using the relationship as a resource for recovery and relapse prevention.

This course provides practitioner training in Couple Therapy for Depression.

Trainees will be expected to:

• Participate in 5 days of formal teaching. This includes didactic teaching, discussions in small and large groups, and roleplays. There is a recorded roleplay on either day 4/ 5.
• 20 fortnightly supervision sessions across approximately 9-12 months. This will be facilitated by the training team and training consultants. Supervision will be conducted in groups and requires video conferencing, which Tavistock Relationships will facilitate.
• Submission of 5 audio recordings of therapy sessions, of approximately 2-3 couple cases, as well as verbal reports.

Applicants will need:

• An interest in developing and extending their practice to work with couples where one or both are diagnosed with depression
• To be in an NHS Talking Therapies Service Service, or be able to access their clinical work through an NHS Talking Therapies Service service.
• To be able to access appropriate couple referrals, from the outset of the course. We recommend referrals of approximately 3-4 couple cases.
• Experience of working with couples is beneficial, although this is not a prerequisite.

Q I’m really interested in couple therapy but have little experience of working with couples. Can I join the practitioner training?

Yes, the training is open to all counsellors and therapists working at Step 3 within an NHS Talking Therapies Service service or in the voluntary sector with a contract with the NHS, who have an interest in extending their practice to work with couples where one, or both, are diagnosed with depression. Access to couple referrals for training cases is essential.

Q I’m a systemic therapist. Is this course suitable for me?

Yes – as long as you have relevant clinical experience. Couple Therapy for Depression has been developed by identifying best practice in a range of behavioural and other types of couple therapies evidenced in RCT effectiveness trials. It is an integrative model and suitable for therapists and counsellors from a variety of training backgrounds. The training team welcomes applicants from a range of approaches to facilitate a rich learning experience.

Q Is this CPD or a training course?

Both! This is a training course in Couple Therapy for Depression in NHS Talking Therapies Service Services and those who complete the training will be competent to deliver this particular model as recommended by NICE. The course is described as CPD by the NHS because it is not itself a baseline therapy qualification – it is an add-on to an existing qualification. It includes assessment of clinical competences and it is possible to not pass the course.

Q I’m a Relate trained therapist. Will you be teaching me anything that I don’t do already?

Yes. As an integrative treatment for depression this 20-session model incorporate systemic, psychodynamic, cognitive, behavioural and emotional focused therapies. You might be familiar with elements of it, of course, as it is based on behavioural principles, but, as a whole, it will be something new. We have found that this mix of familiarity and unfamiliarity can be disconcerting to some Relate-trained therapists, but others say it is exciting and valuable.

Q How will I be supervised?

TCCR provides up to 20 supervision sessions for this course. You will be expected to participate in fortnightly remote supervision which will be conducted in groups with a maximum of four supervisees. Generally this will require telephone or video conferencing. The length of the session depends on the size of the group but will usually last an hour, to an hour and a half. Trainees should attend a minimum of 80% of the supervision sessions.

Q How will I pass the course?

You will need to attend the five day training course and successfully complete two supervised clinical cases of up to 20 sessions with couples. You will be required to submit five digital recordings of therapy sessions, as well as verbal reports of your casework and these need to be rated as competent by your supervisor. We strongly recommend that you self-rate the competencies for each of your recordings.

Q My practice usually offers six sessions of therapy. Why does this model recommend 20 sessions?

We recommend 20 sessions because NICE have specified this number in their guidance for the treatment of depression by couple therapy and our model comes out of their guidance. We appreciate that ordinary clinical practice would make use of a range of number of sessions and we try to be pragmatic within the limits of the existing evidence base. On average, the Integrative Behavioural Couple Therapy literature that forms the backbone of the model suggests between 16-20 sessions and so we try to keep both this and the NICE criteria in mind. What we know about depression is that it is likely to reoccur and that it can be fatal. This makes the model slightly different to ordinary good-enough clinical work with couples. Not least, an important part of the therapy is to reinforce different techniques that couples can put into practice when there is a relapse. With an assessment phase of four sessions and an ending phase of around three sessions, it is clear that a therapy of only a few sessions more than this is unlikely to cover all the things that a couple may need to relieve their distress and keep them safe in the longer-term.

• The training is funded by NHSE for professionals who meet the eligibility criteria, i.e. professionals working within an NHS Talking Therapies Service service or those able to access their clinical work through an NHS Talking Therapies Service Service.
• We also welcome applicants from NHS Talking Therapies Service services unable to access NHSE funding, but able to finance the training.
• Practitioners in private practice who have access to work with couples and able to finance the training.