Guidance for assessing case studies completed outside an academic institution

Case studies are normally assessed as part of post-graduate CBT training. However, not all courses include all four we require. If this applies to you, or you do not have evidence of all the passed case studies, this document provides guidance on both how to write and assess case studies marked independently for accreditation. 

The criteria for BABCP CBT Practitioner Accreditation are set out in our Minimum Training Standards (MTS 2021) - 

• at least four of the eight training cases must be presented and formally assessed as case studies, a further three must have received close supervision
• written case studies should be between 2000-4000 words (or 3-5000 if extended).
• the case studies can cover the same cases that are closely supervised or they can be different
• two of your formally assessed case studies may be delivered as a ‘live’ case report or presentation instead of a written study – if so, there should be supporting information such as slides or a written summary as part of the formal assessment
• case studies must be marked as a ‘pass’ 
• the marker must have experience of marking CBT case studies in an academic setting
• the completed mark sheet for the case study should be submitted along with an application for accreditation

The assessor should be accredited by BABCP or be a CBT therapist who is trained and qualified in CBT to postgraduate diploma level or equivalent (or would meet Minimum Training Standards). 

In addition, they should have experience of marking as a lecturer or tutor on an academic post-graduate CBT training course or equivalent. The assessor may, however, currently be independent of an academic institution.

If possible, we recommend that you contact assessors from your course, local courses or through other contacts. Otherwise, you can download a list of independent assessors here. It will be your responsibility to check that they still meet the criteria for a suitable assessor and to negotiate fees, timescale and, if appropriate, reasonable adjustments with them.

Assessors are asked to confirm that the case study has passed– this means that it is of an acceptable standard for a competent CBT therapist. Feedback should be given to the candidate and expectations of quality, content, layout, writing style and structure should be of a similar standard as case studies marked in a post-graduate programme.

Reasonable adjustments should be made where appropriate where the applicant can provide evidence of relevant additional needs.

The case study should demonstrate theoretical understanding and a research-based rationale for choosing a specific approach and knowledge of alternative options, which is consistent with evidence-based CBT practice. There should be a reflective element which identifies new learning.

All the areas described below should be covered where relevant.

Evidence of structured assessment, including the following areas -

• risk assessment
• current circumstances
• details of current presenting problem(s) and/or diagnosis, including co-morbidity and reason for seeking treatment at this point
• relevant personal history including development of the problem, previous treatment(s) and current coping
• use of appropriate standardised psychometric and idiographic measures
• suitability for CBT and socialisation to the model
• identified treatment goals
• assessment of diversity and relevant socio-cultural factors

• detailed description, explanation and critical evaluation of relevant CBT model(s) with rationale for choice of model
• knowledge of evidence base underpinning the theoretical model and chosen intervention(s)
• any adaptations to the model needed for the case

The report should outline a coherent, concise formulation developed collaboratively over treatment with explicit input from client and include- 

• evidence of individualised formulation at maintenance or cross-sectional level in keeping with diagnosis specific or generic CBT model, which is appropriate to the presentation and justified by the evidence base
• explanation of links between elements in maintenance cycle
• diagrams of maintenance cycles (and longitudinal formulation, if appropriate)
• identification of a trigger or critical incident/explanation of onset of problems (precipitating factors)
• underlying beliefs/assumptions (predisposing cognitive vulnerability factors) and explanation of links between these and maintenance cycles
• explanation of how past events may have contributed to/reinforced the beliefs
• awareness of any missing elements

• Identification of theoretical aims of treatment according to the model used, and in relation to client’s presenting difficulties and goals for treatment
• treatment plan explicitly linked to formulation
• clear identification and description of the main phases of treatment and detail on at least two specific change processes, including the cognitive and/or behavioural interventions utilised and the rationale for their use
• examples of written materials used (may be in appendices)
• justification of any deviation from model or protocol used
• identification of client’s learning
• continued refinement of formulation (if necessary)
• evaluation of outcome including progress towards treatment goals
• changes in psychometric and idiographic measures, changes to client’s general functioning and client’s evaluation of therapy relapse prevention plan

• reflection on the progress of therapy and outcome of therapy, and the therapist’s learning. Including identification of therapist and client factors that helped or hindered therapy, use of supervision, the role of the therapeutic relationship and likelihood of treatment gains being maintained 
• comment on the therapeutic alliance (interpersonal process) and if relevant how difficulties in treatment or the therapeutic relationship are understood in terms of the formulation, and how these were managed
• identification of what therapist may have done differently given another chance
• broader implications for the model or evidence base
• reflection on diversity and relevant socio-cultural factors

The overall presentation should include -

• coherent structure with logical flow 
• clarity of communication, grammar and spelling
• use of diagrams, tables and/or figures where appropriate
• quality of referencing in text and in reference list
• limited, judicious use of appendices 

The criteria for written case reports above should be applied to marking verbally presented case studies, including the assessor criteria and the requirement for the report to pass. In addition -

• the presentation should include the opportunity for assessor(s) to give feedback and ask questions
• the presentation should be a minimum of 30 minutes’ duration (which may include the time for questions)
• there should be supporting information such as slides or a written summary
• any marking criteria that relate to the written aspect of the presentation should be used to assess the verbal aspect of a verbally presented report e.g. adhering to the word count would be equivalent to adhering to the allocated time
• as with written reports, the presentation should meet the standards expected of a healthcare profession with a post-graduate level qualification e.g. accurate and detailed slides, clarity of expression, logical sequence covering the areas outlined above, clarity and coherence of the content, respect for client confidentiality, effective use of tables and figures, lack of grammatical and spelling errors, appropriate links to evidence base and referencing 

A BABCP case study feedback sheet is available here. It is optional and assessors can use a different system of ensuring and demonstrating that the case studies have met all of the requirements. 

A copy of the feedback sheet should be sent to the applicant for them to include with their accreditation application.

If the case study is not marked as a pass, please provide the applicant with constructive feedback. 

We may request a copy of the report in order to moderate the marking.