CBT-L5 Application Form | Unlock Psychology

Application form for CPCAB Level 5 Diploma in Cognitive Behavioural Therapeutic Skills and Theory (CBT-L5)

This is the application form for the Level 5 Diploma in Cognitive Behavioural Therapeutic Skills and Theory (CBT-L5), delivered by Unlock Psychology Ltd and awarded by CPCAB. Full details of the course can be found by clicking here.

You can book a place on an upcoming open evening with the Course Director, Dr Alastair Pipkin, by clicking here.

Please ensure all of your details are complete and accurate, and that you upload any documents including your previous qualification certificate(s).

Once you have completed the application form, a tutor will be in contact to discuss your application and confirm suitability. You will then be offered a place on the course which you can accept following reviewing the full terms and conditions and payment of the initial deposit of £200.

Please be aware we gather and process your data in line with our privacy policy which you can view by clicking here. Please do get in touch if you have any questions about this.

Your Details

We collect your details so that we have contact information and demographic information for equality monitoring. Please be aware that your demographic information (ethnicity and gender) are not part of the selection process, they are stored confidentially in line with our Data Protection Policy and used only for statistical purposes about equality, diversity and inclusive practice.

First name

Last name

Phone

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Ethnicity

Gender

Unique Learner Number (if relevant)

Peronal and Professional Suitability

Please tell us what interests you in joining our CBT-L5 course and your academic background to date. Please note you need to upload a copy of your highest academic qualification relevant to the field of counselling/psychotherapy.

Which cohort are you applying for?

April 2027

September 2027

Other

Tell us about your highest academic qualification to date (e.g. Level 4 Diploma) including: The subject studied; Completion date; Grade; Training Provider

Please upload a copy of your certificate for your highest level of qualification relevant to counselling/psychotherapy practice. Please note, we may require transcripts if you are from a non-traditional route (i.e. if you do not have a Level 4 Diploma)

Tell us about any accrediting/regulatory bodies you are currently accredited with and what level of membership you hold (e.g. BACP membership; NMC). Please provide your membership number/pin number.

What has made you apply for CBT-L5? What interests you in adding CBT to your current practice?

What do you hope to achieve from the course? How do you intend to use the qualification?

Can you confirm that you will be able to attend 85%+ of the taught academic program, and work with us to catch up for any missed sessions? Is there anything we should be aware of regarding your ability to attend and engage with the course?

Current Practice

Please provide details of your current practice. The course requires a 30-hour, supervised clinical placement, which will need to be in place for the course. Knowing your current practice helps us to ascertain whether support may be needed for finding a placement, or if your current workplace might suit. We can offer placements in-house so please indicate if this is of interest.

Are you currently practicing as a counsellor/psychotherapist? If yes, please tell us your current role.

Please describe your current theoretical approach (e.g. person-centred, integrative, psychodynamic)

How many client hours have you completed to date roughly?

How many clients are you seeing currently?

Do you have a current supervisor who is proficient in supervising CBT? (e.g. is CBT trained, holds a supervisor certificate or equivalent)

Yes

Other

If you are not currently in practice, do you have any thoughts or ideas about where you will access a placement from?

Safeguarding and DBS

We have a duty to protect prospective students and their clients. Please provide details of any unspent criminal convictions and confirmation that you have a DBS check in place, or will do by the start of the course. If the answer is yes to the latter two questions, we will discuss with you separately.

Do you hold a current enhanced DBS certificate?

Yes

Other

Have you ever been convicted of a criminal offence (including spent convictions, as per the Rehabilitation of Offenders Act 1974 exemptions)?

Yes

Have you ever been the subject of a safeguarding concern or investigation, or had any complaints upheld against you because of your practice?

Yes

Learning Needs and Reasonable Adjustments

Please provide details of any learning needs and adjustments that might help you learn and progress with the course. Please be aware that the below does not inform part of the selection process, it is simply to help inform us of how we could best support you as a learner.

Do you consider yourself to have any specific learning differences or additional needs that may affect your studies with us? If yes, please provide details (e.g. dyslexia; ADHD; autism; visual impairment).

What, if any, reasonable adjustments do you feel would support you in your learning? You may like to share adjustments from previous learning which have helped.

Funding

Please provide details of how you intend to pay for the course fees. This will enable us to setup the invoice correctly and to the correct person.

Who will be paying the course fees? You or someone else? (please be aware we do no currently accept Adult Learner Loans)

Self-funded

Employer

Other

Please select which payment option you would like.

Upfront (includes £50 discount)

Termly payments (3x payments of £834, £833 & £833)

Monthly payments (12x payments of £208)

Declaration and Consent

Please provide declaration of accuracy for this form and confirm you are in agreement with us processing your data for purposes of the application process.

I confirm that all information provided in this application is accurate and complete to the best of my knowledge. I understand that providing false or misleading information may result in withdrawal of any offer of a place.

I confirm that I meet, or will meet by the course start date, the entry requirements for the CPCAB CBT-L5, including holding a Level 4 Diploma in Therapeutic Counselling or equivalent.

I confirm that I have access to, or am actively arranging, a suitable clinical placement in which I can work a minimum of 30 contracted client hours under clinical supervision.

I understand that BACP-aligned clinical supervision is a mandatory requirement throughout the course, and I take responsibility for arranging and funding adequate supervision.

I consent to Unlock Psychology Ltd processing my personal data for the purposes of administering my application and, if successful, my enrolment, in accordance with the UK General Data Protection Regulation (UK GDPR) and the centre's Privacy Notice.

Consent to storage outside the UK – I acknowledge that some of my data may be stored on servers outside the UK (e.g., Google Workspace, Zoom) and that appropriate safeguards are in place to protect my data in accordance with UK data protection law.

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