Building Clinical Confidence with Process-based Behaviour Therapy (PBBT)

Blog post written by Dr. Ciara McEnteggart and Dr. Yvonne Barnes-Holmes

In the world of psychotherapy, clinical confidence is crucial; not only does it impact a Practitioner’s sense of competence, but it also influences the Therapeutic Alliance and Client outcomes. An alarming 70% of Practitioners report feeling burnt out, and up to 60% of them are at risk of leaving the profession; a choice many don’t want to make. Clinical confidence plays a significant role in burnout, because uncertainty about competence is so deeply unsettling. In the helping professions, we all want to feel that we are doing exactly that – helping; and it is very painful for us to think that we are doing less than that. 

In PBBT, we help Practitioners to build confidence and resilience in their clinical work. In our experience, there are four key ways that PBBT supports clinical confidence.

1. We Focus on Core Processes Instead of Diagnoses

Many traditional therapies offer diagnosis-driven treatment plans. But PBBT is process-based, allowing Practitioners to work directly with the core psychological processes that drive behavior and emotions. This shift in focus frees Practitioners from the constraints of rigid diagnostic categories, instead equipping them to address the roots of psychological challenges. Focusing on core processes builds precise understanding, which fosters confidence and reduces the uncertainty that often contributes to burnout.

2. Our Scientific Basis Reduces Uncertainty 

Built on several decades of rigorous empirical research, PBBT is grounded in a scientifically-defined framework of human behavior. This foundation gives Practitioners confidence that their clinical concepts are solid and thus their decisions based on these concepts are accurate. This fosters a sense of certainty for Practitioners in their knowledge and its application in their clinical work. This scientific reassurance reduces the likelihood of ongoing self-doubt, reducing the risk of burnout.

3. We Can Adapt to Individual Needs 

A standout feature of PBBT is its breadth in addressing each Client’s unique presentation. By targeting the core psychological units as they present individually, Practitioners can tailor PBBT Techniques to the specific needs of the Client, rather than relying on a generic protocolized solution. This adaptability allows Practitioners to meet Clients where they are and to adjust as their therapy journey evolves. Being able to adapt and evolve builds a Practitioner’s confidence and reduces the frustration of continually getting stuck, a significant factor in burnout.

4. We Can See Real Progress

PBBT’s Clinical Pathway enables a clear assessment of a Client’s progress over time. Practitioners can monitor and record shifts in the core psychological processes at each PBBT Phase, giving them a clear way to gauge their own efficacy. Observing these incremental changes and witnessing Client improvement brings confidence and a sense of empowerment, which circumvent burnout.

Practical Tips to Improve Your Clinical Confidence

Here are a few short actions you can take now to help support your clinical confidence:

1. Reflect on What you Want and What You’re Good At
   Think about what you really want to achieve as a Practitioner. Ask yourself: What do I add to my Clients’ lives? Reconnect with the reasons why you are in this job. Connect with what you feel you’re good at, no matter how small.
2. Get Peer Support and Supervision
   Discussing cases with colleagues or a supervisor is always helpful; they always see things you don’t and give you valuable feedback on your insights and observations. Sometimes, it’s just the emotional support that you need. Discussions with peers helps you get confidence on your strengths and face into areas where you’re not so strong. Find your tribe and lean on them!
3. Continuous Learning is Continuous Growth
   Confidence grows with competence, so stay curious. Invest time in deepening your skill set and keeping your knowledge fresh. Things change and new things are inspiring, interesting, invigorating.
4. Be Kind to Yourself
   No Practitioner has all the right answers. We all make mistakes. Neither of these define our competence. Some cases are just difficult, but these are often the ones that build our resilience. Remind yourself that you are where you are today and it is likely better than before; you are doing your best and that is enough. 
5. Have Little Projects
   Little projects are exciting but manageable areas where we can change and improve without undermining where we are now. Think about knowledge areas or skills where you’d like to improve and mark out a runway toward that. Just make it one step at a time, it’s just a little project, it’s your little project and you are enjoying the doing as much as the outcome.

Conclusions

In a time when burnout threatens the sustainability of our mental health professional community, we need to look after each other now more than ever. Clinical confidence isn’t just about skills, it’s about feeling empowered and supported in your clinical work.

If you would like to learn more about how PBBT can support you as a Practitioner, get in touch with us.

Feel free to join us for an informational webinar on 22nd January 2025 at 4pm where we will speak more about PBBT, the PBBT Institute, and our new Professional Diploma in PBBT. Applications for the Diploma are now open.