Volume 42 Number 3 September 2014
With this issue: New era for Branches and Special Interest Groups
10k membership milestone passed On 10 November 1972, the inaugural meeting of the British Association for Behavioural Psychotherapy took place at Middlesex Hospital in London. In its first year, the fledgling organisation had 195 members. Almost 42 years later - and with the ‘C’ for Cognitive added in 1992 BABCP now has over 10,000 members.
From the Lead Organisation for CBT in the UK and Ireland
On hearing the news, BABCP President Professor Rob Newell (pictured) said: ’This is a landmark occasion for what started as a small interest group in a newly developing area of psychological treatment. It is also a great achievement. The Board thoroughly recognises and
appreciates everyone’s contribution to this. I must note that being a member of BABCP is not required to practise CBT, nor is BABCP Accreditation. The fact that our membership continues to grow, in what are difficult financial times, is a testament to the fact that members see what we offer as valuable and important. Thank you so very much for your continuing contribution to the BABCP and CBT in general.’
Supervision Special Interest Group At a time when many of us are facing ever-increasing demands and reducing resources in our working environments, opportunities to reflect on our practice can be scarce. Supervision, as a mechanism to take care of ourselves, and to ensure we are delivering high quality, evidencebased CBT practice, is vital. Over recent years, increasing attention has been paid to the core elements of effective CBT supervision, and a number of models have been developed. Opportunities for training in supervision are increasing, although the availability of specialist workshops and CPD events with a supervision focus remain small compared to the number of CBT practice events. With some of these issues in mind, members with a particular interest in supervision formed the BABCP Supervision Special Interest Group (SIG) towards the end of 2013. With a groundswell of interest in supervision, it is an ideal time to have developed this new group. Moreover, it was encouraging to see so many members from across the UK and Ireland who gave up their sunny Birmingham lunchtime to attend our first national Supervision SIG meeting at this year's Annual Conference.
Volume 42 Number 3 September 2014 Managing Editor - Stephen Gregson Deputy Editor – Peter Elliott Associate Editor - Patricia Murphy 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 mailed posted free to all members. Back issues can be downloaded from www.babcp.com/cbttoday.
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Thank you to all of you who did so. Lots of interesting ideas were suggested as to how we might take the SIG forward. Finding ways to communicate and facilitate networking seemed especially important, perhaps by creating a forum, or via local subgroups. There was a clear interest in research in terms of both contribution and dissemination, as well as hope that the SIG could become a force to increase research in the area of supervision within CBT. Attention was given to an upcoming special issue of the Cognitive Behavioural Therapist journal, which will focus on supervision. You will find a call for contributions on page 22 of this issue. A project to develop a supervisor training manual is also underway at the University of Newcastle, in association with BABCP. Discussions are already underway with Derek Milne as to how the SIG might become involved with this. Of course workshops are one way of meeting up and we already have a number of events planned. The first will have taken place as this issue of CBT Today goes to print, with our next event to be held in Newcastle in November.
Main aims of the Supervision SIG include: • Promoting and upholding high standards of evidence-based CBT practice, disseminating research and good practice by providing workshops of a high calibre • Helping to make supervision accessible • Offering training and development opportunities to existing CBT supervisors, as well as providing a resource for those who have not supervised before • Providing support and guidance to those wishing to become BABCP Accredited Supervisors • Delivering affordable and accessible training events for CPD in the UK and Ireland
Join the Supervision SIG If you would like to join the group, please contact us at supervision-sig@babcp.com
Submission guidelines
Next deadline
Unsolicited articles should be emailed as Word attachments to editorial@babcp.com, except for PWP-related articles which should be send to pwptoday@gmail.com. Publication cannot be guaranteed.
9.00am on 3 November 2014 (for distribution week commencing 1 December 2014)
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.
Advertising For enquiries about advertising in the magazine, please email advertising@babcp.com.
© Copyright 2014 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.
Warwick, here we come
As usual, the Scientific Committee will be meeting throughout the year to organise the scientific programme. We aim to produce the best learning experience available in the field of CBT, in all its varieties.
contribute to evidence generation and theory, as well as evidence-based work. A call for submissions is on page 15 of this issue. Just make sure that you get yours in on time - and remember that there are two deadlines for different types of work, so make sure you do not miss the relevant one.
We want to give you the opportunity to learn from a wide range of national and international presenters. That is not enough to grow the field, however. We therefore want to give you the chance to present your work. We encourage everyone to think about submitting papers, posters, workshops, skills classes, symposia, and round table discussions.
A word or two about the facilities. You will remember that we have been to Warwick before, and I am happy to say that they continue to develop their facilities. The accommodation is all of a good standard, with different classes of room, all within a short walk from the conference area itself. The meeting rooms are close to each other. Finally, free wifi is available everywhere. Just don’t aim to arrive in the town of Warwick itself, as the University of Warwick is on the outskirts of Coventry.
Our philosophy remains that we want to combine the scientific and the clinical; the science should be relevant to practice, and clinical presentations should be clearly grounded in research and theory. We also welcome clinical ideas that
In case you were wondering, we do look at all the feedback that you give. So, in the light of the (generally highly positive) feedback following the Birmingham conference this year, we will be adjusting the conference content and facilities in order to
address as many of your points as we can. Some of the major keynote speakers are already lined up, with more yet to be announced. Keep your eye on the conference website as plans develop, names are announced, and social events are planned. We look forward to seeing you in Warwick. If you are not there, you will never understand why the conference logo looks so much like a snail. Glenn Waller Chair, Scientific Committee
Submission deadlines Please submit your proposals by: • 5pm on 12 January 2015 for workshops, symposia, skills classes, round table discussions • 5pm on 27 February 2015 for open papers and posters Guidelines will be on the conference website at www.babcpconference.com
Kyrosho at en.wikipedia
The 2015 BABCP Annual Conference and Workshops will be held at the University of Warwick, with the workshops held on 21 July and the main conference held from 22 to 24 July.
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Board notices Subscription increase The Board of Directors (Trustees) proposed the following rates of membership subscriptions to apply from 1 October 2014 to 30 September 2015. These rates were agreed at the Annual General Meeting held at the University of Birmingham on 24 July 2014. Annual payment
Reduced Rate **
UK & Ireland
Overseas *
UK & Ireland
Overseas *
Paid by Direct Debit
£70.00
£78.00
£40.00
£48.00
Paid by Cheque/Card
£78.00
£86.00
£48.00
£56.00
Fellowship Member Subscription by Direct Debit
£102.00
£110.00
£72.00
£80.00
Fellowship Member Subscription by Cheque/Card
£110.00
£118.00
£80.00
£88.00
** All overseas mail will be by airmail ** The reduced rate is available to those Members who can demonstrate that they have a gross income of less than £21,388 per annum. At a meeting on 22 May 2014 the Board decided to remove Mr Mike Davison due to substantial breach of the Trustees Code of Conduct. This is in accordance with the provision of the Code of Conduct and Article 26 of the Articles of Association.
2015 EABCT Congress in Jerusalem At its AGM in Birmingham earlier this year, BABCP passed a motion expressing regret that the 2015 EABCT Congress was to be held in Jerusalem. Following this, David Raines, who proposed the motion, has asked BABCP Board of Trustees to consider further action in this matter. BABCP Board will be looking at David’s proposition at its September meeting and will ask for conclusions to be published in the next issue of CBT Today. David will also be contributing an article laying out his view of some of the key issues involved in holding the Congress in Jerusalem.
Applications are invited from BABCP members for appointment as
www.babcp.co.uk
Accreditation Liaison Officers Salary from £43,096 per annum pro-rata - 22.5 hours per week As BABCP membership tops 10,000 - and with a rapidly increasing volume of accredited members - the Accreditation Team is looking to recruit two additional Accreditation Liaison Officers to increase overall resource in order to appropriately meet the challenges this will mean for the services we provide. Each position will involve a commitment of 22.5 hours per week working from the BABCP office in Bury. Therefore, please note these positions will only suit someone prepared to be predominantly working from the Bury office. Appointments will initially be for 12 months. The newly appointed members of the team will assist the Senior Accreditation Liaison Officer and the existing Accreditation Liaison Officer in developing the Accreditation Register; assisting in overseeing processes for accreditation; being responsible for supporting a team of accreditors processing applications, and providing impartial and informed advice to BABCP members.
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Applicants will have been Accredited BABCP practitioners for at least two years, and have a thorough understanding of the Accreditation process. An application form and further particulars are available from Company Secretary, Ross White, by emailing ross@babcp.com. If you wish to make any informal rolespecific enquiries then please contact the Senior Accreditation Liaison Officer, Charlie McConnochie, at charlie@babcp.com or for organisation-specific queries contact Ross White. Please note that a copy of all questions asked by shortlisted candidates and respective answers will be made available to all shortlisted candidates following shortlisting. Closing date for applications 7 October 2014 Interviews will be held in Bury week commencing 2 November 2014
s rs er te tt at ma y m ty it si rs er ve iv Di D A study in cultural competence Somerset-based High Intensity CBT therapist Jason Carombayenin (pictured left) recently carried out research on cultural competence and diversity awareness in dealing with patients in a multi-cultural society. Here Jason gives a brief insight into the findings which he hopes to publish
Diversity has always been a fascinating subject for me, particularly when I was working in central Bristol, where there is a large ethnic minority population. When I first started thinking about researching this area, I was well aware of ethnic minority issues in mental health. In particular, I knew about problems involved in accessing psychological therapies. I was keen to find out more about why psychological therapies were under-utilised, and questioned whether many of the treatment approaches were equally accessible by minority ethnic populations. I tried to keep my views and opinions in check to ensure I was working as objectively as possible, from the perspective of a scientific practitioner. Although I doubt this has been a 100 per cent ‘pure’ quantitative study, as I am minded that I have been influenced to some degree by researcher subjectivity regarding the chosen topic. Further rationale for this study was whether researchers highlight a paucity of empirical research in the area of investigating cultural competence. This study has been designed to add value to the research in this area. The aim of the research was to develop an understanding of CBT practitioners’ views towards their cultural competence within the framework of awareness, knowledge, skills and organisational support. Whilst I have been well aware of my own ethnic identity (Mauritian/Irish) throughout the research, I have been very careful to emphasise that I am no expert on this subject. Engaging in this study has made me more
informed on the subject as a result of consulting the literature and becoming conscious of other points of view in order to form more balanced ideas around this topic. All this has helped to shape my awareness and knowledge as to what barriers are present for clients, therapists and organisations. Critical to the improvement of mental health services for minority ethnic groups have been three key government publications, namely Inside Outside, Delivering Race Equality and Race Equality Training in Mental Health Services in England. The mental health system within the NHS acknowledges the need to develop cultural competence amongst its workforce, and there is much evidence in relevant literature to inform the practice of psychotherapy. Studies show that, of those who enter therapy, non-white clients are more likely to terminate therapy than white clients. This phenomenon could be explained by the stereotypical assumptions that some therapists may have regarding minority ethnic clients and discrimination. The research was important for two reasons. Firstly, it enabled therapist’s attitudes about their own awareness, knowledge and skills to be measured, as well as the level of organisational support they received in relation to cultural competence. Secondly, I hoped the study would bridge the gap in the empirical literature with regard to this currently neglected subject. There also appears to be other contextual factors that engender a level of awareness, knowledge and
skills that facilitates cultural competence, such as experience of living in other cultures and a personal motivation to learn from and work with clients from other cultures. It could be argued that this is as valuable as being taught cultural competence on a training programme. There are many differing views between therapists, as well as within the literature, that support the argument for further research into cultural competency. I used what was essentially a quantitative method to answer the research question; however, I am sure that a mixed-method methodology incorporating quantitative and qualitative methods would provide other valuable insights into the variables involved in acquiring cultural competence and into the dynamics of the acquisition process. My findings suggest that it is possible for therapists to work in a culturally competent way with ethnic minority clients without having used CBT for a number of years; without being ethnically or racially matched to the client; without having worked with ethnic minority clients for a long time; and without having completed a comprehensive training programme. Conducting this study involved total commitment on my part, as well as the expenditure of much effort and time. That said, it has enabled me to develop my practice further, allowing me to grow as a person. The knowledge I have gained has meant that I am now able to read and interpret the methodology sections of other research with fresh eyes.
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services in Scotland in academia and the NHS. Her legacy will include establishing and leading the South of Scotland CBT course to accreditation, co-founding the Glasgow Institute for Psychological Interventions, developing the Matrix used by Scottish Health Boards to guide the most appropriate psychological therapy to patients, and her role as Clinical Psychology Advisor to the Chief Medical Officer for Scotland. Kate’s contribution to BABCP began in the 1980s when she was elected Chair of the Lothian Branch. Last year she was co-opted onto the Board, whilst this year she was elected to the role of Honorary Secretary for a threeyear term.
Jolly good Fellows At the AGM held on 24 July during the Annual Conference at the University of Birmingham, retiring BABCP President Professor Trudie Chalder announced this year’s five recipients of the Honorary Fellowship in recognition of distinguished service to the Association and the CBT community. Professor Paul Salkovskis’ contribution to the science and practice of behavioural and cognitive therapy has been outstanding. In particular his work on models of panic, phobias, health anxiety, chronic pain and OCD has provided a foundation for understanding and effectively treating these disorders. His seminal 1985 theoretical paper on the cognitive theory of OCD highlighted the role of appraisal and the particular importance of responsibility in the maintenance of that disorder. Paul developed the key concept of ‘safety-seeking behaviour’, highlighting its role in the maintenance and treatment of anxiety disorders. Paul’s extensive work encompasses health screening, medical decision-making and the concept of evidence-based patient choice. Paul’s influential work has led to the development of cognitive-
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behavioural treatment strategies and the refinement of CBT treatment formats. He was recipient of the 2006 Aaron T Beck Award for his contribution to cognitive therapy. Paul has personally contributed to the teaching and training of innumerable therapists as well as providing seemingly tireless efforts to enfranchise service users to seek and utilise better therapy. Paul has also served BABCP as longstanding editorin-chief of the journal Behavioural and Cognitive Psychotherapy. His career-long dedication to the effective understanding and treatment of anxiety disorders makes him a worthy recipient of his fellowship. Professor Kate Davidson has made a sustained and significant impact on the delivery of mental health services in Scotland where she has largely specialised in treatment for borderline and antisocial personality disorders. Kate is also recognised for the benefits her work has brought to prisoners in England. Indeed, as a consequence of her input, HM Prison Frankland operates the only accredited therapy programme in the whole of the UK prison estate. Over a distinguished career, Kate has been recognised as a leader, teacher, researcher and innovator in CBT
The contribution to the development and practice of CBT made by Dr Jim White has been as a practitioner, researcher and innovative leader of professional services in the NHS. Jim’s patient-focused approach to stress control has been rolled out across the UK and Europe in both public and private settings through group intervention. The Glasgow STEPS model has had a profoundly positive impact on those suffering mental health issues amongst disadvantaged communities in the area. STEPS became a Scottish Government Exemplar Project which led to Jim becoming Special Advisor to the Scottish Government Mental Health Division. Jim has maintained a strong focus on teaching and training in his work and has trained around 1,500 CBT therapists in stress control and the STEPS model. As a result stress control is now widely available on the NHS in the UK, as well as across Europe, Asia and the Americas. Professor David M Clark can claim to have had the greatest impact on the science and practice of CBT of any BABCP member. He developed the highly influential cognitive model of panic disorder while his original paper on the topic in Behaviour Research and Therapy received an award for being the most outstanding article published in the journal's first 30 years since it was established in 1962. With others he also developed highly effective
cognitive models and treatments for Social Anxiety Disorder, PTSD and Health Anxiety. A feature of his work is that all these models and treatments are supported not only by evidence from numerous RCTs, but also by experimental psychology research on the basic psychological mechanisms underlying the disorders.
awarded an OBE in the 2011 New Year's Honours list in recognition for services to Mental Health Care.
In 1992 David was elected Chair of the Association while, in 2000, he was voted the most influential CBT therapist by its members. This was before he played a crucial role in the development of England’s IAPT programme, which has considerably increased access to evidence-based psychological therapies. He has been the National Clinical Advisor for IAPT throughout the programme.
In the CBT world, Professor Tommy Mackay has played a central role in promoting therapy within the profession of education psychology and in developing the evidence and practice base for CBT with young people on the Autistic Spectrum. Tommy has also made significant contributions to service development; for instance, therapeutic interventions for children, young people and families in Scotland was prioritised after he defined educational psychology and its impact there.
Among many other distinguished honours, he is a Fellow of the British Academy, a Fellow of the Academy of Medical Sciences, and an Honorary Fellow of the British Psychological Society. He received a CBE in the 2013 New Year Honours for services to Mental Health. As both an academic and clinician, Professor Paul Gilbert is part of a long line of dedicated, insightful and brilliant individuals who work tirelessly to alleviate suffering. Through his career he has been involved in developing and shaping our scientific understanding of difficulties such as depression, shame and self-criticism, whilst his focus on the scientific understanding and application of compassion, as a means of addressing such debilitating experiences, has resulted in the development of the internationally respected Compassion Focused Therapy. In 2006 he founded the Compassionate Mind Foundation, a charity whose aim is to promote wellbeing through the scientific understanding and application of compassion. Paul was elected BABCP President in 2002. He has also been a member of the NICE Depression Guideline group and has been awarded distinguished honours including Fellow of the British Psychological Society, Fellow of the Royal Society of Medicine and a Foreign Affiliate of the American Psychological Society. Paul was
This year BABCP also bestowed Fellowship status on two members for the significant contribution they have individually made to the advancement of behavioural and cognitive psychotherapies.
In 1974,Tommy established the Kilmarnock Autistic Unit, the first of its kind in Scotland. In a career extending over 30 years, Tommy has always maintained a strong focus on teaching and, in 1998,
he helped set up the postgraduate autism teaching programme at the University of Strathclyde in 1998 which he still teaches on to this day. Kathryn Mannix is recognised largely for her major impact in pioneering psychological assessment and intervention for palliative care, helping patients and their families as well as palliative care practitioners. The impact of her research has been extensive; for example, her research into ‘Effectiveness of Brief Training in CBT Skills for Palliative Care Practitioners’ led to the roll-out of CBT skills for palliative care staff across NHS England between 2009 and 2012. More recently her research work has been focused on CBT for depression in palliative care for patients suffering with cancer. Kathryn has developed training and teaching on a local, regional and national level, from tutoring at the Newcastle CBT Centre to devising CBT training courses responsible for supplying trainers for five cancer networks. Her approach to training and teaching is by use of a cascade model so participants are equipped to train new trainers.
Do you have what it takes to be a BABCP Fellow? The Board is inviting self-nominations from BABCP members for the next round of Fellows. Nominees should have been a BABCP member for a minimum of five years and demonstrated the significance of their contribution to CBT across of a range of domains, such as research, teaching, provision of clinical service, or services to BABCP itself. There is a fee of £150, which is payable on application to cover processing costs, peer review and a small premium to raise funds for BABCP. In the event of an application being unsuccessful, BABCP will refund the fee less £50 for administration costs. The deadline for this next application round is 30 March 2015, with successful applicants to be announced at the AGM in July 2015. Further information on BABCP Fellowships, as well as the application form, can be found online at www.babcp.com/fellows
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Putting
ACTin context
This December will see the 2014 ACT/CBS Conference in Dublin, to be jointly hosted by the BABCP Acceptance & Commitment Therapy Special Interest Group (ACT SIG), the Irish Association for Behavioural & Cognitive Psychotherapies and the UK and Ireland Chapter of the Association for Contextual Behavioural Science. Headline speaker Professor Steven Hayes (pictured left) talks to ACT SIG member Louise McHugh about his pioneering work Louise McHugh (LMc): For those of us who didn't make it over to the ACBS Annual World Conference in Minneapolis, were there any new ideas or developments in Contextual Behavioural Science (CBS) that really struck or inspired you? Steven Hayes (SH): There are a lot of things happening. The use of Relational Frame Theory (RFT) as a ground for clinical work is increasing. The importance of evolution science to CBS is becoming more obvious. The importance of bridge building is clearer and more successful.
the wellbeing of the human community but what matters in a more proximal way is building an effective behavioural science and practice community that is dedicated to making a difference there, but is outwardlooking, flexible, relatively nonhierarchical, coherent, and supportive. That is not an easy task but we have done shockingly well so far, simply by empowering the values-based actions of researchers and practitioners, and by sharing our successes and our failures in an open way.
The disciplinary focus is expanding. I had the sense that CBS is maturing and becoming more self-confident and that it is growing in a healthy way despite the challenges of rapid expansion.
LMc: The BABCP ACT SIG has a belief and a commitment to bring ACT to our wider communities, beyond our clinics. Where would you like to see CBS being put to good use?
LMc: How might these influence your own future research and what will we be hearing about in your contribution to the Dublin conference?
SH: I agree enthusiastically with that idea. The clinic is a window in a much larger world. But it is not the only such window. I disagree with the idea that helping one at a time is a waste. Every one of us moves many when we move.
SH: My research and scholarship is moving strongly in these general directions and I will indeed to talking about them in my presentations in Dublin. I am doing an intermediate workshop and plan to explore the implications of evolution science and RFT as central themes, for example. LMc: As a leading member of the CBS community, what matters most to you about the work that you do? What drives you? SH: I long ago became convinced that science was a social enterprise and the only way to make a long-term difference was to build a community that was supportive of each other inside a coherent set of philosophical assumptions. What matters to me in the long run is
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mutually supportive. That is very rare in the history of the behavioural sciences. We can be proud of it. But we dare not rest on our laurels. There are many basic issues that we've barely touched. That means that there are very few 'untouchable' issues in CBS. Contextualism is necessary because it is a pre-analytic assumption and without it CBS is not CBS; empiricism is necessary for science and we are a science-based organisation; the basic purposes of CBS can be stated but not really challenged since they are pre-analytic as well. Everything else is on the table. I think when really good minds see that, they are drawn to the sense of freedom inside a coherent and supportive community. From there the answer to your question is clear; stay connected and supportive, but support diversity without our core commitments, and put CBS to the issues and domains people have heart for. Together we will make progress by staying true to our deep concerns and passions.
But there are many, many gateways to human suffering and human prosperity. Work, prosocial groups, churches, government, physical healthcare, schools, sports, recreation, media, families, and on and on. ACT, RFT, and CBS are inside all of these areas. We have projects or studies across that wide range. That is incredibly exciting. I think there is room for us to pursue them all, if the community is large enough. CBS follows the 'way of the turtle'. It depends on slow, careful work that spans basic and applied domains. The reason it is beginning to feel like progress is fast is because the community is large, diverse, and
Full details of the Dublin conference can be found at www.actcbsconference.com
CBT for psychosis in a high security environment Jonathon Slater is a Nurse Psychotherapist at Rampton High Secure Hospital. Here he talks about initiatives in providing CBT for Psychosis in the UK’s high security hospital estate
In accordance with national guidance, CBT for Psychosis (CBTp) is offered to patients in each of the UK’s four high secure hospitals in order to aid patient recovery and transfer to lesser secure conditions. A broad and well-established evidence base supports CBTp provision in less secure settings; however, little research has been published relating to delivery within conditions of high security. High secure patients are typically less adherent and more complex and chronic than their community counterparts. Each high secure hospital in the UK has therefore developed and evaluated site and population specific modes of CBTp delivery in response to the complex recovery needs of their patients. This has led to a rich diversity in service provision, such as Group CBTp, Individual Chief Complaint Orientated CBTp, Symptom Specific
Individual CBTp, Combined one-toone CBT for Psychosis and Personality Disorder among several others. Local service evaluation studies suggest these initiatives are having an encouraging impact on psychosis, recovery, risk and resilience. Whilst these developments may be considered innovations in themselves, however, they existed largely in isolation until recently. The UK High Secure Hospitals CBTp Collaboration Group, which I chair, was set up at the start of 2014 to data share and innovate in order to comply with NHS Commissioning Board requirements. These promote standards of equity and excellence in specialised care contexts, stipulating that patients should have equal access to consistent and effective services regardless of location. This indicates a need to
consolidate and harmonise CBTp across the UK high secure sites. Pooling its combined knowledge, experience and study results, the Collaboration Group has developed a CBTp algorithm synthesising the best of what has been developed across the sites. The Collaboration Group was fortunate enough to present the algorithm alongside the supporting evidence at this year's International Association of Forensic Mental Health Services meeting. This is one of the first collaborations of its type between the UK high secure hospitals, which has taken passion and persistence to achieve. The Collaboration Group now hopes to explore the feasibility of cross-site studies of efficacy. It has been a real privilege to work with and learn from the members of the Collaboration Group and an amazing opportunity to have presented with them at international level. We are all keen to collaborate with the aim of improving patient recovery and lowering risk.
Members of the UK High Secure Hospitals CBT for Psychosis Collaboration Group presenting at the International Association of Forensic Mental Health Services 14th meeting in June 2014 From left to right: Jonathon Slater (Rampton), James Tapp (Broadmoor), Alison Dudley (Broadmoor), Patricia Cawthorne (Carstairs) and Bob Cooper (Ashworth)
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“ ” There are often issues of ill health and loss (such as mortality and loss of role), which can bring up strong feelings in a PWP
Working with older people Raj Saraw is a PWP who offers self-help (GSH) to older adults in Sussex. Here she reveals her feelings and responses to ageing and how she manages these within her role Ageing: what does this mean to you? Does a particular person come to mind...whether this is a family member...celebrity or neighbour? What sort of feelings does this term evoke in you? Christine Padesky suggested that the ultimate efficacy of CBT is enhanced or limited by the beliefs of the therapist. When working with older adults then, it is crucial to be aware of your own ageist assumptions. It is noteworthy that the editorial in a 2004 issue of Behavioural and Cognitive Psychotherapy, highlighted that therapists ought to utilise the cognitive approach in order to challenge their stereotypical view of age. It is vital, therefore, to be mindful of our own assumptions when working with this patient group. In 2002, the Department of Health stated that a person’s age should not preclude them from psychological therapies. The proportion of the UK population aged 65 or older
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continues to rise, and the question of how best to meet the needs of this client group is highly relevant to IAPT services. Referrers often miss the signs of depression and assume that older adults' emotional difficulties are related to physical health problems. Within my service, following on from the assessment process, the aim is to be collaborative with an emphasis on the therapeutic relationship as well as empathy, warmth and compassion. CBT is active, directive and structured and this is implemented throughout sessions of GSH. Such sessions tend to be planned in advance, whether over the telephone or face-to-face, and the patient is given a contract for an overview of the sessions. The patient is discussed in supervision on a regular basis. During sessions of GSH with older adults, we spend time exploring what CBT is and the five areas model. Often an older adult’s response can be along the lines of 'well that makes
sense... that is obvious... I have to do things I have never had to do before such as paperwork and paying bills'. As a PWP, I understand that making adaptations is necessary in order to ensure the patient benefits from our sessions. It can become quite difficult to plan and define problems, due to a lack of motivation or an inability to engage in strategies which require effort. Often there is a lack of awareness and negative comparisons with 'old self', which can be explored through learning to become more self-compassionate. There are often issues of ill health and loss (such as mortality and loss of role), which can bring up strong feelings in a PWP. I find this affects the sessions of GSH especially when the patient may have relied heavily on their partner or other close friendships. On the other hand, it can also enrich the sessions as this all builds on the therapeutic alliance. As I reflect on my experience, I am able to take a step back from the feelings that were initially evoked. I can reflect on the way that I initially felt whilst with a patient, as this may have affected the therapeutic relationship. I try to break away from the idea that I am the expert with the tools to remedy the patient’s difficulties, choosing instead to set SMART goals which are reviewed during GSH. I have become aware of my own approach towards older adults. I have a great sense of respect for the older adults I work with as a PWP. I believe they have a lot of 'life experience' and I value this as part of their journey in life. Family and society within my own cultural background value older adults’ wisdom and guidance, while younger generations are expected to care for elders. This is not the same in the UK, and therefore those older adults from other cultural backgrounds can find adjustment to a new society a tough one. Older adults often feel that they are wasting NHS time and resources, and that someone worse off than them may benefit from treatment rather than themselves. When offered this view by older adults, I use this as a
www.babcp.co.uk
Spring Conference
CBT for personality disorders King’s College London 9 and 10 April 2015
basis to educate and reassure them that, at times, we need to offer a little extra support. This has the advantage that they can then learn new skills that can be valuable if faced with symptoms of anxiety or depression in the future. One particular patient that I worked with was able to access basis computer skills as one of his goals, which he found practically helpful and also led to discovering new friendships in the process.
valuable it is to notice and be aware of reflexive feelings that are all part of the therapeutic relationship.
In terms of future practice, I have adapted my approach by using an easy-tounderstand model of the five areas which provides case studies of people that may be depressed or anxious. I can only highlight, therefore, that the positives of reflective practice is, firstly, to be aware of one's own feelings, and secondly, to be able to talk and express them openly. Taking this approach has nourished my learning and development as a PWP. By using reflective practice, I can see how
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Improving support available via the internet In an ever-expanding online world, the internet is being used more and more by those seeking therapy. CBT therapist Eoin O’Shea discusses his involvement in the development and evaluation of structured online support groups for depression and anxiety For the past two decades, the emergence and rapid expansion in use of the internet has quickly presented clinicians and researchers with ample opportunities both to develop and evaluate various methods of online mental health support. Interventions and online formats vary considerably. Commonly cited strengths of online interaction include accessibility and convenience, cost effectiveness, factors such as disinhibition when interacting online, as well as simple personal preference. Accompanying challenges include ensuring safety and an oft-cited tendency for higher drop-out rates in some studies when compared with face-to-face support. It could be argued that much of the promising evidence concerning online therapy and self-directed programmes has been accrued through the use of CBT for various disorders. Perhaps this makes sense given that the relatively structured and active features of the approach may lend themselves more to delivery online, whether or not a therapist is directly involved. Some interesting findings by researchers at Macquarie University in Australia, for instance, concern the circumstances under which CBT programmes may be successful. The team, led by Professor Nick Titov, found not only that CBT delivered online holds up well against face-toface sessions in terms of effectiveness, but also that even a relatively untrained ‘technician’ guiding and supporting the user’s therapy appears to yield results similar to those of the fully-trained CBT therapist.
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As someone who is both a CBT therapist and also working at an online mental health organisation, I am keen to contribute to the further development of cost-effective, efficacious and easily accessible CBT for a range of disorders. Indeed, I have begun part-time doctoral studies through a London university whose aim is to develop, deliver, and evaluate two 10-week programmes of structured online support groups or ‘S-OSGs’; one for depression and the other for generalised anxiety disorder (GAD). Both group programmes will broadly consist of two components. The first of these consists of weekly – but entirely automated – eLearning modules which focus on psychoeducation regarding either disorder. With between 10 to 17 slides per module, each week’s material has to be read and a multiple choice quiz passed in order to progress to the next module. Each module and accompanying quiz are intended to educate participants concerning key features of either depression or GAD. In addition to the weekly modules, which users can complete in their own time, they will also be encouraged to attend weekly SOSGs. Rather than constituting an experiential, process, or interpersonally focused intervention, the S-OSGs are structured much like a standard CBT session with initial mood check, feedback from the previous group, discussion of assigned homework, introduction of a new topic or theme, shared examples from members, setting of next week’s
homework and closing with brief feedback. The focus is placed more on consideration of, and support in applying, module content rather than extended discussion of specific users’ life circumstances. The basic rationale guiding the programme is two-fold. Firstly, we may be able to make the best use of self-paced psychoeducation by automatising this component of CBT delivery, thereby reducing therapist time and cost involved. That said, we may concurrently be able to address the somewhat high general drop-out in some online therapy studies, as well as help users to apply material in the very personal formulation concerning their own lives by providing a more ‘human’ contact and opportunity for inquiry through the weekly groups. An attempt to optimise safety will be sought through an initial screening for exclusion criteria such as suicidality, ongoing self-harm and comorbid drug or alcohol dependence. Information such as contact details of both the user and their primary healthcare provider will be required before participation can proceed. Those scoring in the ‘severe’ range on measures of either disorder will be excluded, but offered information and support in accessing more appropriate services. It is hoped that both programmes – if both effective and acceptable for users – may then be rolled out on a larger scale. We may also develop similar combined programmes for various other disorders as well as skills-based programmes for managing emotions for self-harm.
The women’s room almost four million devoted listeners, 44 per cent of whom are men. Attending a live radio recording is pretty thrilling and to be in close proximity to the show’s formidable hosts - Jenni Murray, who has been at the helm since 1987, ably assisted by Jane Garvey who joined the programme in 2007 - guaranteed a palpable sense of reverence and excitement in the audience.
Changing the game Continuing our series of articles on women, feminism and mental health, Associate Editor Patricia Murphy meets four female 'game changers' who have made a significant contribution both within BABCP and the wider CBT community
In 2013, Radio 4’s Woman’s Hour launched its annual Power List of the 100 most powerful women in the country. The list highlighted the achievements of women working in a broad range of sectors, from politics and law to the arts and science. But the list also revealed some significant gaps, notably the lack of ethnic diversity amongst women in positions of the greatest power, with no-one from a minority ethnic background making it into the top 20. This year the spotlight was refocused specifically on women who were changing the way power operates in society. This produced a more ethnically diverse list, ranging from high-profile whistleblowers to grassroots social media campaigners, and was judged by an equally diverse panel of women, all of whom had made their mark in their own right. The Woman’s Hour Power List 2014 Game Changers were announced in a live broadcast from the BBC’s Radio Theatre in April this year, with tickets unsurprisingly sold out. Woman’s Hour has been broadcasting since 1946 and regularly attracts
When Doreen Lawrence was announced as the number one Game Changer, the audience erupted. By the time she had walked onto the stage, there was an outpouring of heartfelt emotion and some tears shed, not least by Murray herself. Doreen spoke movingly and graciously about her journey which was ignited by the most terrible of personal tragedies, the racist murder of her son, Stephen. This theme of personal trauma was repeated in the profiles of many of the women on the list; women who had been living relatively quiet lives but, in reaction to adverse events, found themselves compelled to embrace social activism and campaigning. Successfully challenging some of the nation’s most powerful institutions as Doreen Lawrence has done is not for the fainthearted and it was clear that the personal cost to her had been enormous. When she told the audience, for example, about an aversion to public transport and acute discomfort with the public gaze, one got a sense not of a life chosen but a life bent out of shape by tragedy. For all the achievements and accolades garnered this is a woman who would give it all away to have Stephen alive. Similarly, Julie Bailey, campaigner and founder of Cure the NHS, who exposed the failings at Stafford Hospital following the death of her mother Bella in 2007, endured the negative consequences of whistleblowing, including online abuse which forced her to sell up both her business and home because of threats to her personal safety. Despite the clear dangers sometimes associated with shifting the balance of power, the audience were encouraged to think of themselves as Continued overleaf
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having the potential to be game changers in their own lives and communities. As therapists, we understand the potential that therapy has to transform the lives of our clients. It is apt, then, as part of The women's room series, to reflect on the significant contributions made by some of the highly distinguished women in both our Association and professional community who have not only advanced our understanding of psychological distress, but also pioneered the development of clinically effective treatments. This, then, is an up close and personal sample of just some of the many women in the world of CBT who have raised the bar. ROZ SHAFRAN Roz Shafran is Professor of Translational Psychology at the Institute of Child Health, University College London. She is co-founder of the Charlie Waller Institute of Evidence-Based Psychological Treatment and is a former Wellcome Trust Career Development Fellow at the University of Oxford. Her clinical research interests include cognitive behavioural theories and treatments for eating disorders, OCD and perfectionism across the age range. More recently, Professor Shafran’s work has addressed the dissemination and implementation of evidence-based psychological therapies, and the interface between physical and mental health. She has provided training workshops in her areas of clinical expertise and has over 100 publications. She received an award for Distinguished Contributions to Professional Psychology from the British Psychological Society as well as the Marsh Award for Mental Health work. Until recently, she served as co-chair of BABCP’s Scientific Committee. Patricia Murphy (PM): Is this the work you imagined you would do as a young woman? Roz Shafran (RS): I always thought I would work with children but it just never happened. My career took me in different directions for about 20 years, but I am very pleased that I am now working with the population that I 14
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have always wanted to work with. However, I have always managed to do a little bit. For example, my very first job was as a volunteer, looking for some work experience at Great Ormond Street when I was 18 years old.This has led to a life-long association with Great Ormond Street. In fact I gave my Inaugural Lecture in February and, whilst preparing, found a report from a careers adviser when I was 15 which very accurately described me as someone who should work with people and who would want to be an expert in their field. She absolutely got me! PM: When did you become aware of human suffering? RS: When I was 13, a friend of mine developed anorexia nervosa. I remember writing an essay about it which won a Young Telegraph Writers merit award. I am a very emotional person as is my dad, and so I would say that I am probably more aware of emotion than suffering. PM: Have you always wanted to do good? RS: Yes. My dad worked in finance and he was a regular reader of the Financial Times, and I promised myself from a very early age that I would never read it. I have never been interested in that side of things. My life had to have meaning. Some women give up work when they have children but that just was not an option for me. That is not to say that motherhood is not very important to me. But, my work gives my life a deeper meaning and, although combining motherhood with a career can be a struggle at times, overall I have very few regrets. PM: What three things have contributed to your success? RS: You know, I do not feel successful. I think it is relative so I would say I am probably more successful than some and less than others. I guess I could have done more if I had given up some things along the way. I mean I
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am okay! I have been very, very lucky particularly with mentors and colleagues. Also, I love what I do; I am passionate about it and I work very hard. I am a grafter. PM: When things get tough, how do you keep yourself going? RS: That is a really good question. I cry first! I try to remind myself of what is important. You know, to be truthful, going through the corridors of Great Ormond Street and seeing what these sick children have to cope with is a great leveller, and reminds me that whatever I am facing is trivial and puts things in perspective. I hope it goes away but I also try to problem solve. PM: What are you most proud of? RS: I think I am most proud of the fact that I have tried to maintain my professional integrity and aspired to always treat others with decency and respect. PM: Which women have inspired or influenced you, and why? RS: Zafra Cooper, Principal Investigator at the Department of Psychiatry in Oxford, immediately springs to mind as someone I hugely respect. She is able to combine intelligence with kindness plus balance in life; all the things I really respect. Emily Holmes is a peer whom I greatly admire. She has balls and a strategic mind! I would also have to include Lady Rachel Waller and the inspirational way in which she responded to the tragic loss of her son from suicide aged 28. I should also mention Rachel BryantWaugh, Consultant Clinical Psychologist at Great Ormond Street who was running up and down a corridor when she gave me my first job! Isobel Heyman, Consultant Child and Adolescent Psychiatrist also at Great Ormond Street is another. I am probably forgetting people because there are so many women I could mention, including my first lab partner Maria. We worked together in Continued on page 16
A report from a careers adviser when I was 15 described me as someone who should work with people and would want to be an expert in their field. She absolutely got me!
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www.babcpconference.com
BABCP Annual Conference and Workshops University of Warwick 21 - 24 July 2015
The Scientific Committee invites submissions of Pre-Conference Workshops, Symposia, Clinical Roundtables, Panel Discussions, Skills Classes, Open Papers and Posters Deadline for Workshops, Symposia and Skills Classes: 12 January 2015 Deadline for Open Papers and Posters: 27 February 2015
For more information please visit www.babcpconference.com
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Vancouver and she helped to change my view of team working in a very positive way. PM: Is there a book that helped inform and shape your thinking? RS: It would have to be Rachmann and Hodgson’s Obsessions & Compulsions. That is the one! PM: What do you see as the major challenges women currently face in terms of protecting their emotional wellbeing? RS: I think the major challenges that women currently face in this field are similar to those that men face becoming over-involved with clients’ distress, becoming ‘burnt out’, and trying to deliver high quality evidence-based interventions in an era of cost-cutting. PM: What piece of advice would you like to pass on to the next generation of CBT therapists? RS: To understand the psychopathology with which you are dealing and the principles as well as the practice of CBT, so that it can be delivered both with fidelity but also with flexibility and fun! MELANIE FENNELL Dr Fennell is a pioneer of cognitive therapy for depression in the UK, and a founder member of the Oxford Cognitive Therapy Centre. As research clinician in the Psychiatry department of Oxford University, she contributed to the development and evaluation of cognitive models and treatment protocols for depression and anxiety disorders. She developed and directed the highly successful Oxford Diploma in Cognitive Therapy, the Oxford Diploma/MSc in Advanced Cognitive Therapy Studies (a world first, dedicated to training CBT disseminators), and MSt in Mindfulness-Based Cognitive Therapy. She has published widely and has extensive experience of teaching and training both CBT and MBCT. She has a particular interest in cognitive therapy for depression and low selfesteem. In July 2002, she was voted ‘Most Influential Female UK Cognitive Therapist’ by the members of BABCP, and, in 2013, was awarded an Honorary
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What attracted me [to clinical psychology] was the idea of combining the intellectual stimulation of theory and research with the human contact of clinical work Fellowship of the Association.
Patricia Murphy (PM): Is the work you do now the work you dreamed of as a young woman? Melanie Fennell (MF): Not at all. In my last years at school, I studied English Literature, French and Latin. At university I did my first degree in English, and anticipated finding some fascinating and glamorous job in publishing. I wished neither to teach nor to conduct research, which seemed like the most common options following such a degree – which is ironic, given that (alongside therapy) those have been my main activities and pleasures since the early 1980’s. The glamorous publishing job did not turn out, so I went into the Civil Service. Good solid broad management training, which I thought would come in handy no matter where I ended up, but I spent most of my time looking at my watch to see if it was time to go home yet. Then, purely by chance, I met up with an old school friend who had become a clinical psychologist. I thought, that sounds interesting, I’ll have a go at that. What attracted me was the idea of combining the intellectual stimulation of theory and research with the human contact of clinical work. And I have not looked at my watch to see if it is time to go home yet since. PM: When did you first become aware of human suffering? MF: From childhood. My father was a prisoner of the Japanese for four years. He then lost my mother who died when I was born. PM: Have you always wanted to do good? MF: That is not how I thought about it. I was brought up to believe in the ideal of service to others, and my father’s work as a Church of England vicar in a small country parish exemplified just that. The school I went to encouraged the same values. I think the message was that my life was very fortunate, and that it was right to give something back. I still
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fundamentally believe that. I have been amazingly blessed to find such rewarding work, in a place of excellence, and with so many people I both like and respect. If, along the way, it has been possible to help some people, then I cannot really ask for more. PM: What drew you to your particular areas of interest?
MF: In terms of CBT, my clinical training at Birmingham University was in Skinner’s radical behaviourism. Anything cognitive was pretty revolutionary, and indeed often regarded as irrelevant. When I moved into my first clinical job in south London, I duly applied what I had learned. But, as time went on, I became increasingly frustrated. The behavioural approach was pretty good with anxiety, but at that time pretty hopeless with depression. Then I saw an advertisement for a research clinician’s job in Oxford, with John Teasdale. The project was one of the first clinical trials of cognitive therapy for depression in the UK. We had intensive training from people at the Center for Cognitive Therapy in Philadelphia, including Jeff Young. So getting interested in depression followed from developing skills in understanding and treating it, I think, and seeing how helpful CBT could be to people who appeared completely stuck. My interest in selfesteem grew out of that work, and the next project I was involved with – a clinical trial of cognitive therapy for generalised anxiety disorder with Gillian Butler. I became aware that there were people who were not simply either anxious or depressed, but a mix of both, and difficult to say which came first or was the most important. Could there be a common root? As to my interest in training, being there at the very beginning of CBT in the UK was a real stroke of luck. Everybody wanted to know how to do cognitive therapy for depression. The other stroke of luck was that John Teasdale was not at all
The women’s room interested in training, so I got lots of opportunities to pass on what I had learned to other people - thanks above all to BABCP for that. I discovered that I loved training, it was great to see people enthusiastically learning, and fun to create interactive sessions that got people engaged and active. Best of all, as Seneca said, ‘When people teach, they learn.’ So thanks also to all the participants and trainees I have been lucky enough to work with, here and abroad, who have kept me learning and interested and intrigued with all their searching questions. PM: What three things have contributed to your success? MF: Curiosity, liking people and being in the right place - Oxford - at the right time. PM: When things get tough, how do you keep yourself going? MF: Good genes - both my parents had robust, humorous temperaments. My upbringing, which taught me to be strong and independent. Laughing with people I love, good food and good wine. Meditation. And denial and distraction - I am a great believer in both. PM: What are you most proud of in your career? MF: Having made a difference in people’s lives, through therapy, through training and through writing. PM: Which women have inspired or influenced you, and why? MF: Joan Kirk, head of the Department of Clinical Psychology at Warneford Hospital, whose warm, intelligent, facilitative management style gave me the opportunity to extend my training skills, and to develop the Oxford Diploma in Cognitive Therapy and then the Diploma/MSt in Advanced Cognitive Therapy Studies. I remain enduringly grateful to her. Gillian Butler, for helping me to see the importance of remembering that even the most distressed and damaged people have resources to build on. Christine Padesky for being an innovator and an absolutely wonderful trainer. PM: Is there a book that helped inform and shape your thinking? MF: The book from which everything I
have done since has flowed is Beck, Shaw and Emery’s Cognitive Therapy of Depression. It saddens me that few people read this seminal text, because it is full of insight and practical wisdom and, aside from the rather sexist language, remains as relevant now as it did when it was published.
developed her practice of individual and group-based Compassion Focused Therapy. She went on be a founding member and chair of the Compassionate Mind Foundation. She is also a trainer in the CFT approach and, in 2012, wrote The Compassionate Mind Guide to Building Self-Confidence.
PM: What do you see as the major challenges women currently face in terms of protecting their emotional wellbeing?
Dr Welford moved to Cornwall two years ago where she was commissioned to provide mental health provision within the Government’s Troubled Families initiative. She also heads up a Compassion in Education initiative, is developing workshops in Compassion for Therapists and works with a number of athletes using compassion to improve their lives and performance.
MF: The same as always.‘Postfeminism’ is a myth. Especially if you look outside the Western democracies. PM: What piece of advice would you like to pass on to the next generation of CBT therapists? MF: The great thing about CBT is that it is an ever-expanding field. We never reach the horizon, there is always more to discover, more questions to ask, more puzzles to solve. Isn’t that great? Remember that the theory behind CBT is about how human minds work, not about how diagnostic categories work. Human beings are more diverse, more complex and more fascinating than that. And remember you are a human being too, and all this applies just as much to you. Finally, we are fantastically privileged to do the work we do - enjoy it! MARY WELFORD
Patricia Murphy (PM): Is the work you do now the work you dreamed of as a young woman? Mary Welford (MW): In preparation for my clinical psychology interview, I recall a qualified member of staff saying,‘Whatever you do, if you are asked why you want to do the training, don’t say you want to help people’. I remember being puzzled by this and maybe too ashamed to ask why they thought this was such a negative thing to say. In my interview, I mentioned wanting to conduct research, study CBT and contribute to the literature, yet my true motivation was indeed to help individuals and also prevent distress.
Dr Welford qualified as a Clinical Psychologist in 1999 from Manchester University. Whilst training she became an active member of the North West BABCP Branch. Mary subsequently went on to hold posts as an ordinary member of the National Committee, BABCP Magazine Editor and Scientific Committee member for the Manchester EABCT Conference. Recognising the need for greater support for Branches, she successfully proposed the setting up of a Branch Liaison Committee.
Alongside this, I suppose I did dream of working with like-minded people and my work being valued by others, whatever my job. I did not dream about writing or being so involved in training others, but I am really grateful that I have been given such amazing opportunities to do so. Maybe because many of the things I do were beyond my aspirations, this accounts for why I am so happy in my work and regularly have to pinch myself.
Clinically, Dr Welford went on to work under the supervision of Adrian Wells and Tony Morrison on a number of CBT research trials and, in a split post, also developed her clinical skills within Community Mental Health Teams. It was here that Mary
MW: I recall my own suffering before I ever had a sense of other people’s. For a number of reasons, I had times in my childhood when I had a profound
PM: When did you first become aware of human suffering?
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sense of being an outsider and, as a consequence, would strive to fit in. I was unhappy at times, would often worry and lacked self-acceptance and true self-confidence. Of course, at other times, I was blissfully happy and content. It was only as a teenager that I began to look around me and realise that other people in my immediate environment struggled, and suffered too. In many ways, this helped. I felt more similar to other people and began to open up to them. But, as I looked beyond my own struggles, I found the pervasive nature of some people’s difficulties more distressing. Whether it was the images on TV of the famine in Ethiopia, the girl who came to school smelling of urine or the boy who was shamed by a certain teacher and cried uncontrollably in front of his class. I recall feeling despair that things were just not fair for some people and, as an adult, felt a deep-seated motivation to address this as and when I could. PM: What drew you to your particular areas of interest? MW: Whilst in Manchester, I was inspired by the work of Adrian Wells,who supervised me for a number of years. I found his metacognitive approach, emphasising the way people relate to and interpret the thoughts and images that occupy their minds, of great assistance to those I worked with. In equal measure, I was inspired by Tony Morrison’s work with individuals experiencing psychosis. His CBT framework and his emphasis on harnessing meaningful service user involvement is a great model for all services to aspire to. His service was an amazing one to work in. However, whilst some individuals benefited greatly from applying such approaches to their lives, I witnessed that others seemed to be ‘left cold’ by the approaches. It was then that I turned to the work of Paul Gilbert to explain the blocks many people experienced and provide a framework for addressing these. It is the application of this approach to my life that has resulted in great changes for me personally. It is also
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the continued application of this approach to my life that allows me to continue to approach and engage with the suffering of others. PM: What three things have contributed to your success? MW: My dad was a police officer in the days when the local bobby was known to almost everyone in the community within which they worked. He spoke about the diversity of his work life. One day he would be dealing with an individual who had broken into a car, whilst the next he was dealing with the driver of a Jaguar car who had broken down at the side of the road. He advised me to treat everyone with the same respect and interest - we are all so much more similar than we are different. This gave me confidence to approach others, no matter what their position, and speak to them as a human being first and foremost. As such I tended not to be intimidated by others, and the ability to initiate and have conversations with others opened doors for me. My mum has amazing compassion for others. She is at her strongest when she is ‘there’ for other people and shows incredible courage, strength and sensitivity. I am sure that her compassion has had a great positive influence on me. Not only showing me the importance of such qualities and modelling them but, most importantly, being my ‘safe base’ to whom I can turn throughout my life. Finally, I have been very lucky to have met individuals within my career, many of whom have become friends, who have inspired and encouraged me. Surrounded by a network of amazing people, I am able to be open about the things I find difficult and empowered to voice my own thoughts and reflections regarding my work. All of this means I am forever learning, which I love. PM: When things get tough, how do you keep yourself going? MW: Thankfully I can turn to colleagues, family and friends. These
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days I also choose self-compassion rather than hostile self-criticism. In doing this I recognise that things are difficult, rather than undermining myself, and look towards the future instead of ridiculing myself about the past. I have a number of other ‘props’ to help me. For example, I have a necklace that says ‘my life, my rules’ that I wear when I feel I need the courage to stick to my principles or ethics. I write to myself, sometimes letters, sometimes single words on my hands. I listen to specific pieces of music or go and look at a vista in order to help me gain a sense of greater perspective on things. PM: What are you most proud of in your career? MW: When I look back, I feel most proud about specific pieces of work I have done with certain individuals who have been on their own with their distress. Being able to create an environment in which someone is able to connect with the pain of their difficulties or experiences is incredibly powerful. I feel moved when I think about those sessions, privileged but I suppose proud too. PM: Which women have inspired or influenced you, and why? MW: I suppose my greatest female influences come in the form of friends and family. I have mentioned my mum previously, but my sister is an incredibly strong women who holds and maintains values that I admire. She is a passionate primary school teacher, the kind of class and maths teacher I wished I had. I also have a lot of female friends within the profession and their ongoing support is vital to me. PM: Is there a book that helped inform and shape your thinking? MW: There are a lot of academic books that have helped shape my thinking. But, the book that has had the most profound effect on me is Harper Lee’s To Kill a Mockingbird. The novel revolves around very serious
I recall feeling despair that things were just not fair for some people and, as an adult, felt a deep-seated motivation to address this as and when I could
The women’s room issues of inequality, yet is gently written and strikingly warm and humorous. It makes me reflect that maybe this is a good recipe for effective therapy. PM: What are the attitudes that help to keep you balanced? MW: A number of mottos were frequently used in my childhood family home. The top four were: - There but for the grace of God go I - Remember what matters - Don’t be a sheep - To thine own self be true Of course, such statements remain relatively meaningless unless they are associated with certain attitudes, emotional tone and guided behaviour. Another further perspective that helps me is my belief that we are all part of the flow of life. To me this means we are all connected. It ensures that I neither feel isolated, or get above my station. PM: What do you see as the major challenges women currently face in terms of protecting their emotional wellbeing? MW: The fast pace of life and competing roles and responsibilities mean that we all have the capacity to overlook our emotional wellbeing. In the past this was maybe truer for women who often had specific roles in the family. I now see less gender specific expectations and many males also struggle for balance too. I am also struck by so many marketing campaigns, articles and programmes that place increasing pressure on us all to have a ‘perfect life’, ‘perfect house’ and ‘perfect body’. They indicate that this is the key to happiness. In actual fact, they can make us feel inadequate or ashamed. All of this has an impact on our emotional wellbeing. PM: What piece of advice would you like to pass on to the next generation of CBT therapists? MW: Learn about and develop a lifelong compassionate practice and infuse your personal and professional life with such qualities. This will help you to recognise what you are good at and also warmly recognise the things you need to work on. Turn to others for support.
Realise that you are part of a family of individuals who are working to change lives for the better and everyone’s contribution is vital. DEBORAH LEE Dr Lee is a Consultant Clinical Psychologist, Head of Berkshire Traumatic Stress Service and South Central Veterans Service. She is also an honorary Senior Lecturer at University College London. She is a board member of the Compassionate Mind Foundation and author of The CompassionateMind Guide to Recovering from Trauma and PTSD: Using Compassion-Focused Therapy to Overcome Flashbacks, Shame, Guilt, and Fear. Dr Lee has worked in the field of trauma for 20 years and specialises in the treatment of PTSD and complex trauma. Her particular area of clinical and research interest is in shame-based PTSD and self-criticism. She has developed the use of compassion-based treatments including the use of compassionate imagery in shame-based flashbacks to enhance clinical practice in this field. She has pioneered the use of developing compassionate resilience as part of a phased-based treatment approach to complex PTSD. She has widely contributed to the dissemination of her clinical knowledge through writing and delivering clinical workshops and talks in North America and Europe. Patricia Murphy (PM): Is the work you do now the work you dreamed of as a young woman? Deborah Lee (DL): I cannot quite remember what I wanted to do with my life as a young woman, but I am pretty sure I never thought I would end up being a clinical psychologist and helping people who have suffered so profoundly at the hands of others. I think, if I am honest, I had absolutely no idea I even wanted to be a psychologist and probably dreamed of being an actor. I certainly never thought I would teach and give whole-day workshops, as I used to be terrified of public speaking. I even recall missing double English at school because the teacher used to make us read out loud and I could not stand that, as it made me so nervous. As for writing books, now that did cross my mind, but I think a
lot of us fantasise about writing a book. What I did not contemplate about when I was younger was that I would write about compassion, trauma and shame. I had more of a blockbuster in mind. PM: When did you first become aware of human suffering? DL: When I first started to work with people who have PTSD and have been on the receiving end of the worst aspects of human behaviour. I went straight into my clinical training after completing my undergraduate degree in Psychology and I was young and naïve. When I qualified, I worked as a child psychologist for a couple of years before taking a research psychologist post in a PTSD trial. I have really grown into my career as I have got older, and experienced life and suffering. But it was working with traumatised people that touched me profoundly, and I was deeply moved by people, who through no fault of their own, had suffered at the hands of others. I remember the first talk I gave which I titled,‘There but for the grace of God go I’. I realised, very clearly, that it was randomness that placed my patient in one chair and me in the other. PM: Have you always wanted to do good? DL: I certainly have never contemplated a life where I do harm to others or do not serve humanity in some way. Instinctively, I have always been motivated to work for the collective greater good. I remember that, when I was younger, I wanted a life that made a difference to others. But I never quite realised what type of humanitarian work I would become involved in. PM: What drew you to your particular areas of interest? DL: It is interesting for me to think about what drew me to work with shame and compassion. Since my training, I was interested in working with PTSD and trauma and I have been very motivated to work with women who have suffered violence and sexual violence. I really felt the sense of injustice, that the women I worked with loathed themselves because they had been abused by others. I wanted to do what I could to help these Continued overleaf
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The women’s room amazing too, hugely creative, inspiring and capable of great things.
women learn to like and accept themselves again, or even for the first time, and to help give them an opportunity to live a life that allowed them to flourish. So it is probably no surprise that I met Paul Gilbert and became interested in developing compassion-focused ways of working. It takes such courage to disclose memories of abuse, it takes such courage to disclose that you loathe yourself, and it takes such courage to develop self-compassion.Yet, every day I see the benefits for my clients when they live in their minds with care and kindness for themselves.
DL: I think I am most proud of my selfhelp book about compassion and trauma. I still cannot believe I wrote it, but so much more than that I am so touched when someone from the general public writes to me and says the book has helped them. For me, it is such an honour to have been able to make a difference to someone’s life and I do not think I will ever take that for granted.
PM: What three things have contributed to your success?
PM: Which women have inspired or influenced you, and why?
DL: Now that really is a tricky question and my very first thought is passion. I am passionate about my work and I love my job. I really do feel so fortunate to have my job and every day I enjoy going to work. I think, if you are passionate about things, it naturally motivates you to achieve and succeed. But I also work hard and I am not good at being told,‘that won’t work, we can’t do that or I am sorry this is the way it has to be’. For some reason, I always believe we can do that, this will work and there is always another way.
DL: One is Dr Helen Kennerley. I first saw her present a BABCP workshop in 1993 and I just thought she was amazing. She was clever, glamorous and her work with survivors of CSA was inspiring, motivating and clear. She has always been a heroine of mine as her contribution to the field of CSA and complex trauma is outstanding and has hugely helped me in my clinical practice. I finally got the privilege to work with her in OCTC for a few years and we became friends. To work alongside Helen was a career highlight for me. The other woman who stands out in my mind as inspirational is Dr Mary Welford, my friend and colleague from the world of compassion. Mary lives and breathes compassion as demonstrated in her clinical practice and her life. She has shown me such compassion and friendship when I have needed it in my own life. She influences my clinical work and my personal life in such a good and positive way.
PM: When things get tough, how do you keep yourself going? DL: I find this a difficult question to answer because I do not really know the answer. I just keep going as I do not want to let people down, I have a strong sense of duty and the good fortune to be able to call on friends when in need. My best friend Mhairi is a clinical psychologist too, and so talking to her is so helpful and reassuring to me. She is a huge influence in my life. I remind myself I am doing what I can to be the best I can be and I accept that, at times, I am not firing on all four cylinders because other things are going on in my life. But I also use my dear friends, family and professional colleagues when I need support, reassurance and advice. When you work in trauma, it is important to make sure you remember that human beings are
PM: What are you most proud of in your work?
PM: What are the attitudes that help to keep you balanced? DL: Well, I am a firm believer in evolution. Everyone is equal, no-one is better than another, and that people can change their lives. Life is
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random, no-one is special or better, we are all doing what we can to survive the challenges of life, and we all suffer. So we have more in common that we have difference. PM: What do you see as the major challenges women currently face in terms of protecting their emotional wellbeing? DL: This is an interesting, challenging and worrying age for women. I spoke to my teenage girls and their friends this weekend about this question, and they unanimously answered, ‘Social media is the biggest ruin of our contentment’. They said the biggest threat to their emotional wellbeing is Facebook, Instagram, Twitter and being taken advantage of on the internet. I know what they mean because we live in such socially comparative times when the focus is on looks, popularity and many female role models are fame addicts. It would seem that the number of ‘likes’ can make or break your mental health for the day. Yet, the daily stresses of juggling a passion for a vocational career, family and everyday life do not go away as opportunities increase for women to have it all. PM: What piece of advice would you like to pass on to the next generation of CBT therapists? DL: You have a tough and demanding job so be proud of what you do – you make a difference to so many people’s lives. Empathy, warmth and care are so important in our work, so we must not forget that we are in a very privileged position to know the mind of another and to see their pain - so treat it with care and always act from a place of kindness. The NHS is facing tough times, and we all feel squeezed and pressurised. It feels like everyone wants something for nothing. But, even if you can only offer a drop in the ocean, that drop creates a ripple of change and that makes a difference to someone.
For more information on the Woman’s Hour Power List, visit www.bbc.co.uk/womans-hour-power-list 20
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You have a tough and demanding job so be proud of what you do - you make a difference to so many people’s lives
Perinatal CBT Perinatal depression and anxiety are frequently experienced following childbirth, with short and long term adverse consequences for both mother and infant. Leeds-based Senior Infant Mental Health Practitioner and Cognitive Behavioural Therapist Claire Wild talks about the use of CBT in these circumstances Although there is substantial evidence supporting CBT in the treatment of perinatal depression and anxiety, less emphasis has been given to the impact of maternal mood disorders upon the infant. The Leeds Infant Mental Health Service in which I work sits within CAMHS, and focuses upon strengthening relationships between parents, usually the mother and her baby. The team encompasses a diverse mix of skills and modalities, including specialist health visiting, clinical psychology, psychotherapy, cognitive analytical therapy and CBT. Therapeutic support is offered any time in pregnancy up until an infant's second birthday. CBT is combined with parent-infant psychotherapy, which holds both mothers and infants in mind. The new mother cannot be treated in isolation; indeed her relationship with her infant is often integral to her recovery. Growing evidence demonstrates the negative consequences of depressed or highly anxious parenting upon the infant’s developing mind and sense of
self. Depressed or anxious parents are more likely to present in either flat or highly aroused emotional states. These result in reducing a parent’s ability to manage or tolerate their infant's emotional state, or to read their baby's cues. Even if a depressed or anxious parent can meet their baby's physical needs, the infant may still be at risk if their emotional needs are not being met. CBT with parents and their infants draws upon attachment, psychoanalytical and systematic theory to inform treatment for both mother and baby. Third wave CBT approaches, which focus upon mindfulness and compassion, are frequently utilised in this work. Assessment considers parental emotional history, childhood experiences, relationships, obstetric history and the mother's thoughts and feelings about her baby. Crucially, close observations of both mother and baby's behaviour and interaction is assessed. Even the newest of babies can tell us a lot about the current presentation.
Including the baby in the formulation of the mother’s experience of depression or anxiety is vital. The CBT therapist works with the mother to identify unhelpful feedback loops between mother and baby by exploring how the mother’s emotional state impacts upon the baby and in turn how the baby’s emotional state impacts upon the mother; the mother’s thoughts and beliefs about her baby; how the mother’s behaviour affect her baby and in turn the baby’s behaviour affect the mother. We are helping the mother to face the reality that the baby’s experience is not a benign or passive one. Indeed these first two years of life are critical for baby. The CBT therapist must neither overlook the baby nor the fact that, although the mother’s mood may improve, the relationship with their baby may not improve in parallel. Equal focus and attention needs to be given to the baby and the mother-infant relationship. Blending CBT and parent-child psychotherapy has the potential to be an effective therapy for both mother and baby.
Advertisements Therapy space available at Brackenbury Natural Health Clinic in Hammersmith, West London. Light, quiet, comfortable rooms, excellent reception service. Please contact Stelyana Spassova on 020 8741 9264 or info@brackenburyclinic.com
Using EMDR with Veteran and Military Clients – 3rd Dec 2014, London. Matthew Wesson, a veteran of 21 years military service, EMDR consultant & CBT therapist leads this workshop. It will cover relevant research, clinical obstacles, therapy techniques, interactive exercises & video material. It can count towards BABCP and EMDRUK CPD hours. Just £99. Contact: admin@stressandtrauma.co.uk
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DVD review
Rational Emotive Behaviour Therapy with Dr Debbie Joffe Ellis In this two-hour DVD, produced mainly for psychologists, therapists and students of psychology and counselling, Dr Joffe Ellis gives a live and powerful clinical demonstration of REBT in action and explains in depth the principles of REBT to a group of student observers and two of their professors. Many of us will recall the video footage of Dr Albert Ellis treating Gloria. Ellis’ wife, Dr Debbie Joffe Ellis, to whom he entrusted his REBT legacy, continues his excellent work some 49 years later. The DVD begins with Dr Joffe Ellis hosting a discussion about REBT and answering questions from professors and students. This pioneering cognitive therapy, which heralded in a revolution in psychology, empowers the person to change their attitude about themselves, others and the world. Dr Joffe Ellis explains to us that, if a
client is committed to work on making healthy changes, then REBT can help enormously. With empathy, rapport and persistence, the REBT practitioner displays unconditional acceptance of the client and teaches the client unconditional self-acceptance. The practitioner then distinguishes the activating event from the troubling emotion whilst clarifying and disputing the irrational, unhealthy shoulds, oughts and musts that create anxiety anger and depression, as opposed to preferences that create the healthy negative emotions, in response to an undesired event, of sadness, annoyance and concern. A live, vibrant therapy session is shown with Dr Joffe Ellis identifying the client Eileen’s therapeutic goals following an extremely upsetting divorce situation. She zeroes in on the unhealthy negative thinking and awfulness the client believes, which became habitual
following from a rigid upbringing and kept active now with a shoulding on self and being over-responsible, harshly self critical and procrastinating. Dr Joffe Ellis skilfully and expertly provides insight and shows and empowers Eileen towards a more effective way of thinking, and therefore with the client feeling a lot calmer within a 45-minute period. An evaluation and summary takes place afterwards in discussion with the students and professors giving further understanding about the use of REBT and its effectiveness in helping a person not only to feel better, but get better long term. Robin Thorburn The DVD is part of the Systems of Psychotherapy series from the American Psychological Association
Call for papers: the Cognitive Behaviour Therapist (tCBT)
Special issue: ‘Supporting & developing CBT supervisors’ We are delighted to inform you that there will be a 2015 special issue of the Cognitive Behaviour Therapist (tCBT) dedicated to the issue of clinical supervision. The guest editors for this edition will be Derek Milne and Robert Reiser, who will be considering submissions, supported by the regular tCBT referees. The angle that we want to take in this special issue is timely, and concerns the infrastructure that should be in place to support and guide CBT supervisors. Amongst other things, this includes:
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Educational needs assessments; training/support objectives and analysis; competence frameworks
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Supervision (and therapy) guidelines
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Feedback systems and materials (including clinical outcome monitoring; supervisee feedback)
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Training manuals (e.g. video demonstrations; learning exercises)
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Supportive arrangements (peer support groups; ‘supervision-of-supervision’ arrangements;‘metasupervision’)
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Organisational analysis and development (e.g. consultancy; work environment assessment and intervention)
Measurement instruments (e.g. satisfaction; learning/development; qualitative options)
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We are inviting you to contribute a paper for this special issue. If you are interested in joining us in this effort, please let us have a draft title by 1 November 2014. Your manuscript should be no more than 5,000 words and submitted by 1 April 2015. We will be writing an introductory review paper, outlining the case for increased attention to supervisor support and development. Contributors will receive a copy, to try and enhance the coherence of the special issue. Once we know that you are participating, we will send you a draft of that paper. Please email derek.milne@ncl.ac.uk with any queries. Queries about tCBT should be emailed to: journal.office@babcp.com Information about tCBT can be found at: journals.cambridge.org/cbt We hope that this is may encourage you to contribute, and look forward to hearing from you. Kind regards Derek Milne & Robert Reiser (Special Issue Guest Editors) emails to: derek.milne@ncl.ac.uk
BABCP Couples SIG presents www.babcp.co.uk
Cognitive-Behavioural Couple Therapy: Addressing Health Problems London - Monday 13 October 2014 Manchester - Thursday 16 October 2014
How to Supervise Couple Therapy London - Tuesday 14 October 2014 Manchester - Friday 17 October 2014 Presented by: Professor Donald H Baucom PhD, Richard Simpson Distinguished Professor of Psychology, University of North Carolina
Group Supervision and Networking for Couples Therapists 27 October 2014 Venue: The Royal Foundation of St Katherine, 2 Butcher Row, London E14 8DS
An Introduction to Cognitive Behavioural Couples Therapy 27 November 2014 Presented by Carla Swan and John Williams Venue: David Lloyd Conference Rooms, Livingstone Drive, Newlands, Milton Keynes MK15 0DL
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A joint event by the DBT SIG and the Southern Branch
BABCP West Branch presents www.babcp.co.uk
Putting DBT in to your Practice Presented by Dr Fiona Kennedy
Solent Conference Centre, 157-187 Above Bar, Southampton SO14 7NN Tuesday 7 October 2014 - 9.30am-4.30pm Overview of the workshop A theoretical and practical course for those wanting to know more about DBT and how to incorporate it into their practice. The day combines an overview of DBT principles with case discussion and practical demonstration of treatment techniques. What is DBT, who can use it and who is it for? • DBT is a treatment package that was developed for BPD (Borderline Personality Disorder), and has been adapted for many other problems including substance misuse, suicidal teenagers, eating disorders and treatment resistant depression. • DBT techniques can also be incorporated into your style of practice. Each technique is a powerful therapeutic tool. • If you are not a therapist but come into contact with people with personality problems the day will give you new ways of working. The workshop will cover • An outline of DBT • Engaging Clients in Treatment • Building Acceptance, Alliance and Trust To register for this event, please go to the BABCP Event webpage at www.babcp.com/Training/Events.aspx or email dbt-sig@babcp.com Registration Fees: BABCP Member: £100, Non-member: £120, Student: £70* Discounts of £50 per head for group bookings of five or more. Price includes refreshments but not lunch. CPD certificates will be issued. * Evidence of student status must be provided with application
Glasgow Branch presents
www.babcp.co.uk
Acceptance and Commitment Therapy: Introduction and Skills Building Dr David Gillanders Chartered Clinical Psychologist, Senior Lecturer and Academic Director of the Doctoral Programme in Clinical Psychology at the University of Edinburgh.
Thursday 9 & Friday 10 October 2014 9.00am-5.00pm (Thursday) 9.00am-4.30pm (Friday) Registration from 8:30am Bristol Zoo The Clifton Pavilion College Road Bristol BS8 3HH Registration fees BABCP Member: £150 Non-member: £170 Price includes two course buffet lunch, refreshments and entrance to the zoo for both days of the conference. For further information including how to register, please visit www.babcp.com/cpd
North West Wales Branch presents www.babcp.co.uk
CBASP - Innovative Treatment for Persistent Depression: A Primer Presented by Marianne Liebing-Wilson and Bob MacVicar
www.babcp.co.uk
Treating Disgust across the Disorders Presented by Dr David Veale
Friday 17 October 2014 - 9.30am to 4.30pm Centre of Therapy & Counselling Studies, 8 Newton Place, Glasgow G3 7PR Cognitive Behavioural Analysis System of Psychotherapy (CBASP) is to date the only psychological therapy specifically developed (McCullough 2000, McCullough 2003, McCullough 2006) to meet the challenges presented to therapists when working with the persistently, or, chronically depressed patient (Keller 2000, Swan, MacVicar et al. 2014).
Thursday 30 October 2014 - 9.30am to 4.30pm Neuadd Reichel, Bangor University, Ffriddoedd Site, Ffriddoedd Road, Bangor LL57 2TR
CBASP has been demonstrated in a number of studies to offer some benefit to those depressed people most difficult to treat; people who have been depressed for two or more years with less than eight weeks of feeling well in that period. Our experience is that ‘standard’ or ‘formal’ CBT does not seem to impact on the persistently or chronically depressed; hence our interest in and use of CBASP.
About the workshop: Disgust is a core emotion and its derivatives such as self-disgust (shame and contempt) has been a neglected area in research. It is part of the threat system that keeps a person safe. Disgust is associated with phobic avoidance but standard exposure is less effective for disgust than for anxiety. Furthermore, beliefs associated with disgust are often inaccessible. Disgust elicitors include eating/food; excreting; sex and death but there is also inter-personal disgust and moral disgust. We will focus on the treatment of disorders that have a large component of disgust or self-disgust, namely fears of contamination and mental contamination in obsessivecompulsive disorder, specific phobias of vomiting and body dysmorphic disorder (BDD).
Registration fees: BABCP Member: £80 - Non-member: £100 Lunch and refreshments included and CPD certificates will be provided
Registration Fees: BABCP Members - £65, Non-members - £70 Prices include lunch and refreshments. CPD certificates will be issued.
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The Compassionate Mind Foundation’s 3rd International Conference
Learning from Experience: Advances in Compassion Focused Therapy 26th-28th November 2014 Birmingham Three days of workshops, symposia, keynotes and skills classes plus social events Topics include: Trauma, Group work, Working within Organisations and Teams, Parenting, Eating related difficulties, Psychosis and Imagery Over 20 Speakers to include: Paul Gilbert, Rony Berger, Deborah Lee and Chris Irons
For full programme details, fees and how to book please go to our website:
www.compassionatemind.co.uk
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Advanced CBT Workshops for 2014-2015
Psychological Therapies @ UEA Faculty of Medicine and Health Sciences 5 December 2014
Dr Kerry Young Based at University College London/ Trauma Service Central and North West London
Mental Imagery for PTSD
20 February 2015
Professor Marcantonio Spada Based at Department of Psychology, London South Bank University
Metacognitive Therapy for Addictive Behaviour
24 April 2015
Professor Adam Radomsky Based at University of Concordia, Canada Therapy for OCD
Difficult to treat? Not anymore! Cognitive
22 May 2015
Professor Rob DeRubis Based at University of Pennsylvania, USA
Working with Cognitive Processes & Alliance and CBT
26 June 2015
Professor Rick Heimberg Based at Temple University, USA
Master class in Group Therapy for Social Phobia
All workshops are held in the John Jarrold Suite, Sportspark at the University of East Anglia, Norwich, NR4 7TJ. *Closing date for applications is one week prior to the workshop taking place* Cost: 1-day workshop: ÂŁ130.00
To apply: Please email Helen Sayer: cbt.workshops@uea.ac.uk
It is a pleasure to invite you to a one day conference
Improving Access to Psychological Therapies (IAPT) for British South Asians 1st OCTOBER 2014 UNIVERSITY OF MANCHESTER Keynote address by Dr David Kingdon-Professor of Mental Health Care Delivery at the University of Southampton, UK Organisers: Dr Nusrat Husain & Professor Imran Chaudhry, Global Mental Health Research Group, the University of Manchester and Lancashire Care NHS Foundation Trust For bookings contact: nadeem.gire@manchester.ac.uk
Delegate rate: ÂŁ95. Please make cheques payable to Lancashire Care NHS Foundation Trust. Cheque and money orders accepted
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