Finding My Confidence with CBT Trainer

As a first-year trainee in the Low Intensity Cognitive Behavioural Interventions program at UCL, I still remember the panic I felt before my first OSCE assessment. Despite hours of lectures on therapeutic techniques and competency frameworks, I had barely any opportunities to actually practice them in realistic scenarios.

My training cohort tried to organize role-play sessions, but coordinating schedules was nearly impossible. When we did manage to meet, I'd spend most of the time playing the patient for others, getting maybe 20 minutes of actual practice time in a one-hour session. And even then, performing in front of peers who were evaluating my every word made my anxiety skyrocket.

"How am I supposed to become competent when I can't practice?" I wondered, scrolling through yet another email from a classmate canceling our practice session. That's when I first heard about CBT Trainer.

My Experience: From Skeptic to Advocate

I was initially skeptical. An AI application that simulates patient interactions? How realistic could that really be? But with my assessment approaching and few other options, I decided to give it a try.

My first session with the virtual patient "Eden" was a revelation. The interaction felt surprisingly natural, and I could practice asking assessment questions, formulating case conceptualizations, and managing challenging moments—all without the fear of judgment or wasting someone else's time.

When I made mistakes (and I made plenty), there was no awkward silence, just an opportunity to try again. The immediate competency-based feedback helped me understand exactly which aspects of my approach needed refinement. I could see that my risk assessment questions were too abrupt and my agenda-setting skills needed work, but my information gathering about cognitions was strong.

Over the next weeks, I logged nearly two hours of practice across multiple sessions with different virtual patients. Each scenario presented unique challenges—from a client with social anxiety who struggled to elaborate on their experiences to another with agoraphobia who had complex avoidance behaviors.

The Difference It Made

The impact on my training was profound:

• Confidence Boost: By the time my assessment arrived, I'd conducted dozens of practice sessions. The nervousness was still there, but I had a reservoir of experience to draw from.
• Skill Refinement: I could target specific competencies I struggled with rather than hoping they'd come up in random role-plays.
• Flexibility: Late-night practice became my norm—I could squeeze in 15 minutes of focused practice between commitments without coordinating with anyone.
• Enhanced Supervision: My supervision sessions became much more productive because I could identify specific challenges I'd encountered during practice.

As one of my classmates put it: "It's like having a patient who's available 24/7 and never gets tired of helping you learn."

Beyond Individual Benefits

What impressed me most was how CBT Trainer democratized quality training opportunities. In my cohort, some students had previous mental health experience, while others (like me) were complete novices. Some had supportive placement supervisors with ample time, while others received minimal guidance.

CBT Trainer helped level the playing field, ensuring everyone had access to consistent, high-quality practice opportunities regardless of their circumstances. For international students in our program, it also provided a safe space to practice therapeutic language and expressions without fear of judgment.

An Invitation to Fellow Trainees and Programs

If you're a trainee feeling that gap between theory and practice, or a program director looking to enhance your students' learning experience, I can't recommend CBT Trainer enough. It's not a replacement for human supervision—nothing can substitute the wisdom and guidance of experienced clinicians—but it's an invaluable complement that addresses real gaps in our training processes.

The app is available for iOS on the App Store, with an Android version coming soon (you can join the waitlist by contacting contact@soymh.com).

Program directors interested in making this available to their students can contact the same email for demonstration and institutional licensing options.

For those interested in the research behind the app, there's a preprint available at https://doi.org/10.31234/osf.io/h84qn_v1 showing the impact across 59 trainees like me.

Looking Forward

As I continue in my training, CBT Trainer remains a constant companion. When I encounter a challenging client presentation or need to refresh a specific therapeutic technique, I know I have a resource that can help me practice and refine my approach.

Mental health training has remained largely unchanged for decades, but innovations like CBT Trainer suggest a promising future where technology enhances—rather than replaces—the human elements of our education.

For fellow trainees wondering if it's worth trying: Yes, absolutely. Your confidence, competence, and clients will thank you.