CBT Today Vol 44 No 4 (Dec 2016) by BABCP

Volume 44 Number 4 | December 2016

The happiest place to work as a therapist? - Page 14

Volume 44 Number 4 December 2016 Managing Editor Peter Elliott

Contributors Elizabeth Cotton, Kate Daley, Rachel Densham, Laraine James, Steve Kellett, Mike Sullivan 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. Back issues can be downloaded from www.babcp.com/cbttoday. Submission guidelines Unsolicited articles should be emailed as Word attachments to editorial@babcp.com. Publication cannot be guaranteed. An unsolicited article should be approximately 500 words written in magazine (not academic journal) style. Longer articles will be accepted by prior agreement only. In the first instance, potential contributors are advised to send a brief outline of the proposed article for a decision in principle. The Editors reserve the right to edit any article submitted, including where copyright is owned by a third party.

Inside 4

Accreditation updates

Refugee mental health

Surviving work

The transition years

Northern PWP network

The happiest place in the UK?

Why do therapists remain in the NHS?

What are EU member states doing about the mental health of refugees?

Elizabeth Cotton writes about how workplaces can help employees

What can be done to help children and young people during their transition into adult mental health services

Mike Sullivan lets us in on life as a therapist in the Western Isles

Kate Daley writes about her research

Participation in the BABCP Spring Conference Laraine James looks back at her Spring Conference experience

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 Monday 30 January 2017 (for distribution 24 February). Advertising For enquiries about advertising in CBT Today, please email advertising@babcp.com. ÂŠ Copyright 2016 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.

CBT Today | December 2016

ALSO IN THIS ISSUE: 6

Boys do cry - Mental Health Foundation survey

Research study request

CBT in Ireland - save the date!

The Decider - an update

12 CBASP SIG update 17 Rob Durham obituary 20 CBT Medics SIG update

President’s message

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We value the process of accreditation, which is of importance to individuals, employers and BABCP. We will move to an annual process of ongoing self-declaration that accredited practitioners have achieved CPD and supervision requirements

A large focus over the last few months has been on trying to reduce the pressure on the office by putting in place key new appointments and getting back to full capacity. I’m pleased to say we have now appointed Moragh Hunt as our new Senior Financial Officer. She has been working with Company Secretary Ross White and Honorary Treasurer Gerry McErlane to streamline our financial reporting so these are both timely and present more helpfully grouped data.

We have also advertised but failed to appoint the Senior Clinical Adviser (SCA) post. The Board has approved changes to make this part-time post more attractive to senior practitioners, including approval of an increase in salary to the equivalent of an 8C level. The third critical post we are now focusing on is to appoint a muchneeded Membership Manager. This is the next post we are moving to appoint, hopefully in the New Year. We are wanting to make BABCP a place which provides friendly and efficient services to members. Our moves to increase efficiencies include the development of a new IT system including an online diary to help us all monitor our CPD activities. We expect this will be ready for launch in early 2017. Finally, we have agreed a plan ahead for amending the re-accreditation process. We have chosen an approach that retains the strengths of our respected accreditation process, whilst simplifying the reporting back at re-accreditation.

Key Points: Accreditation strategy

We value the process of accreditation, which is of importance to individuals, employers and BABCP. We will move to an annual process of ongoing selfdeclaration that accredited practitioners have achieved CPD and supervision requirements. This will be backed by a new process of audit to maintain and enhance standards. This will consist of an annual selfdeclaration that CPD and supervisory requirements have been achieved and include a record of names and contact details of supervisors. This needs to be backed up by the following information to be available for audit of a sample of accredited members. 1. Evidence of a commitment to ongoing CPD • CPD should be appropriate to the person’s work • We will provide an online recording system as an aid to record keeping

• A record of meetings/cases discussed needs to be kept i.e. evidenced and available for possible audit. A supervisors report can be requested as evidence at audit

• Examples of good supervisory practice will be given - however these are not mandatory e.g. use of the CTRS, live sampling etc. The supervisor and supervisee should agree the elements suited to the clinical practice. We expect some elements of good supervisory practice to be present and be available to audit 3. Robust audit We will randomly audit a percentage of such self-declarations with a significant percentage being audited, i.e. it likely that audit will happen at some time for accredited members. Over the coming months the CBT Practitioners Accreditation Committee will be working to ensure that this strategy can be delivered in a practical framework for as early in the new year as possible.

• With CBT accredited or accreditable practitioners i.e. experienced practitioners

Finally, it is very important to be clear what our accreditation processes mean. It is not the same as professional recognition. It is not the same as saying the person is clinically safe. However it is a high quality statement that individuals have received a good CBT training, and are committed to keeping updated through CPD, and good practice (through supervision and commitment to our code of practice).

• These can be face to face or telephone/skype or equivalent

Chris Williams BABCP President

• Evidenced by attendance certificates available for audit • Optional five self-reflective statements can be made available 2. Evidence of a commitment to ongoing supervision

CBT Today | December 2016 3

Accreditation service updates There are three significant new updates to report as listed below:

2. Cognitive Behavioural Psychotherapist (CBP)

1. New Accreditation phone service times:

Level 2 Provisional Accreditation

Following feedback from members, we are pleased to inform you of an increase to the service offering members-only accreditation advice. The phone service will usually operate on: Monday: 10am - 12pm Tuesday: 1pm - 3pm Thursday: 2pm - 4pm Due to the above spread, there will only be one Accreditation officer available for each session, and this will be subject to availability. Please check the website for availability updates availability on a weekly basis. These changes will be reviewed after three months.

Following discussion between the Course Accreditation Committee and the CBT Practitioner Accreditation Committee it has been agreed that a variation be made to the process for those who have graduated from Level 2 accredited CBT trainings which will make the provisional accreditation application stage simpler. • Graduates from BABCP Level 2 accredited trainings are now able to make an application for Level 2 Provisional Accreditation straight away or shortly after passing the course and before taking up a CBT position • In this case, the course will provide to BABCP a list of students who have passed, following confirmation by an external examiner

• You may also apply using this application form if you have completed a Level 2 accredited training in previous years, so long as you provide evidence of course completion (course certificate) • Please check that your course was accredited at the time of your training and graduation (see BABCP website Accreditation link) • Please do not apply before you have been told by your course that you have passed and the list has been sent, as it may delay your application if sent before BABCP have been notified • You do not need to provide any supervision evidence or supervisor/professional reference reports The new process will require applicants to provide evidence of: 1 Core professional training or KSA equivalence 2 Accountability to a senior mental health professional for a period of one year after qualifying in core profession; or 3 The date you completed the final piece of evidence for your KSA 4 Confirmation of Level 2 course attended and completed

Meet our new Accreditation Liaison Officer Rowan Newby was amongst the earliest of practitioners to train in CBT without a core profession, graduating from the University of Derby in 2005 and hence also completed one of the earliest KSA accreditation applications. Prior to that she had made a radical career change from working as a television director to training in massage therapy, stress management and yoga teaching which led to her running a small Stress Management Coaching practice. Since then she has worked in the NHS and a private hospital, but the majority of her clinical experience remains in private practice; she is additionally trained in EMDR and Schema Therapy, supervises practitioners and students and is a visiting lecturer on CBT training courses.

CBT Today | December 2016

You will also need to sign a declaration for submission of full accreditation within 12-18 months of being successfully awarded Provisional Accreditation with BABCP. 3. Extended Practitioner Accreditation Expressions of interest are invited for a new title which is being offered by the Association of ‘Extended Practitioner Accreditation’. The title will be available to applicants whose CBT Practitioner Accreditation has lapsed by virtue of their ceasing clinical practice, but

BABCP Annual Conference & Workshops

www.babcpconference.com

Manchester University, 25 - 28 July 2017 Confirmed Workshop and Keynote speakers so far: Lars-Göran Öst, Stockholm University Arnoud Arntz, University of Amsterdam Daniel Freeman, University of Oxford Stephen Barton, Newcastle University Kate Rimes, King’s College London

Sarah Halligan, University of Bath Blake Stobie, South London and Maudsley NHS Foundation Trust Colin MacLeod, University of Western Australia Roz Shafran, University College London Colin Espie, University of Oxford

Submissions are now open Submission for Symposia, Symposia Papers, Workshops, Skills Classes and Roundtables will close on 6 January 2017 Submission for Open Papers and Posters will close on 1 March 2017 Full details will be available at www.babcpconference.com

who are continuing to offer supervision and/or training. It will apply for a period of two years from the date of the last client session or from formal notification to relinquish accreditation. Please note: There will also be a restriction to individuals who are providing supervision/training on Accredited courses, since these are the only circumstances in which CBT Practitioner Accreditation is actually a requirement.

Please send your request to the BABCP Accreditation Liaison Officers at accreditation@babcp.com with the subject line “Extended practitioner accreditation” in the first instance, stating when you ceased clinical practice and when would like the two-year period to commence. Please provide information on how many hours of ongoing practice in supervision and/or training you expect to be providing and with which course(s) you are associated. Thank you for your interest. Accreditation Services, December 2016

All other supervisors and trainers whose Accreditation has lapsed will continue to be able to provide those services. To avoid any misunderstanding, this new service is NOT restricted to those who are Supervisor and/or Trainer Accredited, though of course these would also lapse in the event of stopping clinical practice.

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Boys do cry A recent survey commissioned by the Mental Health Foundation has found that not only are men less likely to seek help, they are less likely to tell friends and family when a problem develops. When asked, 28% of men had not sought medical help for the last mental health problem they experienced compared to 19% of women. The survey – the largest of its kind, polling over 2,500 people with lived experience of mental health problems – comes at a time when there is an increased focus on men’s mental health with the #RUOKM8 and #BoysDoCry campaigns. The survey also found that: • A third of women (33%) who disclosed a mental health problem to a friend or loved one did so within a month, compared to only a quarter of men (25%) • More than a third of men (35%) waited more than two years or have never disclosed a mental health problem to a friend or family member, compared to a quarter of women (25%)

Mark Rowland, Director of Communications and Fundraising at the Mental Health Foundation said: “Mental health is so central to our experience of being alive that if we’re ever to rise to challenge of preventing mental health problems, it will be because men feel more able to share when they are vulnerable. “This is not about being more of a man but being more in-touch with our humanity. It takes real courage to be open and honest about mental health, but when suicide is the leading cause of death for young men, we all have a responsibility to push for cultural change.” Dave Chawner, a 27-year-old comedian who lived with anorexia and depression for 10 years before seeking support said:“I think it’s important to talk about gender when we talk about mental health, because the ways we’re expected to deal with things is different. It is more accepted

for men to deal with stress, emotions and situations with anger and aggression. Anything else is interpreted as vulnerability and shut down. “It’s so important that a reluctance to seek help isn’t mistaken for a lack of severity, especially when it comes to men. Men are more likely to say something like ‘I’m feeling a bit shit’ when really they mean, this is the worst I’ve ever felt in my life and I can’t imagine feeling worse.” The survey was carried out online by YouGov Plc in October 2016 with a total sample size of 6247 adults, of which 2,511 had experienced a mental health problem.

Seeking participants for a research study

How do therapists use humour in their work with obsessive-compulsive clients? A Grounded Theory study by Rachel Densham, doctoral candidate in Counselling Psychology Purpose of the study: There have been various debates presented in the literature on therapeutic humour, with mixed views as to its potential use. However, there has been almost no empirical research on the use of therapeutic humour in the treatment of Obsessive-Compulsive Disorder (OCD). Participants: I am keen to interview therapists from a range of modalities who have experience of working with clients with OCD (which may include clients with a formal diagnosis of OCD or Obsessive-Compulsive Personality Disorder, or those who simply identify with or seek to work on their obsessions or compulsions) either within the NHS or in private practice, and, preferably, with at least

CBT Today | December 2016

five years’ post-qualification experience. Further information about eligibility and participation can be obtained by emailing red0196@my.londonmet.ac.uk The study has been approved by the London Metropolitan University School of Psychology Research Ethics Review Panel and is supervised by Dr Philip Hayton. If you would like to take part in this research or have any questions about what it will involve, please contact me by phone: 07730 312638 or email at the address above. Many thanks Rachel Densham

Is Europe getting it right for refugees’ mental health? In a recent position paper, Mental Health Europe (MHE) explored the human rights, economic and social rationale for providing mental health and psychosocial support to migrants and refugees in Europe and warned of the possible consequences of inaction. More than a million migrants and refugees crossed into Europe in 2015 and more than 300,000 have arrived since January 2016. Many of them have endured physical and emotional trauma, including torture, loss of loved ones, violence and exploitation. Many organisations on the ground have warned authorities of the heightened risk of migrants and refugees experiencing mental distress that could lead to mental health problems in the absence of appropriate support. Providing access to mental health and psychosocial support should be seen as a priority, not a luxury, and providing quality mental healthcare and support is key to helping migrants and refugees settle in Europe. Denying access to mental healthcare and support today will only lead to future challenges in EU member states tomorrow. The World Health Organization acknowledged that prevention and early intervention in relation to mental health is cheaper in the long-term. Besides the obvious economic and social case for providing mental healthcare to migrants and refugees, they say that the EU should not forget its core values including human rights and freedom. MHE President Nigel Henderson stated:“EU member states need to be reminded that all migrants, irrespective of their status and nationality are entitled to their fundamental rights including the right to access mental healthcare. “Psychological reactions and distress experienced by migrants and refugees in response to the challenges they face are completely normal. Many can be supported by social interventions whereas some may need more extensive mental healthcare or support. However, it is crucial to remember that if mental health support is to be effective it needs to be culturally sensitive, personcentred and accessible.” “Many of them may never have even heard of mental health and wellbeing before, or they might understand it differently or associate it with stigma. They may express fear or other emotions in ways that are unfamiliar to us”. The position paper calls for: • A coordinated and human rights-based European response to the current crisis • Culturally appropriate and accessible mental healthcare and support for all migrants and refugees regardless of status • Mental health and cultural training to be provided to all personnel who come into contact with migrants and refugees so that they can identify, understand and support people experiencing mental distress.

CBT in Ireland Save the date! The inaugural CBT in Ireland event will take place in Dublin’s Hilton Hotel on 5 May 2017 to promote CBT as the evidencebased treatment of choice for a wide range of conditions. This IABCP event will market and promote CBT throughout the island of Ireland, and enable networking opportunities with other practitioners and policy makers. The event will also raise the profile of IABCP as an organisation with decades of experience in supporting CBT members across diverse settings including health and social care, education and research. IABCP Chair Stephen Herron said: “This one-day event will be of strong interest to multidisciplinary researchers and clinicians in CBT, along with mental health professionals, GPs and policy makers in health and social care”. Confirmed speakers include Professor David Clark (University of Oxford), Professor Chris Williams (University of Glasgow), Rodney Morton (Service Improvement Lead at Health and Social Care in Northern Ireland), and Dr Harry Barry (GP). In the afternoon Professor Clark will lead on a workshop for social anxiety. This will be a very exciting and informative event, relevant for anyone with mental health interests on the island of Ireland. More information and registration details will be available in due course at www.babcp.com/IABCP

CBT Today | December 2016 7

Surviving Work Elizabeth Cotton is a writer and educator working in the field of mental health in the workplace. In 2012 she set up Surviving Work to provide practical resources for people on how to do just that - surviving work. Here, she tells CBT Today about her endeavours Coming from a trade union background, I found working and training in psychotherapy was a real shock to the system. Not wishing to blind you with industrial relations science, but these jobs are becoming impossible in the current mental health crisis and like many people I found myself walking a thin line between being a competent professional and feeling like a fraud at managing my own mental health at work. Therapists face a range of employment relations problems, including the growth of selfemployed workers, short-term contracts for private contractors, agency labour, the use of unwaged labour or honoraries and the insecurity of ‘permanent’ staff in the NHS. Many people working in mental health are not earning enough to live and many are managing workplace problems by going part time or turning to private practice. There is a generational gap of opportunities for progression within the sector and a reluctance to face up to the impact on recruiting the next generation of workers into training.

When I first started running discussion events for therapists on the theme of ‘Do you have to marry a rich man to be a psychotherapist in the UK?’ it sounded provocative. Now it does not. Because of the precarious nature of many of the jobs within mental health, many of us are reluctant to talk about our experiences of work, particularly the difficulties of making a living and protecting ourselves from insecure states of mind. In the years I have been working with health workers I would say the most common survival strategy is to keep our mouths shut and heads down. Despite therapists being in the business of talking, we are typically not spending much time talking to each other about how to address the realities of our working lives. As part of an ongoing project to develop resources for front line workers and managers in healthcare, I carried out a series of conversations with practitioners at the Tavistock & Portman NHS Trust. Our aim was to think about how psychodynamic

ideas can help people working in healthcare to survive and improve their working lives. All of these people gave their time and ideas for free and helped create a safe framework for talking about the demanding issues of racism, bullying, teams and group dynamics in healthcare. Based on these conversations we launched a website which offers free resources focusing on ten core themes (listed below). The resources include videos, short podcasts and two survival guides. All of the resources take a jargon free, de-stigmatising and practical approach to addressing the real problems of working life. Our ethos is based on a relational model of work - that, in order to survive work, we all need to build our relationships with the people around us. A psychodynamic framework is a model of talking and listening, and allowing other people to influence how we see the world. It is also a model that respects the ‘ordinary’ expertise and authority of surviving work and recognises that through our

Bullying at work

Why healthcare has a culture of bullying and why we are all involved

Healthy organisations

What makes workplaces sick and why we can't stop getting ill

Understanding Healthcare

What are the systemic factors that shape healthcare delivery

Precarious Work

The realities of working conditions and wages in healthcare

Precarious Workers

What happens to us when we work in precarious jobs

Dynamics in Groups

Why working with other people makes us anxious

Racism

Why discrimination happens everyday in healthcare

Managing Healthcare

How to manage dysfunctional teams and survive the process

Team working

Why team working is the only show in town

Solidarity in healthcare

How to make friends and influence people at work

CBT Today | December 2016

relationships we are capable of solving both individual and workplace problems. The resources propose adopting frontline management and team building approaches that allow people to talk and make decisions about their work. This model of ‘democratic leadership’ is very much part of our psychoanalytic tradition and the proposal is that these are methods that should be revived in healthcare, not least in order to improve patient care. These are just online resources and not a substitute for talking to the people you work with - but they are a way of opening up debates at work

about the tricky and painful stuff of earning a living and bullying cultures. Our proposal is that surviving work is a dual task – it involves both trying to change our working conditions, while at the same time surviving them. This involves developing our ability to see reality in all its ugly glory, allowing ourselves to get angry about it, but still trying to understand it, learning to find help and relying on our relationships with others. I hope that you can use these resources in your activities, meetings and trainings. Just send the link to anyone you think would find it useful. If you are working on the front line of mental health services, you don’t have time not to listen.

Elizabeth began publishing the results of the Surviving Work Survey in November 2016. These results - along with the resources listed - are available at www.survivingwork.org Her next book, Surviving Work in Healthcare: Helpful stuff for people on the frontline, will be published in 2017 by Taylor & Francis.

The Decider - an update In September 2015 we ran an article about Michelle Ayres and Carol Vivyan, cognitive behavioural psychotherapists and co-creators of The Decider. Carol also runs the website www.getselfhelp.co.uk which is used extensively in mental health services. Carol gave us an update on their work recently, saying: “We have had a very busy time since we were awarded Mental Health Nurse of the Year 2015 by the British Journal of Nursing. “We have been developing The Decider Life Skills; a 12 skills simplified version of The Decider, for use in health, education and business settings, voluntary agencies and charities. It is proving to be a successful model, used in a range of services and as a waiting list intervention.“ They have been busy taking their work round the UK, as she added:“We have also facilitated workshops in Cumbria, Jersey and Ireland and the feedback has been very positive.” Michelle explained “As psychotherapists, we know that CBT has an impressive evidence base. It is adaptable and flexible. Most of all, it makes sense to most people! “One of the greatest challenges all therapists face is equipping people with the skills to understand and manage their own emotions and mental health. The way we teach clients and clinicians The Decider Skills really seems to be effective. “The workshops are fun, creative and interactive, using didactic teaching, demonstrations, music, visuals and reflection and skills practice to aid learning.”

CBT Today | December 2016 9

The transition years As Therapies Lead at the Brighton and Hove Wellbeing Service, Kelly Cahill offers some thoughts as to how the transition for young people into adult mental health services could be developed.

There are high levels of referrals for young people into IAPT services. A proportion of these are referrals straight from CAMHS services where young people with complex mental health care needs will have received years of involvement individually and with their families. However, at 18-years-old many young people will still not meet the threshold for AMHS (Adult Mental Health Services). This is where IAPT primary care mental health teams may be particularly well placed to provide a service to this group of young people. The NICE guidelines set out to improve the transition for young people into adult mental health services. Young Minds have also been campaigning to improve transition care. It reports that many young people may be left without support as CAMHS’ involvement ends, and the narrow focus on severe and enduring illness in adult services means some young people are seen as ‘not ill enough’ for AMHS. The period in which young people move into adulthood - ‘the transition years’ - is recognised as being difficult and stressful for many young people. It is also well documented that mental illness onset generally starts in late adolescence, making this a crucial time to access appropriate services. The Joint Commissioning Panel for Mental Health identified several factors in 2012 that present barriers to transitions from CAMHS to AMHS. There may be a lack of adult mental health professionals working within IAPT with the skills, knowledge or experience to work effectively with young people. Adapting and adjusting therapy to meet the needs of young people is

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important. This may include adjustments such as; avoiding early morning appointments, checking if the young person would like parents/carers involved and taking account of ‘normal’ developmental phases, such as biological, psychological development in the broadest terms. There are of course a range of excellent examples of transition services that support young people in the 16 to 25 age range, for example ‘Early Intervention Psychosis’ teams and young people services such as the YMCA. The Teen to Adult Personal Adviser (TAPA) team workers in East Sussex and the local IAPT service, Brighton and Hove Wellbeing, have worked together to develop a pathway for referrals that are supported self-referrals and ensure the TAPA team are copied into any assessment or treatment appointments with the consent of the young person involved. This is aimed at reducing Did Not Attend (DNA)/cancelled appointments and young people being discharged back to the care of the GP. In addition young people who are struggling to engage in IAPT therapy can be referred to the TAPA team and offered additional support from this team to help them engage with the therapy being offered and attend appointments. NICE guidelines offer some helpful points for IAPT services to consider in the ‘transition years’. This includes ensuring that young people and carers are involved in the transition to adult (IAPT) services. Developments such as the individual personal transition plan (timeline) can be brought to assessment or first treatment sessions to support them in describing their mental health journey.

For some young people a ‘bridging meeting’ with the CAMHS professional and the IAPT worker may be helpful. Ensuring the young person’s view of carers/parents involvement has been discussed with them and taken into account is important. Whilst there is no prescribed ‘best practice’ model to meet the needs of young people in transition for IAPT services, the following additional elements could be considered: • Develop a link worker role between IAPT and CAMHS • Create an interface meeting with local CAMHS teams to discuss young people who do not meet the threshold for secondary care Adult Mental Health Services • Increase information provided to CAMHS teams about local IAPT services to ensure professionals and young people are aware of what is available and the nature of the treatment available including the time limited, structured and goal focused evidence-based treatments, which may enhance self-referrals

pages for young people about what is available • Develop a young person user group for advice and consultation for each local IAPT service • Make use of IAPT data to analyse the information gathered, such as number of young people aged 18 years accessing the service, DNA/cancellations/withdrawn from treatment, referral sources and recovery rates for young people. This would help create appropriate responses to engaging young people. Taking into account the recent guidelines and their influence to increase our understanding of the needs of young people accessing IAPT primary care mental health services will lead to better transition experiences for young people. More information on the Joint Commissioning Panel for Mental Health can be found at www.jcpmh.info

• Increase the opportunities for a named working and a bridging experience between the two services via the interface meeting • Provide online therapy which may be a more acceptable model of treatment for some young people • To offer IAPT therapy in locations that are accessible and less stigmatising for young people • Hold group work in IAPT specifically for young people • Design websites that are attractive to young people and have specific

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CBT Today | December 2016 11

CBASP SIG - at large in Europe 2016 has turned out to be a good year for promoting the psychological treatment for persistent or chronic depression. The CBASP (Cognitive Behavioural Analysis System of Psychotherapy) approach has seen a great deal of activity by our Special Interest Group through various efforts, and more events are coming up, as Marianne Leibing-Wilson explains. Our CBASP colleagues in Amsterdam, including Jenneke Wiersma and Professor Patricia van Oppen, had managed to invite Professor Jim McCullough of Virginia Commonwealth University, Richmond, USA to deliver a five-day workshop for Dutch therapists. Professor McCullough, or ‘Big Jim’ as he is fondly know by anyone who has ever had the pleasure to meet him, is quickly approaching his 80th birthday, and by his own reckoning, is on the ‘slow track’ to retirement. Ever a passionate promoter of helping the chronically depressed patient, he signed up for the challenge very quickly. Members of the CBASP SIG here in the UK who had training under Big Jim, were told about the proposed training venture and offered assistance in teaching 35 keen delegates the CBASP model and offer practice sessions in the various components of it. The event was attended by therapists from several European countries, including the Netherlands, Germany, Switzerland and Norway. The training

offered an opportunity for people to train with the originator of the model, who has developed this specific treatment for the chronically depressed patient through years of working with patients in his care. Feedback from delegates has been extremely positive and many were keen to come to the UK for further training, in view of Big Jim’s retiral. In September, the EABCT conference in Stockholm offered a further opportunity to spread the word on CBASP. This took the shape of a preconference one-day workshop (international presenters included Jenneke Wiersma, Professor Van Oppen, Dr Phillip Klein and Professor Eva-Lotta Brakemeier), an inconference half-day introduction to CBASP (presented by members of the BABCP CBASP SIG), and a symposium. All of these were well-attended and are helping to put CBASP firmly on the map of psychological approaches. More locally, CBASP has made its way onto the Matrix, the Scottish Government guide to delivering evidence-based psychological therapies in Scotland, as a treatment

with an evidence grade B (wellconducted non-randomised clinical studies or RCT of lower quality). The CBASP SIG is hoping to disseminate more information and offer training to help practitioners get up to speed with this development for patients suffering from persistent depression. You can contact the CBASP SIG at cbasp-sig@babcp.com regarding training opportunities or membership. CBASP SIG presents www.babcp.com

Combining Cognitive Behavioural System of Psychotherapy (CBASP) with CBT to address common interpersonal problems using Situational Analysis (SA) with Jon Linstead

Friday 27 January 2017 Barnsley Registration fees BABCP members: £35, Non-members: £40 To register for this event, please email beattie77@hotmail.co.uk

CBASP - Innovative Treatment for Persistent Depression: A Primer with John Swan and Bob MacVicar

Friday 17 February 2017 Manchester Registration fees BABCP members: £50, Non-members: £60 To register for this event, please email m.liebing-wilson@nhs.net

Three-day Intensive Training in CBASP with John Swan, Marianne Liebing-Wilson and Bob MacVicar

Wednesday 17 - Friday 19 May 2017

The organisers and small group leaders of the Amsterdam CBASP Training 2016 Left to right: John Swan (CBASP SIG), Barbara Baker (Administrator, Richmond VA), Jenneke Wiersma (Netherlands), Anneke van Schaik (Netherlands), Professor James P McCullough Jun. (Richmond VA), Bob MacVicar (CBASP SIG), Marianne LiebingWilson (CBASP SIG), Professor Patricia van Oppen (Netherlands) 12 CBT Today | December 2016

Dundee

Registration fees BABCP members: £280, Nonmembers: £300 To register for this event, please email m.liebing-wilson@nhs.net

Doncaster (wikimedia Commons by Frees)

Celebrating the work of PWPs in the north of England It is now 10 years since the PWP workforce was first piloted in the Doncaster and Newham Primary Care Trusts. The University of Sheffieldâ&#x20AC;&#x2122;s Steve Kellett writes about a recent conference held in York to build upon the work of PWPs in the north. Over 200 PWPs gathered at York Racecourse in September to attend a conference that celebrated their work and considered how to integrate new research evidence into their expanding roles. The conference was a collaboration between Health Education England (HEE) Yorks & Humber, HEE North East, the Psychological Professions Network (a hosted service of North West HEE) and the University of Sheffield, with the aim of supporting the CPD needs of the workforce. Educational commissioners Barry Foley and Cheryl Day opened the conference, setting out the agenda which aimed to build on previous conferences and masterclasses held in different regions, and to consider the role of a Northern PWP Network.

various differing types of guided self-help, the model at the heart of PWP work (COM-B) and the expansion of the PWP role itself. The conference was a great success and helped to forge new links across the regions at Step 2 of IAPT services and associated HEIs, and is hopefully a step towards the development of a Northern PWP professional network. More information on the Northern IAPT Practice Research Network can be found at www.iaptprn.com

BABCP president Chris Williams spoke of the challenges in providing effective guided self-help, emphasising choice and collaboration, while the first research presentation was by Jim White and Jaime Delgadillo who discussed the origins and best practice for stress control and the results from a cross-service study emanating from the Northern IAPT Practice Research Network. Morning skills workshops took place, with Katie Kay leading on the use of IT in guided self-help, Liz Kell, Liz King and Heather Stonebank leading on the senior PWP role, and John Firth, Gill Randall and Nicola Willcocks leading a workshop on a low intensity approach to pain management. Focus shifted in the afternoon, with consideration given to behavioural activation (BA) as a core intervention at Step 2 of IAPT services. Firstly, Dave Ekers fed back results from the recent COBRA non-inferiority trial of BA versus CBT that builds on the gaps identified in previous BA meta-analyses. Secondly, Paul Farrand described the opportunities and evidence at Step 2 of integrating physical activity into BA approaches. The conference was closed by Clare Baguley describing the themes of evidence now better underpinning the PWP role, the need for developing competency measures for CBT Today | December 2016 13

The happiest place to work as a therapist? According to a recent report from the Office for National Statistics it appears that the Western Isles (where I work and live) is the happiest place in the UK (cue applause and wild whooping).

Moving your family lock stock and barrel to the Western Isles would be a huge challenge for anyone. But as Mike Sullivan reports here, working as a therapist in the ‘happiest place in the UK’ has its challenges, as well as its rewards.

Some places in Northern Ireland score a wee bit higher for other aspects that contribute to happiness, but we kind of won overall, just ahead of other wonderful Scottish places. Like a Eurovision song contest there are winners and losers. There were areas at the bottom of the list, but go and find out in the report, I am hesitant to heap more misery on them. So what has this got to do with CBT? It struck me recently after seeing a patient in clinic how potentially disheartening it is to hear this when you actually live in this area and are not happy, content or living the perfect life. How easy does it make it to accept what a lot of people believe is a romantic notion that just living somewhere beautiful and now ‘happy’ would be enough to keep us all in the same good mood. When speaking to friends, colleagues and relatives about living and working on the islands it is a regular occurrence that they are initially

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slightly bemused.“Really” they say in shock,“how can people be unhappy up there, of all places?”,“Surely it’s a great place to bring up children?”, and “The sense of freedom must be great”. Even fellow staff in the caring sector have a bit of a misty-eyed view about how easy the workload would be due to a lack of complex entrenched cases. Alas it is not like that at all. Even some people living on the islands do not identify with the notion that things may actually be difficult for families and individuals living in the community. Don’t get me wrong – many people love working in, retiring to, and visiting the Western Isles, and it has a lot to offer geographically, culturally and socially. But we have the same range of difficulties and stressors present across the country - but just on a smaller scale. The population of the island is approximately 28,000 so it does not demand massive services or staff teams but the referrals to many child and adult services are similar and sometimes higher than other areas across the country. The local CBT service is developing slowly and we now have therapists

across the islands working with a range of conditions. Our islands are not accessible by bridges; so long ferry journeys and flights are the only options. This adds a different dimension to our work when we have referrals for flight and ferry phobias which can really impact on individuals and their families. The isolation can compound many social anxiety presentations; going out for a coffee can be an all-day experience, travelling for hours, potentially, on public transport. Dealing with depression is hard and challenging, but limited social groups, stigma and misunderstanding can compound the reality (as well as the weather, and long winter nights!). Some patients feel the amplification of happiness and beauty on the island can add to the minimisation of such personal struggles. One person’s fantastic beach is another’s reminder of how down they actually feel. So, as you can see setting up those behavioural experiments and exposure plans can have some pitfalls! However it is fulfilling from a professional viewpoint to be able to help with an extensive range of issues and see the real effects and benefits for people. Also to be reminded of them when you see that person on the next flight giving you a knowing nod that means you helped them get there.

As always its different sides of the same coin and the positives of living here are extensive but there are always reminders of what I sometimes miss about the mainland, a bit of anonymity. Just last week I was in the supermarket queue behind a former patient who had some alcohol addiciton issues, and whilst they did try to pretend not to know me, they seemed to take a longer look in my basket spying my own recreational beverages for the weekend (all within government guidelines of course!). Some patients are more than happy to stop and chat with you, especially teenagers. My family have got used to not asking “Who was that?” whenever we are out and about, as your public and private persona can get mixed up a lot.

So the next time you see the films, the pictures and even if you visit here remember yes it’s all really truly wonderful and great that there are many ‘happy’ people living here, but there is another reality too, always another story behind the stats! Mike is in the process of becoming a provisionally accredited member of BABCP and has worked in the Western Isles for 14 years after moving his family to manage residential childcare services. He recently completed his Diploma in CBT at Dundee University and delivers CBT to children and adults as part of his work in a local mental health team. Pictures Mike Sullivan

“ ” Where else can you explore 2,000km of coastline in your spare time?

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Why do CBT therapists remain in the NHS? Dr Kate Daley is a clinical psychologist, CBT therapist and MSc student at Birkbeck University, and discusses the merits of our much-maligned NHS. The NHS is in crisis. It is overstretched, and strikes and low morale are never far from the headlines. Staff describe unmanageable workloads and abuse, not to mention the ongoing pay freeze against rising inflation. Tales of unsustainability and burnout seem commonplace, with the British Psychological Society (BPS) reporting higher rates of depression among NHS Psychological Therapists than we would expect in the general population. BABCP released a statement pertaining to a “bullying and coercive environment” within NHS services, likely created by a target-led, performance-driven culture under constant threat of tender. Anyone who has worked in IAPT services will be aware of the pressure to see more patients for fewer sessions whilst seamlessly inputting data on everything imaginable. Whilst I believe wholeheartedly in the NHS and am in awe of what the IAPT programme has achieved, the demands seem unrelenting. In the face of this adversity and growing alternative employment options, it got me thinking, why do CBT therapists remain in the NHS? To explore this question, I carried out surveys with 27 CBT therapists working within the NHS and subsequently interviewed seven. I asked why they remain in the NHS and what may lead them to consider leaving. A thematic analysis identified nine themes which were consistent to those identified in other professional groups. The themes for staying were NHS benefits (stable income and job security; pension; sickness and maternity pay; annual leave; support, training and reputation), NHS values (free and accessible to all), job content (working with particular groups, working in a team), inertia (not having time or energy to 16 CBT Today | December 2016

change) and a sense of responsibility. Job satisfaction emerged as an overarching theme, with 81% reporting that improvement in patient symptoms made them pleased to be in NHS employment. The majority of those surveyed had considered leaving the NHS (89%), and 25% mentioned current workrelated stress. Reasons for considering leaving were unrealistic or un-patient centred targets, feeling undervalued or under supported, and pay freezes. Worryingly, 46% cited that they felt unable to deliver evidence-based practice due to session limits and high caseloads. Interestingly, 89% expressed dissatisfaction with the NHS as a key reason to consider leaving, with only a few noting ‘pull factors’ from the private sector. All said they would remain in the NHS providing the benefits outweigh the cost. Whilst findings are perhaps unsurprising, it is concerning in the current context. CBT therapists are in high demand, with posts increasing year on year. If the balance tips, the ADVERTISEMENT

NHS could lose valuable skills and experience, in addition to the great financial loss sunk through recruitment and training. This should be seen as a warning, something must change. We can’t magic a cash injection, but what we can do is go back to basics. We can ensure that staff have adequate support and supervision, that targets remain achievable and patient-focused, and NICE guidelines can be adhered to. We can invest in training to ensure staff feel valued, and put initiatives in place to prioritise staff wellbeing. We can align core values and cultivate job satisfaction. As one therapist remarked “I can put up with the rest as most days I really love what I do”. Essentially CBT therapists enter the NHS because they care, but the current system is risking stifling this ability. We need to make systemic change before we lose these wonderful people to other organisations, in a time where it’s likely the NHS will need them more than ever.

Dr Rob Durham Just once in a while you meet someone who has a substantial and beneficial influence on your life and Dr Rob Durham was such a person, and we know that he had similar beneficial influences on a substantial number of other people. They will know who they are and the ways in which Rob influenced them; they will each have their own memories and stories to tell of their time with him. It is with great sadness that we have to let people know that Rob passed away on 31 October 2016 in the company of his family. His leaving was as comfortable for him as one could hope for. Rob had been ill for most of this year. He bore this unexpected and cruel blow in a style that only Rob could; stoically, with enormous humility and the familiar discomfort that Rob often experienced when called upon to be "the centre of attention". He found it hard to believe that so many people were perturbed by his plight

John Swan, Marianne Liebing-Wilson and Bob MacVicar recall their own special memories of Rob Durham.

and genuinely surprised and grateful for visits and associated good wishes. Rob was a clinical psychologist who I first met in the mid 1980's. At that time he was working in the community in and around Dundee. He had recently returned from the United States where he had been exposed to – and trained in – that new fangled Beckian cognitive therapy stuff. A bit of a turn around for someone whose doctoral thesis had focused on Peter Lewinsohn's strongly behavioural approach to depression. Rob, who self effacing to the last, thought he was an inadequate teacher but we can tell you he was simply excellent. He influenced me, a newly trained behavioural therapist in 1988 to come over to the ‘dark side’ and try out Beck's Cognitive Therapy for Depression. He then went on to influence simply hundreds of clinicians in Scotland and beyond in the following decades up to his retirement five years ago.

Rob became the course director for the University of Dundee Post Graduate Training in CBT Programme from the early 1990s. I was lucky to be his associate in this endeavour for the next 25 years or so until he retired. Not only was Rob a consummate educationalist, he was an excellent clinician and researcher publishing many peer reviewed papers and book chapters over the years. Rob took to retirement like a duck to water.This was a surprise to me, to his friends and colleagues and not least, to Rob himself. Although his life has been cut short it is good to know that he enjoyed some years in retirement to be with Tessa, his wife, to travel, enjoy his guitar playing, boating and cycling and to enjoy the company of his two sons and the apple of his eye, his grand-daughter. Recent weeks has been tough for us but our hearts and commiserations go out to his family. Never fear, Rob will be remembered fondly by many across the land.

CBT Today | December 2016 17

Taking part in the Spring Conference Laraine James is a trainee clinical psychologist at the University of Hertfordshire, and reflects on participating at the 2015 BABCP Spring Conference when considering a client presenting with Antisocial Personality traits. When signing up to attend the 2015 Spring Conference I felt waves of anticipation and excitement. As a CBT therapist and clinical psychology trainee, my ambition of working closely with people experiencing personality disorders seemed another step closer. Spoiled for choice with the array of workshops and symposia that were on offer, it struck me that in spite of the dominant discourse in services – namely that personality disorders were ‘hard to treat’ – a number of innovative interventions were coming to the fore that showed real willingness to engage with some of the most traumatised and misunderstood people in society. This realisation evoked powerful feelings within me, and my positive engagement with the conference began; an idealisation of what was hopefully the future of personality disorder services, and this brought about fresh hope in working therapeutically with clients who attracted this label. 18 CBT Today | December 2016

I then wondered if what I felt mirrored a similar process to what was experienced by clients at the beginning of therapy. If so, what feelings were involved and how intensely were they experienced and processed? And what were the typical responses of CBT therapists to early interpersonal ruptures? At this point I was reminded of the importance of adopting a stance of ‘not knowing’ when embarking on cognitive behavioural work with such clients. In my view, taking a position of curiosity from the point of referral enables genuine curiosity to flourish; leading to collaborative exploration and formulation of a person’s lived experience; acknowledging, but trying to look beyond the oftenstigmatising label of personality disorder. After much deliberation I settled on a day-long workshop ‘Working with Antisocial Personality Disorder (ASPD)’. Having worked in forensic services prior to CBT training and finding it

quite difficult, I felt it would be as much an exercise in examining my own (unchallenged) beliefs regarding the client population and systems around them, as it was about learning innovative ways in which to support those who reportedly push clinicians to their very limits. The workshop did not disappoint, and was delivered enthusiastically covering topics such as ‘quick and dirty’ evidence-based risk assessment of ASPD (a necessity in the current austere climate), the influence of substance abuse, psychopathy presentations and indirect intervention ideas for teaching nonspecialist staff. There were references to robust research findings and intriguing clinical examples provided by the facilitators. The interactive style of the workshop led delegates to willingly share ideas and anonymised clinical material. There were also reflections, professional dilemmas and good practice examples conveyed, with no perspective belittled or disregarded.

As such, I was reminded of Dialectical Behaviour Therapy (DBT) principles. Furthermore, while the facilitators illuminated the value of CBT approaches, there were clear influences of systemic, narrative, behavioural and attachment perspectives; highlighting the very complex, multi-systemic and pluralistic nature of this work. As the day progressed, I wondered about the function(s) of the motivational and validatory techniques that were modelled by the facilitators, and how this prepared delegates for participation in a Thinking Skills Group role-play in the afternoon. A growing sense of relatedness was apparent within the group, and this led me to reflect on the benefits of a nurturing, supportive work environment; particularly when working with clients experiencing personality difficulties. To this end, I recalled how this appeared to be lacking some years ago, in previous work, with a similar client group. However, it also dawned on me that my inability to recognise feeling overwhelmed within that setting, had evoked a familiar coping style of denial, over-working, self-reliance and burn-out. My personal highlight of the day was the Thinking Skills Group role-play. Delegates were invited to present a piece of ASPD-related clinical work to their colleagues, and then to remain silent as the group openly reflected upon the main issues that were raised. Finally, the presenter was to reflect on what they had heard. This systemically-informed approach reminded me of team consultation and live supervision within other contexts and was again, analogous to the multi-systemic methodologies that were championed during the workshop. After some thought, I volunteered to present a client (who was anonymised with identifying details changed) I had been struggling to work with in my previous role as a

CBT therapist in an IAPT service. I considered this a behavioural experiment in allowing myself to be vulnerable and less self-reliant, but at the same time it felt quite uncomfortable. As I presented the client and my formulation, I became aware of powerful feelings of shame as I came to realise that I had been somewhat reluctant to let that client ‘go’ to a more specialist service, even though I was working towards a planned ending, and had discussed the case in supervision. I suddenly felt exposed, inadequate and a bit of a fraud. However, the reflections that were made did not match my inner turmoil and consisted of phrases such as “a warm therapeutic alliance” and “…gave the client a positive relational experience”. Other reflections included the group’s concerns surrounding me working therapeutically with a person experiencing antisocial tendencies without the support of a full multidisciplinary team, and how that potentially introduced issues of risk. Further reflections concerned the hypothesised function of some of the disclosures that the client had made, and curiosity around aspects of my

self-care. As I was considering what had been spoken, it soon became apparent that my ‘modelled vulnerability’ in sharing a challenging case had created ripples towards other members of the group where they too felt able to vocalise some previously-unspoken thoughts and feelings concerning their work, by way of normalising my experience. It certainly seemed as if the group as a whole benefited from this role-play. Following this exercise, it felt like a huge weight had been lifted. Coupled with assimilating the concepts and ideas discussed during the day, I exited the workshop realising that being vulnerable in the presence of a ‘safe-enough’ group was crucial to identifying and addressing my blind spots. I am now able to view my work and responsibilities towards clients experiencing personality difficulties quite differently, including the need to foster more empathy and compassion for myself, and to be careful not to act upon the belief that I can rescue every client that I meet. I am also revisiting the idea of working again in forensic services, and have come to realise that I am as much a part of the ‘system’ as the clients and colleagues that comprise it.

Scotland Branch presents www.babcp.com

Experiencing CBT from the inside out: Applying CBT to ourselves as therapists with Dr Richard Thwaites

Friday 24 February 2017 Perth

Registration fees BABCP members: £85Non-members: £105

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CBT Medics Special Interest Group - the first year www.babcp.com

CBT Medics Special Interest Gro

The aim of the Medics SIG is to promote CBT in medicine, share ideas and network, and learn new or consolidate existing skills. The conference’s morning speakers concentrated on issues particular to medics in CBT. Dr Ali Alfaraz and Dr Graeme Whitfield presented research outlining the difficulties that medics have practising CBT after training to a postgraduate level. Dr Steve Moorhead shared his research regarding views on a proposed framework for CBT competencies for CT trainees which outlines specific competencies trainees can transfer from their CBT training to improve their general clinical performance, including in outpatient clinics. This provoked discussion around the perceived importance of doing an actual CBT case as a method of experiencing its power to change. However the framework was felt to be an important addition, in terms of giving an explicit framework for discussions with trainees, around which skills they could develop further, and possibly using alternative methods while in routine psychiatric practice, especially in light of Graeme’s findings. The morning was thought provoking around the role of CBT trained medical psychotherapists, particularly in training junior doctors. The afternoon’s speakers concentrated on sharing practise from more specialised areas of CBT. Dr Lynn Drummond gave an excellent talk reviewing current research evidence for OCD treatment, including pharmacological and psychological interventions. She also 20 CBT Today | December 2016

After much planning and organisation, the CBT Medics SIG held their inaugural conference in March 2016. Happily there was a great turn out, to a superb venue on the outskirts of Leeds. SIG Branch Liaison Officer Katharine Jenkins tells CBT Today readers about the day. presented extremely promising early results from trials of neurosurgery for carefully selected patients. Her talk, for me, showcased the value of a dual training, in being able to run a service offering the best of both psychological and pharmacological treatments. In addition it provided a clinically useful summary of evidence-based treatments for OCD. Dr David Veale gave an interesting and amusing talk on the details of treatment of vomit phobia. It included enlightening details on how to recreate the sounds and smells of vomit within the therapy room! Dr Saju Paddakara gave an informative and accessible talk about the psychological issues of transgender and gender nonconforming people. For me the event was excellent. It allowed networking with other

medics and non medics trained in CBT. It provided a forum to discuss some of the difficulties that the role of a medical psychotherapist can throw up. However, it also allowed sharing of ideas and successful practice in both the training and clinical context. It allowed discussion about how as a body we could use our expertise to take these issues forward. We are now planning to make this an annual event and would welcome new attenders including interested trainees, general psychiatrists and GPs. Such was the success of this year that lunch as well as tea will be included on 17 March 2017! You can contact the committee at medics-sig@babcp.com if you would like to join. Membership is open to all BABCP members.

CBT Medics SIG presents www.babcp.com

Conference Friday 17 March 2017

Registration fees Early Bird (registration up to 17 February) BABCP members: £50, Non-members: £60, Students: £40* Full Rate (from 18 February) BABCP members: £60, Non-members: £70, Students: £50* *proof of student status to be provided on registration

North East & Cumbria Branch

North Wales Branch

presents

presents www.babcp.com

www.babcp.com

Taking Your Next Steps with ACT

DBT Problem-solving in Action: Solving common therapist errors in behavioural and solution analyses

with Richard Bennett

with Dr Michaela Swales

Thursday 16 & Friday 17 March 2017 Grasmere

Friday 17 February 2017 Bangor

Registration fees

BABCP members: £140, Non-members: £180

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 South East Branch

Southern Branch

presents

presents www.babcp.com

Beyond reliving in PTSD treatment: Advanced skill for overcoming common obstacles in memory work

www.babcp.com

Working with Resilience with Joy Maguire

Thursday 23 February 2017 Southampton

with Dr Hannah Murray and Sharif El-Leithy

Friday 3 February 2017

Supercharging CBT for Complex OCD

Registration fees BABCP members: £90, Non-members: £100, Students: £70* *Evidence of student status must be provided with application

with Dr Blake Stobie

Friday 21 April 2017

CBT and the Treatment of Compulsive Sexual Behaviour with Dr Thaddeus Birchard

Friday 12 May 2017 All events are held in Sevenoaks Registration fees (per event) BABCP members: £65Non-members: £75

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Supervision SIG

Couples SIG

presents

presents www.babcp.com

www.babcp.com

Cognitive Behavioural Couple Therapy with Dr Marion Cuddy & Dan Kolubinski

Monday 30 & Tuesday 31 January 2017 London Registration fees BABCP members: £90, Non-members: £110, Students: £75* *Evidence of student status must be provided with registration

Thursday 8 June 2017

Treating Couples with Infertility Friday 9 June 2017

ACTivate Your Supervision

Emotion Focused Interventions for CBT with Couples

with Martin Wilks

Friday 10 February 2017 London

both with Misa Yamanaka

Registration fees

Registration fees (per date)

BABCP members: £80, Non-members: £100

BABCP members: £95, Non-members: £110

London

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

Liverpool Branch

presents

presents www.babcp.com

www.babcp.com

Building Resilience in Therapists

Teaching patients to become their own radical behaviour therapists

with Mary Welford

with Nick Hool

Friday 20 January 2017 Buckfast Registration fees BABCP members: £75Non-members: £85

Friday 17 February 2017 Liverpool To register for this event, please email Liverpool@babcp.com

Working with Dissociation A CBT Model with Dr Fiona Kennedy

Thursday 2 & Friday 3 March 2017 Buckfast Registration fees Early Bird (up to 27 January): BABCP members: £130, Non-members: £150 Full fee (from 28 January): BABCP members: £150, Non-members: £180

CBT Today | December 2016 23

Tesito House Vacancies Psychological Therapist and Advance Practitioner Providing 24 hour support for women who have suffered from complex social, psychological and physical consequences of overwhelming stress and adversity. Alternative Futures Group (AFG) are a leading charity based in the North West that specialises in providing integrated health and social care services for people with lived experience of mental illness and complex needs. We are now extremely proud to announce the opening of Tesito House, based locally here in Ardwick, which is our brand-new 24 bedroom Treatment and Recovery Centre where we will provide a recovery orientated therapeutic service and environment for vulnerable women. We are looking for Psychological Therapists and Advanced Practitioners to join our organisation. If you are interested in being part of a great team and making a difference, please visit our website for further details. Closing date for receipt of applications will be Monday 19th December 2016.

Tesito House: 0845 0176 744 www.AlternativeFuturesGroup.org.uk

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