CTSR vs ACCS: How CBT Competence Gets Measured
By Jaime G. Miralles — BABCP Accredited CBT Therapist & CBT Accredited Clinical Supervisor and Meta Supervisor
TL;DR The CTSR and the ACCS are two of the main scales used to measure CBT competence from recorded sessions. Neither is definitively ‘better’ — the CTSR is what most UK universities use and what the BABCP standard asks for, though I find it can be less inclusive of neurodivergence and learning differences.
Key takeaways
- CTSR and ACCS are both recognised ways of measuring CBT competence from recordings.
- The CTSR is what most UK universities and the BABCP standard commonly use.
- I find the CTSR isn’t always very inclusive of neurodivergence or learning differences.
- Different bodies may ask for different scales — it’s not about one being better, just different.
- I personally prefer more observations than the basic minimum requires.
Why competence measures come up so often
People keep coming back to this: is the CTSR better than the ACCS, or better than another measure? Ultimately, whether you’re from overseas or in the UK, and looking for BABCP accreditation, you need competence metrics for your recorded sessions — and that’s important, whichever scale is used.
Personally, I find the CTSR isn’t very inclusive, and isn’t very flexible. It can leave out things like neurodivergence and learning differences when you’re reviewing recordings. However, this is what most universities in the UK use, and it’s important to know that this is what the BABCP standard asks for, which is entirely respectable, even with its limitations.
Other places will ask for something different, like the ACCS. That doesn’t make one scale better or worse — it’s just different, suited to a slightly different emphasis. What matters is that whichever scale is used, it’s applied by someone properly trained in it.
There are basic minimum levels of observation required, but I particularly believe in requesting more supervision, more tapes, and more observation than that minimum for the people I work with as supervisor. I think it genuinely serves people better, whichever competence scale is being used to assess them.
What’s the difference between the CTSR and the ACCS?
Both are scales used to measure CBT competence from recorded sessions. The CTSR is what most UK universities and the BABCP standard commonly use; other settings may use the ACCS or a different scale.
Is the CTSR the best way to measure CBT competence?
It’s the most widely used in UK training, though I find it can be less inclusive of neurodivergence and learning differences than it could be.
Who can mark a session using the CTSR or ACCS?
The assessor needs to be trained in using that specific scale — not just any supervisor or colleague.
If you’re unsure which competence scale your training or accreditation route requires, it’s worth checking early rather than assuming. Find out more about my BABCP clinical supervision here.
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