CBT Today Vol 45 No 2 (May 2017)

Volume 45 Number 2 • May 2017

n tio ec form e El ions issu P minaitth this BCl for Ndoed w BA Cal inclu

being with mother

Pages 12-15

BABCP Imperial House, Hornby Street, Bury BL9 5BN Tel: 0161 705 4304 Email: babcp@babcp.com

contents Main Feature

www.babcp.com

Being with mother Volume 45 Number 2

12 From midwife to CBT psychotherapist

May 2017

Janet Kingston-Davis talks about her move into talking therapies after a career in midwifery

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14 An information processing model for postnatal depression CAF SIG Chair Maria Barquin looks at recent research in the area of PND

Welcome to the latest CBT Today magazine. Being springtime, It is timely that we feature articles about new life, in terms of supporting new mothers, with a look at an information processing model for postnatal depression, as well as hearing of a therapist's career move from midwifery into the talking therapies.

News 6

Accreditation

9

In brief...

NHS next steps, New guide for working with LGBT people

Also included is the annual Call for Nominations form - if you are interested in joining the BABCP Board at this year's AGM, this is your opportunity to get involved.

11 In brief...

As always, thanks go to all our contributors - if you want to write for CBT Today, please do get in touch.

Features

Peter Elliott Managing Editor peter.elliott@babcp.com

Contributors

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Research Fund information, Course Accreditation committee vacancy

10 The words don't work Jim Lucas looks at the use of language

21 IT Blog Are therapist's jobs under threat from Artifical Intelligence? Sarah Bateup considers the future for using AI in therapy

Maria Barquin, Sarah Bateup, Andrew Beck, Julie Evans, Maggie Fookes, Katy Grazebrook, Janet Kingston-Davis, Jim Lucas, Sarah Plum, Tamsin Speight, Chris Williams CBT Today is the official magazine of the British Association for Behavioural & Cognitive Psychotherapies, the lead organisation for CBT in the UK and Ireland.The magazine is published four times a year and posted free to all members.

Also in this issue

Back issues can be downloaded from www.babcp.com/cbttoday

4

AGM notice

5

Annual Conference

8

Spring Conference

Disclaimer

The views and opinions expressed in this issue of CBT Today are those of the individual contributors, and do not necessarily reflect the views of BABCP, its Trustees or employees.

Next deadline

9.00am on 14 August 2017 (for distribution week commencing 15 September 2017)

Advertising

16 EABCT Conference

For enquiries about advertising in CBT Today, please email advertising@babcp.com. © Copyright 2017 by the British Association for Behavioural & Cognitive Psychotherapies unless otherwise indicated. No part of this publication may be reproduced, stored in a retrieval system nor transmitted by electronic, mechanical, photocopying, recordings or otherwise, without the prior permission of the copyright owner.

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May 2017

18 BABCP and me with Andrew Beck

welcome

President’s update Croeso!

The Spring Conference, which has just taken place in Cardiff was a great success. Great workshops and presentations, a lively audience and fantastic weather in the Welsh capital showcasing all that is best about BABCP. Professor David Clark was the keynote speaker and emphasised the impact IAPT has made within NHS England. The figures themselves regarding take-up and outcome are impressive – but the thing I came away struck by is that the greatest strength for change in IAPT isn’t the focus on high and low intensity CBT per se (though of course in BABCP we advocate CBT can change lives!). Instead, for me the most inspiring aspect of IAPT is its commitment to session by session outcome measures.

You can argue the case whether IAPT measures too much, or whether it measures the right things, but the fact it routinely records amongst other ratings low mood, anxiety and social function means patients, their supporting practitioners, their supervisors, service leads, commissioners and ultimately the general public can know if change occurs. IAPT also publishes this data researchers can review and question results as well as discover important trends in local and national care. That is an amazing commitment to robustness and openness and is rarely seen elsewhere.

Gathering data doesn’t mean IAPT is perfect. It is not. It doesn’t mean everyone engages or recovers – clearly not. But we actually know that is the case.

The key is we have the opportunity to know – whereas in so many other services that key information is not available. A senior Welsh civil servant attended the session as well as a variety of Welsh local service leads and commissioners. If they were struck by one thing I hope it is that commitment to measuring outcomes and then striving to improve these.

As President of BABCP I suspect you’d think I would argue that CBT is the solution to improving outcomes. It can be – but not for all. Some people engage and recover using CBT. Others fail to

engage, or drop out, and either only partially improve, don’t improve at all, or actually feel worse.

In IAPT we know that nearly half recover, another significant group improve and also some feel worse. Also many drop out. That’s why services need to constantly reflect. What is offered? How is it supported? How do we engage and help?

Services need to draw on a range of therapies to engage and help people – not just CBT. Measurement helps that choice, and also allows audit and improvement. But whatever is offered needs to be evidence-based.

It’s disappointing therefore that IAPT is sometimes viewed in black or white ways. Either as a fantastic showcase for new treatment – or as terrible. As therapists, we know that such global labelling it pretty much always inaccurate. Like services all over the UK and Ireland IAPT will have some areas with great results – and some with poorer results – that’s what you get when services are delivered across regions, towns, cities and villages by different staffs, and with different leads, and with all sorts of different local social challenges. IAPT exemplifies the challenges of how a central structure can be made to work locally.

Some have recently criticised BABCP for sometimes appearing too focused on IAPT. It is a very important service in England, but just one approach in that country, and it is not the choice for service development in Wales, Scotland, Northern Ireland or the Republic of Ireland. BABCP serves all these nations.

Here are some points that show this commitment: a) the BABCP board represents the breadth of our membership, with members from each country of the UK – some of which have IAPT and some not. For example, the Honorary Treasurer is from Northern Ireland, the Secretary from Scotland, and the President the son of a Welsh father and English mother, brought up in England, and now living in Scotland.

continued overleaf

Let us know your thoughts by emailing babcp@babcp.com

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As President of BABCP I suspect you’d think I would argue that CBT is the solution to improving outcomes. It can be – but not for all.

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May 2017

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welcome President’s update continued

b) I doubt any of the Board feel any particular personal allegiance to any specific service delivery model. Only one or two are employed in or directly linked to IAPT roles. What we are all focused on is evidence-based practice and helping grow the awareness and delivery of CBT more generally. We want to support CBT delivery throughout the UK and Ireland. c) As part of our work recently we have taken the decision to cease the current PWP accreditation process. Individuals (less than 120 members) who are currently accredited as PWPs will retain that accreditation until it lapses. We chose to end the previous PWP accreditation because the change of IAPT curriculum made our current accreditation criteria outdated. We are actively looking at introducing a reformed accreditation for low intensity practitioners – rather than PWPs alone. The Board will need to discuss and plan a way forward regarding this, but the idea of low intensity accreditation with relevance across the nations represented in BABCP is an important principle. If we choose to go that route it is likely we will focus on the basic training plus the ongoing commitment to CPD and supervision, mirroring the successful format used in our high intensity accreditation. d) Likewise we have recently approved a new Low intensity Special Interest Group. This replaces the disbanded PWP group that closed several years ago.

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e) Our new senior clinical adviser Lucy Maddox has a clear remit supporting external communications across all countries. f ) These are sustained commitments made over a long time. It’s why our annual meeting was Belfast last year, Manchester this year and Glasgow next year. The Spring workshop was in Cardiff and potentially there will be a return to Wales for the 2020 annual meeting. It’s why we have supported the Irish branch in its EABCT bid – and more.

So, let’s welcome the challenge of how we all work to achieve great services using evidence-based approaches – measuring outcomes – and acting on them. Let’s reject simple solutions. Or all or nothing criticism of entire delivery approaches. Life is more complex than that. Data allows people to reflect and improve – and for me that is a key positive.

And if we disagree or take different viewpoints, that is great! Improvements come from constructive discussion. But let’s all discuss things based on the science, and do so in respectful ways.

We are all human. We bruise easily. So let’s be gentle in how we argue and make our points.

Chris Williams BABCP President

Notice is given to all BABCP members of the Annual General Meeting Date: Thursday 27 July 2017 Venue: University of Manchester 4

May 2017

www.babcp.com

annual conference & workshops

www.babcpconference.com

BABCP Annual Conference & Workshops Manchester University, 25 - 28 July 2017 Confirmed Workshop and Keynote speakers so far: Arnoud Arntz, University of Amsterdam Stephen Barton, Newcastle University Rachel Calam, University of Manchester Peter de Jong, University of Groningen Barney Dunn, University of Exeter Colin Espie, University of Oxford Daniel Freeman, University of Oxford Lars-Göran Öst, Stockholm University Sarah Halligan, University of Bath Emily Holmes, Karolinska Institutet, Sweden Nusrat Hussain, University of Manchester

Andrew Jahoda, University of Glasgow Steve Kellet, University of Sheffield Helen Kennerley, Oxford Cognitive Therapy Centre Colin MacLeod, The University of Western Australia Kate Rimes, King's College London Roz Shafran, University College London Blake Stobie, South London and Maudsley NHS Foundation Trust Ed Watkins, University of Exeter

MANCHESTER

Full details will be available at www.babcpconference.com

Andrew Beck takes a quick look at our take on the top ten places to see in Manchester while you’re at this year’s Annual Conference.

1. Museum of Science & Industry A fantastic large-scale museum dedicated to the Industrial Revolution and beyond.

6. Salford Lads Club Legendary scene of the Smiths photo shoot and popular place for fans of the band to reproduce that iconic shot.

2. Whitworth Art Gallery Just five minutes from the conference venue with a great permanent collection and very well curated shows.

7. Peveril of the Peak One of the last of the old fashioned boozers in Manchester and a lovely spot for a pint.

3. The Northern Quarter A pleasant 20 minutes walk from the conference venue brings you to the heart of Manchester's independent bar and cafe scene. Very cool and very friendly.

4. Canal Street Just 10 minutes from the conference and you are in the rightly famous gay village where you can find everything from cool bars, old school pubs, restaurants, nightclubs and saunas.

5. Manchester Art Gallery City Centre Gallery with some genuinely innovative programming plus a substantial permanent collection.

8. China Town Probably the biggest China Town in the UK outside of London, some great places to eat and some very mediocre ones so plan ahead.

9. Manchester Museum Just opposite the conference venue and well worth a look to see an eclectic mix of natural history and archeological exhibits. Highlights have to be the dinosaurs and mummies.

10. The Manchester Jewish Museum On the far side of the city centre this is an excellent museum dedicated to the Jewish community which has been an integral part of the city of Manchester.

May 2017

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Accreditation In light of all the recent changes within Accreditation, including changes to PWP Accreditation and the introduction of the new Maintaining Quality and Standards in Practice (MQSP) the following updates are provided for information.

PWP CESSATION OF ACCREDITATION AND RE-ACCREDITATION After taking advice from the CBT Practitioner Accreditation Committee, the BABCP Board has taken the decision that PWP Accreditation will no longer be offered.

The Board took into account comments from the new Low Intensity SIG and BABCP is currently considering options for how best to provide future support of PWP and low intensity workers more generally.

Current holders of PWP Accreditation will remain accredited until the date at which their re-accreditation would have been due, at which point it will lapse.

PWPs will not therefore be invited to engage in the new process for Maintaining Quality and Standards of Practice (MQSP).

BABCP is actively encouraging feedback on the cessation of PWP Accreditation. Please send feedback and questions to the following email address: pwp@babcp.com. Your feedback will be presented to the Board who will provide a general response which will be communicated to all members.

It is possible that any new forms of accreditation may focus on curricula in IAPT and other public service delivery across the UK and Ireland, in order to reflect Low Intensity practice, rather than PWP work alone.

MQSP FEE SYSTEM EXPLAINED An email was recently sent to all members explaining that a new fee structure for fully accredited therapists would be implemented from May 2017. From then, you will be charged £45 annually on the anniversary of your accreditation date. To avoid confusion, here is a breakdown of these charges to show that no-one is losing out.

Accreditation Maintenance Fee - £30 All accredited members pay an annual £30 fee for CBT Practitioner Accreditation maintenance - this goes towards covering the costs of maintaining the Accreditation Administration and Accreditation Liaison departments, the BABCP website and the CBT register UK. There is an additional fee of £110 for those who choose an annual subscription to a full contact listing on ‘The CBT Register UK’ website to advertise their services to the public. This remains the same and is a separate payment.

Re-accreditation fee becomes MQSP fee - £15 Until now the fee for re-accreditation has been £72 every five years. For MQSP, it has been rounded up to £75 so that it can be easily divisible by five and you pay it over five years instead of in one go.

This £15 each year will now cover the cost of the audit system replacing reaccreditation assessment.

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May 2017

This nominal increase of £3 spread over five years is the first increase since 2012.

Direct debits will be automatically adjusted - you do not need to do anything.

Previous fees were “processing” fees The £72 re-accreditation fee was a fee to pay for the process of the Accreditors retrospectively assessing the preceding five years’ records of supervision, CPD and ongoing clinical practice.

Membership Fees These are a separate fee and will continue to be due on the anniversary of your joining the BABCP. You can check these on the membership page of the BABCP website; they are due for review in July 2017. You must be a member of the BABCP to remain accredited.

Similarly, the £50 fee paid by full accreditation applicants in the past year covered the cost of the Accreditors processing the application and assessing the records of the Provisional 12 month period.

Hence, both fees paid for the review of retrospective material - not an advance purchase of five years’ of accreditation.

New fee system starts in May 2017 The new fee system will start in May 2017.

Anyone who had been due to re-accredit between December 2016 and May 2017 will have paid, or will pay £30 this year.

They will make the first £45 payment on their anniversary date in 2018.

If you take a break If you take a leave of absence, such as maternity leave or a sabbatical, you will remain accredited during your spell away.

(Important - please notify us at accreditation@babcp.com of the dates).

Although the date for you to make your online MQSP declaration may be extended if it falls during the period you are off, your membership and MQSP annual fees will continue to be deducted on their annual due dates. If you prefer not to pay these, you may choose to lapse your accreditation and re-instate when you return to work.

accreditation REINSTATEMENT OF ACCREDITATION AFTER LAPSING If your Accreditation has lapsed, we have a simple two-stage process of Reinstatement of Accreditation. This is available if your Accreditation has lapsed during the provisional year (before an award of Full accreditation was made) or has lapsed following the Full Accreditation being awarded.

Stage 1 - Application for Provisional Reinstatement.

You will need to confirm your current practice and supervision arrangements – and you will also be committing to make an application for either Full Re-instatement of Accreditation or Full Accreditation in 12 months’ time. You will be reentered on to the CBT Register UK on award of Provisional Reinstatement. *If you lapsed in your provisional year, your provisional status will be recorded on the CBT Register UK. Stage 2 - Application for Full Reinstatement or Full Accreditation Depending on which stage your accreditation lapsed, you will either need to make an application for Full Reinstatement or Full Accreditation 12 months after Provisional Reinstatement has been awarded.

• Full Reinstatement You should apply for Full Reinstatement if you previously held Full Accreditation (or Reaccreditation).

• Full Accreditation You should apply for Full Accreditation if your Accreditation previously lapsed in your Provisional year, before an award of Full Accreditation was made.

For both, this involves providing evidence of 12 months supervised Clinical practice, via provision of a Supervision log, a Supervisors Report and also five reflective statements of CPD, from a range of CBT-related activities.

You will also be asked to make a statement of intent to complete the annual online selfdeclaration of Maintaining Quality and Standards of Practice (MQSP) each year thereafter.

You can contact the Accreditation team by emailing them at accreditation@babcp.com

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BABCP is actively encouraging feedback on the cessation of PWP Accreditation.

Please send feedback to pwp@babcp.com

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UP TO DATE DETAILS REQUIRED Our new annual process of MQSP will use email addresses to invite members to complete their annual online declaration. Please ensure your details are current to avoid any problems. We recommend that you use a personal email for all correspondence to eliminate the above problems.

EMAIL AND IT PROBLEMS We are aware that some Accredited members may have not been receiving email communications from BABCP. This may include advertising CPD events or conferences, alongside updates (including the change from Reaccreditation to the new MQSP process).

This may be due to one of the following issues.

1. You may have unsubscribed at some point in the past 2. Your email provider may be blocking emails from the mailing service that we use due to failing spam rules 3. If you are using an NHS or academic email address your organisation may block the emails due to security protocols 4. Your ISP/email provider is blocking the emails

For those who have unsubscribed, please email babcp@babcp.com to resubscribe. If you do not wish to receive third party advertising please indicate this and it can be marked on your record. If you choose to resubscribe you will receive an email with a link to confirm your subscription.

We recommend that you use a personal email for all correspondence to eliminate the above problems.

May 2017

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Spring Conference In the last three years a change of thinking by the conference organisers has meant we are no longer relying solely on university provision for conference venues.

The decision has created the opportunity for a wider variety of venues to be used; last year we enjoyed Belfast’s fabulous Waterfront Centre and - not to be outdone - this April the hard-working Welsh Branches were delighted to give a warm “Croeso i pawb” at their own stunning waterfront venue for this year’s Spring Conference. The sun shone and the venue was superb; the magnificent Wales Millennium Centre in Cardiff Bay. Having the conference come to Wales has been an important goal of many Welsh members, and their Branches have worked hard to create opportunity to raise the profile of CBT and BABCP in Wales at a critical time in the development of

psychological therapies.

On the first day, delegates had the opportunity to choose between four different workshops led by expert speakers, Paul Salkovskis, Trudie Chalder, Lance McCracken and Vicki Mountford.

After, there was then an opportunity to experience the sights of Cardiff by boat with a glass of fizz.

Day two began by welcoming Ainsley Bladon from the Welsh Government Mental Health Strategy Board and Frank Kitt from Time to Change Wales as well as various representatives from Welsh Health Boards. We were treated to some excellent keynote speakers and presentations; David

Clark presented the health and economic benefits delivered by the IAPT service in England and how this is now entering the second phase, along with the exciting developments and opportunities for learning that can be gained from inclusion of modern technology. The afternoon was varied and covered a diverse range of topics including FREED project (early intervention for eating disorders), selfcompassion, treating functional symptoms.

Cynhadledd llwyddianus dros ben!!

North West Wales committee members Tamsin Speight, Maggie Fookes, Sarah Plum and Julie Evans David Clark spoke of the return on investment in CBT services

Keynote speaker Paul Salkovskis Members of the Welsh Branches welcomed delegates to the Millennium Centre 8

May 2017

news

Next steps on the NHS five year forward view NHS England recently announced the next steps in their drive to ensure children and young people do not have to travel far from home for mental health care, funding between 150-180 new beds.

The increase will focus on those who are most unwell, be dependent on need and placed in under-served parts of the country.

A programme of work is underway to improve treatments in the community for those needing urgent or emergency assessment to reduce the number of hospital admissions.

Alongside this there are 67 newlyestablished community eating disorders services being developed and recruitment to get the teams up to full capacity is well under way.

New mothers to benefit from new measures New mothers will also be amongst those to benefit. There are currently 15 dedicated mother and baby units in England, with plans to expand current capacity by 49 per cent by the end of 2018/19 through adding extra beds in existing units, as well as adding four new eight-bed units, which will be in areas with the most need – East Anglia, North West, South West and the South East Coast.

Specialist mental health liaison care in A&E An additional £30m of funding has been offered to 74 sites bidding to achieve the ‘Core 24’ standard for mental health liaison, so that by 2019, 46 per cent of A&Es will be staffed with mental health staff offering specialist, one-hour response on a 24/7 basis to people with urgent and emergency mental health needs.

New guide for MH professionals working with LGBT people in Scotland The Mental Welfare Commission for Scotland has launched a guide to improve mental health services for lesbian, gay, bisexual and trans people.

Co-produced with LGBT Health and Wellbeing, the guide has been launched in a bid to increase awareness of LGBT rights amongst mental health professionals, and help health and social care services to deliver more person-centred care and support.

It aims to address inequalities in the support and treatment of LGBT people across Scotland's mental health services, and features a number of recommendations for making services more accessible and LGBT-friendly. Copies will be sent out to all psychiatric wards in Scotland, as well as primary care and community services.

Dr Gary Morrison, Executive Director (Medical) at the Mental Welfare Commission said: “We are excited to announce the publication of our new guide on LGBT inclusion in mental health services.

“We hope that by producing this guidance we can help eliminate discrimination against LGBT people in mental health services, and equip health and social care professionals with the information they need to provide the best possible care and support.”

Catherine Somerville, Campaigns, Policy and Research Manager at Stonewall Scotland, supported the launch, saying:“It is really positive to see the Mental Welfare Commission putting in place this much needed guidance to support mental health professionals to better meet the needs of their LGBT patients. This guidance is an important step forward to make sure that LGBT people can access mental health services with confidence.”

Digital copies of the guide can be obtained at http://www.mwcscot.org.uk

Advertisement CBT practitioner required at Brackenbury Natural Health Clinic in Hammersmith, West London. Light, quiet, comfortable rooms, reasonable rates. Please contact Stelyana on 020 8741 9264 or info@brackenburyclinic.com

May 2017

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feature

The words don’t work “Many of the words used to explain human suffering simply don't work. They don't work, because they make people feel worse. They don’t work because they increase confusion, fear and prejudice. And they don’t work, because they lead to actions that often do more harm than good,” says Jim Lucas The words I am talking about focus on the differences between people rather than what is common. The words I am talking about are borne out of a view of suffering that believes in a biological cause. Words like 'disease’, ‘illness’, ‘disorder’, ‘diagnosis’ and ‘symptoms’. And there are clear reasons why these words are used; we have a long history of using them.

At first glance, it can seem that statistics like 'one in four will suffer with a mental health problem' help to de-stigmatise and increase awareness. And they may do to a point. But the problem is that biologically speaking, there is nothing to separate sufferers from non-sufferers. There is no boundary between us and them. We are all in the same boat.

All human beings can act with courage and suffer the despair of loss and losing control.

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using words like ‘illness’ and ‘disorder’ have a context, which for many people ties into medicine and abnormal psychology

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10 May 2017

In fact, studies carried out worldwide show that biological explanations of mental health problems do not reduce stigma. They increase fear, suspicion and mistrust. This creates division and is a breeding ground for prejudice, aggression and hatred.

The biological model of human suffering suggests that there are genetic causes or chemical imbalances in the brain, which explain why people suffer. The trouble is that there is virtually no scientific evidence to back this up.

There are many myths about human suffering, which you can read about in books like Cracked: Why Psychiatry is Doing more Harm than Good by James Davies and Doctoring the Mind by Richard Bentall. What these books do well is to illustrate the common unhelpful and inaccurate assumptions that shape the way we think about and react to people who are suffering psychologically.

Contextual behavioural science takes the view that the use of words is an example of an act-incontext. This means that using words like ‘illness’ and ‘disorder’ have a context, which for many people ties into medicine and abnormal psychology. So, when experiences are labelled like this they naturally lead to interventions that try to correct or cure it.

But what if there is nothing to fix? What if a

person’s depression, anxiety or psychosis is perfectly normal for what they have experienced and how they have learned to deal with it? If this were true, then what they would need is not a cure, but compassion, acceptance and skills to help them move forwards with purpose. If our mental health services, communities, research programmes and journalism went more in this direction, then I wonder, how would our experiences be different?

In my view, a change is needed in what words we use and how we use them. Words are powerful of course. They can move people. They can incite you to hatred and violence. And they can make you laugh and to feel loved. The words we use and how we say them have a direct impact on other people, our own experiences and the world we influence.

As mental health professionals, we have a responsibility to do what we can to move in directions that contribute more positively to people’s wellbeing. These endeavours are not just confined to the therapy room. What we say and do in our offices, with friends and family and in our communities also matters. It matters a great deal.

We have witnessed some major political events in the western world in recent times. They have illuminated the fact that people have very different views and different belief systems. The risk here is that we get stuck in a cycle that creates further division.

We are more likely to feed stigma and prejudice when we hold our own views too tightly. This causes us to believe that we are right and they are wrong. It makes it more likely we will use words that attack the other person for what they do and say. And this does not work.

At times, I have been too intolerant of people who hold a different view to my own. I have dismissed them, ignored them or tried to persuade them around to my own point of view. The trouble was that it did not work. I lost respect for them and it did not promote collaboration or build harmony.

My aim going forwards is this. I am going to use words that build bridges. I am going to try do this

news even when I have the urge to turn away. I am going to try to do this even when I want to call someone ‘stupid’ or ‘wrong’. I want to pay close attention to this when relating to people who think and act differently to me - even when they show prejudice, aggression, condescension or neglect.

I do not expect this will be easy. It will require me to act mindfully, to remain curious to what others believe and to act courageously so that I can share what I believe works. It will need me to be persistent even when I feel scared, frustrated or angry.

I want to remain open to points of view that seem dramatically different from my own. I want to connect with them so that I can see what they see.

I also want to challenge people when they act in a way that I think will cause harm. And I want to do it in a way that they will feel safe enough to hear and reflect on what I am saying.

My hope is that having read this article, you too can make some choices about the words you use.

To explore their impact and to connect with people more deeply. My hope is that if we can do this and model this, then we can initiate it in others.

Research Fund The aim of BABCP is to promote the theory and practice of behavioural and cognitive therapy. One of the ways we do this is to fund research from the money raised by your donations through Gift Aid as well as any specific donations from other donors.

BABCP can fund projects incurring expenditure up to £100,000 so including PhD (for three years) or feasibility research projects. The Research Committee will also consider awarding smaller grants to applicants for projects undertaken over a shorter period (eg for a year or less). The Committee will consider the quality of the research as well as the value for money the project offers as part of its decision-making.

The full eligibility criteria as well as details of how to apply for a research grant are available at www.babcp.com/Research.

A copy of your CV, as well as that of any academic mentor or PhD supervisor should be included. All applications will be sent for peer review and then discussed by the Research Committee.

Applicants should be informed of decisions by the end of November 2017.

The world can seem a frightening place when you focus on what you cannot control. And, yet hope remains and grows when you notice what you can.

Jim Lucas is a therapist and founder of www.openforwards.com

Applications should be emailed to babcp@babcp.com by no later than 9.00am on Monday 3 July 2017

Vacancy - Course Accreditation Committee members The Course Accreditation Committee is seeking up to three new committee members to contribute to its work of developing processes and delivering course accreditation on behalf of the BABCP. The committee develops processes and delivers course accreditation on behalf of BABCP. With over 50 CBT courses in the UK now accredited, including training in CBT; specific IAPT trainings, Doctorate of Clinical Psychology trainings, parenting and children’s work; postgraduate trainings and with more than 30 courses expressing an interest in becoming accredited, the work of the committee is increasing. The committee meets approximately monthly via teleconference, with at least one face-to-face meeting each year. The committee also hosts a CBT Course Directors’ meeting twice per year; and members take part in other meetings from time to time as needed, for example with other stakeholders such as IAPT National Teams or the BPS for example.

In order to join the Course Accreditation Committee, it is expected that you will be a BABCP Accredited Practitioner. You will have interests and experience relevant to course accreditation development processes, and you will be able to take part in accreditation panel visits. Previous experience of taking part in panel visits is an advantage but not essential. Please note that this is a voluntary position, though all reasonable travel, accommodation and subsistence expenses will be covered by BABCP. Please provide an expression of interest by way of a brief CV and a brief covering statement of up to 200 words as to why you believe that you are a suitable candidate to join the Course Accreditation Committee. This should be sent via email to Rachel Osborne, Course Accreditation Support Officer, at rachel.osborne@babcp.com before 5th June 2017. Please contact Helen Macdonald at helen.macdonald@babcp.com for further information.

May 2017 11

From midwife to CBT psychotherapist: A different way of being ‘with mother’ Janet Kingston-Davis (pictured) is a CBT therapist and former midwife who gives CBT Today readers an insight into her thoughts on helping new mothers My many recollections of being with mothers before, during and after birth are filled with the richness of human experience; joy, anticipation, nervousness, fear, pain, anger, grief and more.

However, having entered this field in the early 80’s, even with the experiences of general nursing and motherhood behind me, I found myself illprepared for the emotional demands that ensued.

‘Call the Midwife’ it wasn’t!

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At no point in either of my professional trainings or life experiences had I been taught about managing the mental, emotional and behavioural domains of the patient

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At no point in either of my professional trainings or life experiences had I been taught about managing the mental, emotional and behavioural domains of the patient. I was proficient in most aspects of the physical person and could confidently manage antenatal, birth and postnatal care. I could instinctively offer care and compassion, perhaps even more so due to having gone through the physical process three times and shortly to deliver again myself.

What I did learn was how to really ‘be’ with a woman as the term ‘midwife’ (derived from old English for ‘mid wif’ or ‘with woman’) suggests. This intense experience, honed over the many long hours of being with a human being in often extremes of pain and fear, has sourced me well in my current role.

One more child and many more life experiences later, my professional path then led to becoming a health visitor which gave me further access to mothers before and after birth. More of an advisory and monitoring role, I became adept at using the questionnaire called the Edinburgh Postnatal Depression Scale (EPDS) which consisted of 10 questions to elicit postpartum depression.

I have to admit to having had little training in what to do if indeed there were to be a positive score for the last question:‘the thought of harming myself has occurred to me’ with the choice ranging from ‘yes, quite often’ to ‘never’. The option was at that point to refer the client to her GP immediately which I did but with a sense of inadequacy alongside this. The figures for postnatal depression are given as 1:10 but during my time as a health visitor I would say that it was more like two or three in 10.

Our role was to then offer up to six ‘listening visits’

12 May 2017

as they were called. Again, with little training apart from our acquired person skills and no required mental health training, I admit that I found the effectiveness to be sketchy and often inadequate.

However, as in midwifery practice, I found my ability to really listen and empathise become more skilful and subsequently much appreciated.

Perhaps due to this sense of inadequacy I selffunded a degree in child and adolescent mental health and a postgraduate diploma in systemic practice at the Tavistock Clinic. From these lofty heights I became a high intensity therapist (HIT) and practiced in a team specialising in perinatal mental health.

CBT and Perinatal Care I have found that perinatal care, both antenatal and postnatal, requires a highly developed level of empathy as well as the application of Carl Rogers’ other core principles of genuineness and unconditional positive regard. Arguably, these core conditions are and should be an intrinsic part of everyday CBT but in the perinatal period the need is even more important due to the client often being in a heightened sense of vulnerability, defensiveness and anxiety exacerbated by exhaustion, sleep deprivation and stress.

The application of the typical CBT approach may come across as ‘jarring’ to the client if there is insufficient or incongruent use of these core principles. Irvin D Yalom, master psychiatrist and author of The Gift of Therapy, suggests that therapy is enhanced by the therapist entering accurately into the patient’s world.

The world of the perinatal client is rich indeed, involving the mother, the child both unborn and up to toddlerhood as well as the partner (of both sexes) and wider family. All impact on the internal and external world of the client, adding extra layers of emotional and practical complexity. And all need to be born in mind for inclusion in the woman’s treatment, if not directly, as suggested by Milgrom, then at the very least as part of the case conceptualisation.

This brings me back to my earlier point about being with an extremely distressed woman during the birth itself. The experience of attending to the

feature patient, managing my own reactions to her experience and also having given birth five times myself, has been immensely helpful when delivering CBT to a traumatised woman. Many times I have been grateful for my previous knowledge which has enabled me to be more helpful with the client who is reliving her traumatic birth, for example, prompting her gently from the side lines but with that extra ‘knowing’, as if I were there with her.

I recall a woman who was faecally incontinent due to an extremely difficult first birth and the subsequent injury that was sustained. She had been told by a succession of consultants that she would, within a few years, very likely require a bowel resection and a permanent colostomy. From my nursing perspective, the implications of this were very well known to me and from my midwifery, I understood clearly what she had undergone during the birth. From my perspective as a woman I could offer accurate empathy into how she felt about herself and her relationship with her husband and in social situations. My time with this woman was intense and rewarding as she bravely faced her traumatic experience using Ehlers and Clark’s model. During the reliving sessions we were alone but in other sessions she brought her young child with her and it was a joy to have his company, enriching our work by giving her suffering real value and meaning.

I would like to add something here about the potential for a therapist, delivering this highly empathic and intense quality of psychological care, to suffer from vicarious trauma. CBT practitioners are not required to undergo individual therapy as are some psychological disciplines therefore the impact of dealing with these cases can be ignored. I would suggest that there should be regular, in-depth supervision that is offered more frequently than for those therapists dealing with standard cases.

exposure and response prevention in the client’s home for the compulsive cleaning and handwashing so often triggered by the newlyarrived vulnerable and precious little person.

To summarise, the use of CBT in the perinatal period, whether with an individual mother, a couple or in groups works effectively with all common mental and emotional disorders.

Although it isn’t necessary for all CBT therapists working with this client group to have had my experiences, it is necessary for there to be a willingness to be with the client as if they were a midwife, delivering recovery and healing with empathy, genuineness and unconditional, positive regard.

Anxiety disorders can be given less importance perinatally, partly due to the fact that puerperal psychosis - the rare but serious mental state that occurs in about 1:1,000 women is linked to postnatal depression.

Anxiety disorders, however, can be just as debilitating as depression and cause as much impairment to the mother’s functioning and ability to bond with her child. These respond well to CBT and if I could return to my health visiting role, knowing what I know now, my practice would be so different. For example I would make effective use of May 2017 13

An information processing model for

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Unfortunately, PND confers risk for a range of negative child developmental outcomes, at least in part, through its impact on parenting behaviour

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14 May 2017

Postnatal Depression The Royal College of General Practitioners estimates that one in 10 women are affected by mental health problems during the perinatal period (pregnancy and the first year after birth).

However, a more realistic figure could be as much as one in six.

It is thought that only about half of perinatal mental health illness cases are detected and of those, only about half are treated. Lack of understanding, lack of opportunity to access therapy, fear of the baby being taken away and stigma are some of the factors preventing women from seeking help. In addition, the ability of GPs to recognise and refer appropriately can be improved as this seems to be very patchy across the country.

More training is needed at primary care level to increase and improve access to treatment. Online therapy provides a convenient solution for women to access CBT at home.

Fortunately, psychological treatments have good effectiveness and we know that 90 per cent of women diagnosed with perinatal mental health illnesses are cared for in primary care. A successful intervention leads to improvements not just in mood, but also in adjustment to parenthood, marital relationship, social support, stress, and anxiety.

upon which all later learning, behavior, and health depend.”

Unfortunately, PND confers risk for a range of negative child developmental outcomes, at least in part, through its impact on parenting behaviour.

For example, a depressed mother might struggle to meet the baby’s needs; or might feel less close to baby and be withdrawn or overly intrusive. The cognitive mechanisms that may mediate parental depression–parenting are less well understood.

Researchers* have proposed an informationprocessing model based on the findings of a recent systematic review on rumination in PND. Informed by the literature on rumination, the authors present a cognitive model which seeks to account for the specific effects of rumination in the postnatal context. In particular, that rumination impacts on parenting quality via the role of cognitive biases and cognitive control deficits Cognitive control

Sadly, one of the major causes of maternal death is suicide. But without appropriate treatment, the negative impact of postnatal depression (PND) can have long-lasting consequences for women, their partners and children too.

Cognitive control refers to a set of processes that allow information processing and behaviour to change and adapt from moment to moment depending on current goals, rather than remaining rigid and inflexible. It includes processes such as overriding certain responses and inhibiting processing of irrelevant information, switching the focus of attention, and updating working memory.

It has been suggested that cognitive control deficits or biases may play a causal role in rumination and depression.

The potential impact on child development is crucial as the first two years of a baby’s life are the building blocks of their long-term social and emotional development. The Center on the Developing Child at Harvard University claims: “The early years matter because, in the first few years of life, more than 1 million new neural connections are formed every second. Neural connections are formed through the interaction of genes and a baby’s environment and experiences, especially “serve and return” interaction with adults, or what developmental researchers call contingent reciprocity. These are the connections that build brain architecture – the foundation

We need cognitive control, which is a voluntary process, to survive effectively in life. We need more and better cognitive control in certain periods of life. Parenting could be considered such a period.

For example, we need cognitive control so we can appropriately select the information we need from the environment. Imagine you are in a busy airport – you are able to pay attention to the information that is meaningful to you (e.g. your gate) and sort of ignore the rest. And we need to be able to inhibit responses that are not appropriate; for example, we might be in a hurry but we don’t usually jump a red light risking our life in order to get to our destination quicker. It is also helpful to

feature discriminate and retain contextual information (e.g. in Spain they drive on the other side).

Deficits in cognitive control are hypothesised to impair the ability to reappraise or redirect attention away from negative thoughts once triggered; as there might be insufficient control to override ruminative processes once these develop.

These thoughts are therefore subject to continued attention and develop into a repetitive and persistent thought process. And rumination is a very demanding mental activity which will reduce ‘available resources’ for other tasks.

Cognitive biases We are all familiar with what it means having a bias towards negative information. In this context, it refers to interpretation of stimulus, both internal (e.g. thoughts), and external (e.g. baby’s cues). For example, we know people with depression will pay more attention to negative information and will remember better negative information. A mother suffering with PND will have a tendency to focus more negative cues from baby (e.g. baby crying). Equally, she will be more likely to dismiss positive cues (e.g. baby smiling) or ignore or interpret as negative neutral stimulus such as baby showing curiosity about a light. The ability to interpret baby’s facial expressions accurately it is thought to be a prerequisite for sensitive parenting behaviour, having a positive effect on bonding and in forming a secure attachment.

The authors suggest that rumination likely reinforces cognitive biases via rehearsal; and it becomes increasingly likely that negative content and ruminative processes will be activated when future triggers are encountered.

Model The authors propose that rumination is associated with top-down cognitive control deficits and bottom-up cognitive biases. These components of the model are hypothesised to have bidirectional links with rumination. Within the model, rumination is preceded by an initial trigger, which might be internal, such as mood or an intrusive negative thought, or could be external event such as managing multiples demands or encountering infant negative affect. Following this trigger, rumination is maintained through the combined effects of cognitive biases and cognitive control deficits.

Applying the model to practice The relationship between rumination, cognitive biases and cognitive control seems to have an impact on infant cue processing and subsequent parenting responses. Therefore, targeting these cognitive mechanisms are likely to have benefits for both maternal mental health and for child outcomes. For example, interventions that shift the balance of competition between bottom-up biases and top-down control processes should be beneficial in reducing rumination. For example, teaching attentional training to become more aware, to be in the present and so try picking up neutral and positive baby cues.

Further, the authors recommend interventions that are aimed at tacking rumination such as mindfulness approaches; acceptance-based approaches; behavioural activation and metacognitive therapy. An important consideration is that treating PND alone might not be enough to improve child outcomes; targeting residual rumination is key in trying to reduce future relapses. If rumination remains a habitual response triggered when low mood or stressors are encountered, then this would continue to effect parental attention to infant cues and parent-child interaction.

Parenting requires a high level of both concentration and the ability to switch attention quickly. What this model proposes is that women in the perinatal period have deficits or biases in cognitive control, having difficulties terminating ruminative thought processes once these are triggered. Therefore, these cognitive factors impacting and maintaining PND have to be taken into account when planning effective treatments.

Maria Barquin is a mum, clinical psychologist and CBT therapist, and clinical supervisor.

Maria is the Chair of CAFSIG and Branch Liaison Officer for the IT SIG. *The research referred to in this article featured in Behaviour and Research Therapy by DeJong H, Fox E, & Stein A (2016)

Being able to interpret and respond to baby’s communication is thought be a key aspect of effective parenting, which in turn effect health development of baby. The authors hypothesise that high levels of maternal rumination, and subsequent changes in infant cue processing and contingency, play an important role in mediating some or many of these risks.

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European Conference goes to Slovenia in September 2017 The 47th Congress of the European Association for Behavioural and Cognitive Therapies (EABCT) will be held in Ljubljana, Slovenia from 13 to 16 September 2017, writes BABCP’s EABCT representative, Katy Grazebrook The Turkish Association of Cognitive and Behavioural Therapies (TACBT), who are organising the conference, took the difficult decision to relocate the conference from Istanbul to Ljubljana based on concerns about public safety.

The TACBT are past masters at organising conferences and are well-connected internationally, with their president Mehmet Sungur as president-elect of the International Association for Cognitive Psychotherapy (IACP). Keynote speakers will be attending from across the world and across a wide range of specialist areas, with strong representation from the UK, USA and Europe. The congress will start with pre-congress workshops, followed by three days of high quality keynotes, symposia, round tables, skills workshops and poster sessions.

The conference language is English, which is always an advantage to BABCP members.

The other advantage is that as BABCP is a member of EABCT, therefore so are all BABCP members, so you will be eligible for the membership registration rates.

I attended an EABCT meeting in Ljubljana in March this year and visited the

16 May 2017

conference centre, so I was able to find out for myself what it would be like travelling as a lone woman to foreign climes.

Easyjet and Wizz air fly directly to Ljubljana (Brnik international airport) all year round and are joined by Adria airways in the summer months (including September).

There are direct flights from London (Gatwick, Stansted and Luton) and Manchester. Slovenia is well connected by road and rail to its four neighbours Italy, Austria, Croatia and Hungary.

If you pre-order a taxi it is cheaper than picking one up from the taxi rank (it cost me 48 Euros without pre-order, and 36 Euros by pre-ordering for the return journey). I also found out there is a shuttle service for about nine Euros. Although there was no information about this on the airport website and only found out about this from my hotel. Prices of course may be more in September as this will be tourist season.

The Conference hotel is the Grand Union (there are two of these: Business and Executive - but they are next door to each other). The Grand Union Hotel is in the best part of town, opening up onto the

pedestrian areas with designer shops and open-air cafes and restaurants on the banks of the river. It is a 10 – 15 minute walk in the opposite direction to the conference centre. I was told that they would be giving delegates passes for the local busses to get to and from the conference venue. Lots of other hotels are available in the vicinity and will suit a wide range of budgets.

Expect it to be lovely and warm in September (daytime temperatures of around 20ºC). I would recommend extending your stay to explore this beautiful country. The Alps stretch into Slovenia and Lake Bled is only an hour away and accessible by public bus from the bus station next to the main railway station (at the end of the road from the Grand Union Hotel). Slovenia has good skiing in the winter time and walking in the summer time, and it is just to the east of Italy with Venice only 2.5 hours away.

Check out the conference details at www.eabct2017.org, where you can view the full programme, see the accommodation and other details about travel to Slovenia.

eabct 2017

May 2017 17

Q and A and kind in putting me right on things I have been getting wrong. Outside of the mental health field it is probably Spiderman.

Q. What made you want to work in talking therapies?

A. One of my first jobs after I left school was working in a programme to resettle people from the old county asylums as they closed in the late 1980s. I remember feeling pretty helpless at first, I was 20 years old and didn’t really know what I was doing but then we had a really good psychologist who came into the unit and talked us through how to use positive reinforcement to help people develop more adaptive and independent behaviours and I was really impressed by how humane and hopeful they were. On his recommendation I went to University a few years later and started a psychology degree.

Q. What other job might you have done?

A. About a year into my psychology

degree I got really fed up with it so I tried to leave the course and start an apprenticeship as an electrician but I was 23 then and was told I was too old to get one. By then I realised that my childhood plans to be an astronaut were probably not going to happen either so I stuck with psychology.

Q. When did you join BABCP and why?

A. I went to a BABCP conference in 1997

and thought it was fantastic. It is a bit hazy now but I am pretty certain I ended up as DJ at the conference party thanks to Emily Holmes and I got to go attend the conference for free because of that. It was practical and inspiring in a way that my Clinical Psychology training often hadn’t been so that got me interested in the organisation. I joined a few years later mainly for the CPD opportunities. I just realised that 20 years later I will be at the Manchester conference and playing some records at the social event there as well.

Q. What advice would you give someone starting working in CBT? A. Get involved with the BABCP at a branch or Special Interest Group level so you can get to know just how broad and 18 May 2017

Q. What has been your best working moment?

BABCP and me

Andrew Beck is a Clinical Psychologist, IAPT tutor and Chair of the BABCP Equality & Diversity SIG varied the application of CBT can be and how broad the organisation is in terms of member interests and specialisms. I would especially encourage Low & High Intensity IAPT staff to get involved as this is a really important group of therapists and we need to hear their voices more in the organisation.

Q. Who is your biggest hero?

A. In terms of mental health it is a group of South Asian therapists and researchers from across the UK who have been working in innovative and rigorous ways to adapt CBT for Indian, Pakistani, Bangladeshi and Sri Lankan populations and improve service engagement with South Asian communities. It is such a varied group in terms of their expertise and interests but by working in loose networks and supporting and encouraging one another they have really advanced the field over the past three or four years. All of them have been very generous in disseminating their expertise

A. Seeing people I trained and supervised on the IAPT programme three or four years ago coming back to the course as supervisors. It was fantastic to see them develop as therapists and then to find out that their careers had kept on developing in really positive directions after the course.

Q. What are your hopes for talking therapies over the next five years?

A. I think there has been enough research on what works and why and what I would like to see is a shift towards research into how to implement what we know in the workplace. This would include taking some of the excellent research that has been done into how to meet the mental health needs of refugees and minority groups and looking at how you can train staff up to effectively use it. being lost who don’t fit OUR remit.

Q. And fears?

A. That research money will be continue to be wasted on telling us what we already know or what we can’t change instead of looking at how to apply knowledge effectively at the front line.

Q. Name five people (dead or alive) that you would invite to a dinner party?

A. Valerie Kaur, a really inspiring civil rights activist John Coltrane, the jazz musician Aretha Franklin, singer and songwriter Spiderman, possibly fictitious character Jack Kirby, one of the all-time great comicbook writers and artists Q. How would you like to be remembered?

A. As a good dad.

branches and special interest groups Irish Association for Behavioural and Cognitive Psychotherapies presents

Manchester Branch presents www.babcp.com/irish

CBT for Generalised Anxiety Disorder (GAD)

Applying Compassion-Focused Therapy in the Treatment of Problematic Anger

with Dr Kevin Meares

with Professor Russell Kolts

Friday 13 October 2017 Belfast

Tuesday 23 & Wednesday 24 May 2017 Manchester

Registration fees BABCP members: £90 Non-members: £100

Registration fees BABCP members: £120 Non-members: £130

To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com North East & Cumbria Branch

North West Wales Branch

presents

presents

BULLYING: Mental Imagery for Anxiety Disorders with Dr martina Di Simplicio

Fix the problem or fix the environment? with Professor Judy Hutchings

Thursday 18 May 2017

Friday 9 June 2017 Newcastle-upon-Tyne

Supercharging CBT for complex OCD with Dr Blake Stobie

Friday 15 September 2017

Both events are in Bangor Registration fees BABCP members: £55 Non-members: £75

Registration fees BABCP members: £80 Non-members: £90 May 2017 19

South & West Wales Branch

Scotland Branch

presents

presents

The ABC of OCD with Joy McGuire

Tuesday 19 September 2017

OCD: Given the choice between ERP and anything else, why do patients and therapists pick anything else? with Bob MacVicar

Working effectively with anxiety: Flexibility with fidelity

Friday 9 June 2017 Stirling

with Dr Nick Grey

Friday 10 November 2017 Both events are in Swansea

Registration fees

Registration fees

BABCP members: £85 Non-members: £105

BABCP members: £70 Non-members: £80

To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com Supervision SIG

West Branch

presents

presents

How to use the Assessment of Core CBT Skills (ACCS) as a tool for feedback within Supervision with Professor Judy Hutchings

Branch AGM followed by presentation - The use of technology to amplify and augment CBT with Stephen Freer

Monday 26 June 2017 Registration is free - turn up on the night

Is it useful to think of intolerance of uncertainty as a transdiagnostic construct? with Professor Mark Freeston

Thursday 19 October 2017 Oxford

Thursday 12 & Friday 13 October 2017 Registration fees

Registration fees BABCP members: £75 Non-members: £90

Early bird (up to 28 July) BABCP members: £130 Non-members: £150 Full fee (from 29 July) BABCP members: £150 Non-members: £170

Both events are in Bristol 20 May 2017

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branches and special interest groups

Actors, teachers, therapists - think your job is safe from artificial intelligence?

The above headline in The Guardian earlier this year illustrates concerns held by various professions that AI will make them redundant. But is it possible that, at some point in the future, therapy will be delivered by a robot?

The article cites several examples of how robots are replacing humans but technology is still only able to undertake very limited aspects of each role or job.

Whilst it might be argued that computers can do parts of jobs more effectively than a human there still remain areas of human responsibility that AI scientists have no idea how to solve. For example, the ‘lawyer bot’ is very simplistic and is unlikely to cause any employment worries to a lawyer just yet.

The Mackinsey Institute in their January 2017 report Harnessing Automation for a Future that Works argue that “almost every occupation has potential for partial automation”. However, they state that some occupations will prove more difficult to automate than others with significant variation in the potential for automation between industry sectors. They suggest that agricultural, manufacturing and retail industries lend themselves to automation more readily than service industries especially those that provide professional services.

IT Blog

The drive to increase productivity is not a new one. In the industrial revolution the steam engine increased productivity by 0.3%. Early robotics utilised between the years of 1993 and 2007 (predominantly used in the manufacturing industry) increased productivity by 0.4%. The

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The Guardian, 9 February 2017 Mackinsey Institute predict that AI will increase productivity by up to 1.4% by 2065. If that prediction is correct, could AI play a part in increasing productivity in the provision of psychological therapy? I believe so, but maybe not in the form of a robot providing the therapy.

Computers will clearly make inroads in the area of mental health but I believe that they are more likely to displace other less intelligent and less interactive self-help methods such as computerised CBT (cCBT). They may also provide some help for people with less severe conditions who would not otherwise be offered therapy. I believe that trained and experienced therapists will be still be needed to treat people with more severe conditions and for people with complex presentations and comorbidity.

I predict that AI will have a part to play in enabling the therapists of the future to be better, more effective, clinicians. For example, AI might support and assist therapists with more precise diagnostic tools and make suggestions in relation to the most effective disorder specific protocols. As we learn which variables lead to the best clinical outcomes AI could be used to guide therapists to provide more effective treatment. This may be the way that we improve recovery rates in depression, for example. I suggest that it will not be the robots that will be providing the therapy but that the robots will become an assistant to the therapists of the future.

I firmly believe that delivering psychological therapy requires a strong

interpersonal element and this is exactly where AI efforts are most lacking. Many of us will have had an interaction with Siri, Alexa or Google Assistant. Whilst these assistants can be useful at times, they are not best known for their personable manner. It is unlikely, within our lifetime, that AI is likely to make progress in this direction purely because it is so hard to quantify what makes for a good personal connection and what is hard to quantify is hard to model and optimise.

Additionally, AI research is very expensive and still quite hard. For example Alphabet/Google have poured huge sums of money into self-driving cars but no fully autonomous cars are in production yet.

The cars that are in production are limited to motorway driving and braking automatically when the car in front brakes suddenly. This is very useful but it certainly does not make the car a driver. The same might be said of automated therapists, the technology can be used to make therapy safer and more effective by predicting risk or clinical outcome, for example. These features would be very useful but it does not make the computer a therapist.

One thing is for sure, with three in every four patients going untreated and at least 50% of these patients presenting at Step 3 or above, there is plenty of work for all of us for some time to come.

If you have an interest in the use of technology and IT in CBT, you can get in touch with the IT SIG by emailing them at it-sig@babcp.com and you will be sent details of workshops they organise

Artificial Intelligence (AI) is a hot topic in the media. Sarah Bateup returns to consider the threat posed to therapists by the increasing use of AI.

May 2017 21

Control Theory SIG

Chester, Wirral & North East Wales Branch

presents

presents

The Method of Levels: A transdiagnostic approach to effective and efficient patientperspective treatment with Professor Tim Carey

Monday 31 July - Wednesday 2 August 2017 London

Borderline personality recognising the problem and addressing traits where they emerge during other interventions with Arthur Fairbanks

Wednesday 17 May 2017 Chester

Registration fees BABCP member: Day 1 - £65, Days 2 & 3 - £130, All 3 days - £180 Non-member: Day 1 - £75, Days 2 & 3 - £140, All 3 days - £200

Registration free – turn up on the night

To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com East Midlands Branch

Couples SIG

presents

presents

CBT for Eating Disorders with Dr Navjot Bedi and Tara Cousins

Treating Couples with Infertility

Friday 9 June 2017 Nottingham

Thursday 8 June 2017

Emotion Focused Interventions for CBT with Couples Friday 9 June 2017 with Misa Yamanaka

London Registration fees BABCP member: £80 Non-member: £90

22 May 2017

Registration fees (per day) BABCP members: £95 Non-members: £110

“Supercharging Your CBT Practice: Integrating the best of DBT, ACT and CFT for maximum effect”.

7th & 8th December 2017, London If you want to:

What you will get from the workshop:

• Formulate your client’s journey using the best of the best therapies

• Ways to navigate and rapidly formulate using 3rd Wave therapies

• Gain a better understanding of 3rd wave therapies and their practical application

• A toolkit packed with the best tools from cutting edge third wave therapies

• Take your CBT practice to the next level

• Methods to effectively blend CBT, DBT, ACT and CFT in your own practice • Increased confidence in applying these skills into your own therapy context • A free copy of Get Your Life Back, The Most Effective Therapies For A Better You

Then this course is for you!

The Trainer Dr Fiona Kennedy is a Consultant Clinical Psychologist who is a highly experienced, engaging and fun presenter. With her warm sense of humour, and her renowned ability to make complex concepts accessible, she will make this a memorable workshop.

Based on the exciting, newly published book Get Your Life Back The Most Effective Therapies For A Better You Dr Fiona Kennedy will guide you on how to use this easyto-follow approach, bringing together CBT, ACT, DBT & CFT into a coherent client journey. The 2-day course will be interactive and invite participation from you, showing how to use the therapies for real-life issues. www.getyourlifeback.global

www.greenwoodmentors.com/therapy/what-we-do/

Attend in person or via live interactive webcast

For more detail, go to www.contextualconsulting.co.uk May 2017 23

24 May 2017

CBT Training in Cardiff Postgraduate Certificate in CBT One year part-time study designed to fit alongside working practice (14.5 days at university)

Postgraduate Diploma in CBT A further year part-time study delivered via specialist supervision sessions http://psych.cf.ac.uk/degreeprogrammes/postgraduate/cbt

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