Rounded Rectangle: Assessment of Core CBT Skills (ACCS)

What is the ACCS?

The Assessment of Core CBT Skills (ACCS) provides a framework which assessors can use to deliver formative and summative feedback about a therapist’s performance within an observed session of cognitive behavioural therapy (CBT) and which therapists can use as a tool for self-reflection. The scale assesses core general therapeutic and CBT-specific skills required to appropriately deliver individual CBT to adults experiencing mental health problems.

Can I use the ACCS?

Please feel free to download and use the ACCS scale using the links below. If you are planning to use the ACCS within your service or training course, we would be grateful if you would email letting us know where and how you will be using the scale.

The ACCS manual

The manual provides guidance about how to use the scale. We recommend that you spend some time reading and familiarising yourself with the ACCS manual before conducting an assessment.

Click to download the ACCS manual

ACCS feedback form

This form can be used by assessors to provide therapists with feedback about their performance or for therapists to reflect on their own performance. It is designed to highlight the therapist’s key strengths as well as any learning needs.

Click to download the ACCS feedback form

ACCS submission cover sheet

The ACCS submission cover sheet provides additional contextual information which will help assessors make an informed rating of the therapist’s performance.

Click to download the ACCS submission cover sheet

Why was the ACCS developed?

In 2013 we conducted a systematic review of methods for assessing competence in cognitive-behavioural therapy (Muse & McManus, 2013). This review highlighted the need for improved measures for assessing CBT competence, particularly those which assess whether therapists can demonstrate the skills necessary to effectively deliver CBT. We therefore developed the ACCS- a novel CBT competence rating scale which aims to further develop and build upon currently available measures.

Has the ACCS been evaluated?

In 2014/15 we completed a mixed-methods evaluation of the ACCS scale. During this evaluation study, the ACCS was used within real world CBT training and NHS routine practice settings. Results from this study are promising, indicating that the ACCS is a useful learning tool, is easy to use, and has good psychometric properties. Results of this study are currently in press with the Journal Psychological Assessment. We will post a link to this article once it is available online.

What training do I need to use the ACCS?

The ACCS was designed to be as easy to use as possible. We have provided detailed rating guidance in the scale manual and have found that simply providing therapists with the ACCS manual is sufficient to achieve acceptable levels of both usability and agreement between assessors (i.e. inter-rater reliability). However, we did find that inter-rater reliability and therapist’s usability ratings for the ACCS did improve after attending a one-day workshop in using the ACCS scale. Training could also be useful for those new to using competence assessment measures, or those who would like to consider how to use the scale as an effective tool for feedback and self-reflection.

Training Workshops:

Kate Muse will be delivering training in how to use the ACCS as a tool for feedback and self-reflection on the 9th February 2017 with the Oxford Cognitive Therapy Centre. Click here to find out more details.

We are also happy to discuss bespoke training opportunities. Please email Kate Muse on

Independent Training:

If you would like to use the ACCS scale in your service but are unable to attend a training session, we would suggest the following plan:

1-      All staff download the ACCS manual, feedback form, and cover sheet (see above) and then watch this ’ACCS Overview’ video below. This will provide you with key information and guidance on how to use the ACCS.

2-      All staff complete ratings of a recorded therapy session or role-play session. Ratings should first be completed independently. Staff should then come together as a group to discuss the ratings they provided for each item and to reach a group consensus. This will help to improve reliability across the group.

We are currently developing recorded role play sessions and acompanying standardised ratings which you can use in your training. We will post these on this web page once they are finalised- watch this space!

Related publications

Muse, K., & McManus, F. (2013). A systematic review of methods for assessing therapist competence in cognitive behavioural therapy. Clinical Psychology Review, 33, 484–499.

Muse, K., & McManus, F. (2015). Expert insight into the assessment of CBT competence: A qualitative exploration of experts' experiences, opinions and recommendations. Clinical Psychology and Psychotherapy, 23(3), 246-259.

Muse, K., McManus, S., & Rakovshik, S. (2016). Development and psychometric evaluation of the Assessment of Core CBT Skills (ACCS): An observation based tool for assessing Cognitive Behavioural Therapy competence. Psychological Assessment. Online FirstView.

Rakovshik, S., McManus, F., Vasquez-Montes, M, Muse, K., & Ougrin, D. (2016). Is supervision necessary? Examining the effects of internet-based CBT training with and without supervision. Journal of Consulting and Clinical Psychology, 84(3), 191-199.

Click here to find these articles on Research Gate.

Who developed the ACCS?

The ACCS was developed by Kate Muse, Freda McManus, Sarah Rakovshik and Helen Kennerley.

This research was supported by a grant from the British Association for Behavioural and Cognitive Psychotherapies (BABCP) awarded to Kate Muse and Freda McManus and was conducted in affiliation with the University of Oxford’s Department of Psychiatry and the Oxford Cognitive Therapy Centre (OCTC).

A number of individuals also participated in the development and evaluation of the ACCS. In particular staff at OCTC, First Step IAPT service, University of Derby CBT course, and South of Scotland CBT course.

Contact Us

You can contact the lead author, Kate Muse on

Oxford Cognitive Therapy Centre

University of Oxford