Training and Clinical Preparation of Nurses Delivering Cognitive Behavioral Therapy: A Systematic Review

Cognitive behavioral therapy (CBT) is increasingly being incorporated into nursing practice across mental health and chronic care settings. However, limited attention has been given to how nurses delivering CBT interventions are trained, supervised, and professionally prepared within existing research.

This systematic review aimed to examine the characteristics, training, supervision, and reported outcomes of CBT interventions delivered by nurses with formal or structured CBT preparation across clinical settings.

Following PRISMA guidelines, a systematic search was conducted across five major databases. Eligible studies included interventional studies that examined CBT interventions delivered by nurses with formal, structured, or supervised CBT training. Data extraction and methodological quality assessment were conducted independently by two reviewers using the Effective Public Health Practice Project (EPHPP) quality assessment tool.

Five studies met the inclusion criteria, involving diverse clinical populations including individuals with schizophrenia, adults with chronic illnesses, and pediatric family caregivers. Considerable heterogeneity was observed in nurses' educational preparation, intervention characteristics, supervision structures, and outcome measures. Training pathways ranged from brief certification programs to extended supervised clinical training. Across studies, nurse-delivered CBT interventions were associated with improvements in psychological and functional outcomes. However, the overall methodological quality of the evidence was weak. Common methodological limitations included small sample sizes, lack of blinding, attrition, and inconsistent reporting of competency assessment and intervention fidelity.

Healthcare organizations considering nurse-delivered CBT interventions should establish clearly defined training pathways, structured supervision, competency assessment, and explicit procedures for monitoring intervention fidelity. Given the limited and methodologically weak evidence base, implementation should be cautious, supported by standardized intervention protocols, and accompanied by systematic evaluation of clinical and implementation outcomes.

CRD420251148159.