Volume 43 Number 3 | September 2015
ve What can I do once I ha qualified as a PWP?
“
”
Allán Laville is Senior PWP Clinical Educator in the Charlie Waller Institute at the University of Reading, and has trained over 200 PWPs since 2011. As an advocate of the PWP role, he explains how far the position has developed in that time On qualifying as a PWP in 2010, I realised that the options as a qualified PWP were limited. First of all, very few, if any qualified PWPs were delivering supervision to trainee PWPs. Secondly, there was some room for qualified PWPs to work in a specialist area; however, these opportunities were few and far between. Thirdly, there was very little post-qualification training, so this left qualified PWPs feeling frustrated and that they had ‘reached the ceiling’ as far as the PWP role was concerned.
At that time, the Senior PWP role was in its infancy and very few posts existed. The result of this was that many of my fellow PWPs left the role to complete other clinical or CBT training. However, the picture now in 2015 is far from what I experienced upon qualifying in 2010.
Continued on page 3
Volume 43 Number 3 September 2015 Managing Editor Peter Elliott Associate Editor Patricia Murphy Editorial Consultant Stephen Gregson
Inside 4
‘Coercive’ therapy proposals for job centres The BABCP Board responds to reports of treatment being provided in job centres
6
Prestigious award for Guernsey CBT therapists
Contributors Jaime Delgadillo, Kayleigh Hopkins, Allán Laville, Patricia Murphy, Eoin O’Shea, Sophie Pratt CBT Today is the official magazine of the British Association for Behavioural & Cognitive Psychotherapies, the lead organisation for CBT in the UK and Ireland. The magazine is published four times a year and posted free to all members. Back issues can be downloaded from www.babcp.com/cbttoday. Submission guidelines Unsolicited articles should be emailed as Word attachments to editorial@babcp.com. Publication cannot be guaranteed. An unsolicited article should be approximately 500 words written in magazine (not academic journal) style. Longer articles will be accepted by prior agreement only. In the first instance, potential contributors are advised to send a brief outline of the proposed article for a decision in principle. The Editors reserve the right to edit any article submitted, including where copyright is owned by a third party. Disclaimer The views and opinions expressed in this issue of CBT Today are those of the individual contributors, and do not necessarily reflect the views of BABCP, its Trustees or employees. Next deadline 9.00am on 26 October 2015 (for distribution week commencing 27 November 2015) Advertising For enquiries about advertising in CBT Today, please email advertising@babcp.com. © Copyright 2015 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.
2
CBT Today | September 2015
Patricia Murphy speaks with Michelle Ayres and Carol Vivyan about their ground-breaking work in Guernsey
8
Healing hidden wounds
11
Message from the President
16
Unmissable opportunity
17
the Cognitive Behavioural Therapist – call for papers
BABCP-accredited PWP Kayleigh Hopkins talks about her work with military veterans and their families
Rob Newell looks ahead to his second year as BABCP President
Sophie Pratt reflects on the benefits of placements during study
Special issue planned for 2016
ALSO IN THIS ISSUE: 10 Welcome back to the Board 12 Jolly good Fellows 14 In the company of the Becks 15 International recognition for CBT pioneer 18 Doing the rights thing 20 Northern IAPT Practice Research Network 20 Delivering and augmenting CBT with technology 22 Accreditation enquiries Correction The previous issue of CBT Today was incorrectly labelled as Volume 44, instead of Volume 43. CBT Today apologies for any confusion caused. Please note that the electronic version of the previous issue, found on the BABCP website, has been amended to show the correct volume number.
What can I do once I have qualified as a PWP? Continued from page 1 Many trainee PWPs are now being supervised by a qualified PWP. This is seen in the number of qualified PWPs completing supervisor training with us and the impact of this is two-fold. Firstly, the supervisor has worked or is working at low intensity so they are familiar with this approach. This is important so to ensure fidelity to the evidence-base and to avoid ‘medium intensity’ drift. Secondly, after receiving supervision from a qualified PWP, trainee PWPs are motivated to complete supervisor training after their initial PWP training. This serves as a good way to develop a qualified PWP as well as retaining the workforce. Within the initial PWP training, many areas of diversity are covered. In fact, the current PWP curriculum contains an entire module on diversity issues. The main areas reviewed are working with long-term conditions, interpreters, culture and diversity, older adults, gender and sexuality. In practice, qualified PWPs are now being provided with more opportunities to work within a specialist area and to develop their knowledge and understanding. This is dependent on the service the PWP is based in, however specialist areas such as veterans, medically unexplained symptoms, offenders, perinatal care, and learning disability are becoming part of the PWP role. From the conversations I have had with both trainee and qualified PWPs, the opportunity to work in a specialist area is regarded as interesting, motivating and an
excellent opportunity to develop within the PWP role. It is always encouraging to hear PWPs tell me they are aware of how they can develop within the role and that they do not necessarily have to retrain. The provision of post-qualification training for PWPs has also improved over the past five years. One constraint of the current PWP curriculum is the limited number of days for the intervention teaching. In response to this, post-qualification training has aimed to develop the PWP’s skills in conducting treatment interventions. As far back as 2011, post-qualification training for Behavioural Experiments has been offered nationally. More recently, post-qualification training for using worry techniques for GAD as well as Exposure and Response Prevention for OCD have also been delivered. All PWPs will be working with GAD at Step 2 and so this training supports PWPs to use worry management techniques. This is important so the PWP feels confident and competent in the treatment of GAD. All PWPs will be assessing for OCD with some Step 2 services also requiring PWPs to treat mild OCD. The training of ERP for PWPs is crucial for the treatment of OCD at Step 2 and is the central intervention within the 2005 NICE guidance. Another area for post-qualification training is working with sleep difficulties or insomnia. The current curriculum does offer training on
“
Sleep Hygiene; however, this postqualification training aims to develop PWPs’ understanding of how sleep difficulties can impact on an individual’s wellbeing. Collectively, this range of post-qualification training is important to support qualified PWPs to develop within the role. Back in 2010, the Senior PWP role was only beginning to come into existence. The Senior PWP role, dependent on service, offers qualified PWPs to have a managerial/ supervisory role within the PWP workforce. This role often includes delivering Case Management, Clinical Skills and line management supervision. This is in addition to the clinical or specialist area commitments of a qualified PWP. In recent years, with the increase of Senior PWP roles, some services have introduced the Lead PWP role, which has greater managerial responsibility than a Senior PWP. In addition, the Lead PWP is often involved in the strategic development of the PWP team. These two roles support the career progression of qualified PWPs and provide a pathway to holding either a Band 6 (Senior PWP) or Band 7 (Lead PWP) role. The areas discussed here highlight how PWPs can be supported to develop within their role. It is of paramount importance that PWPs are provided with these opportunities in order to address the current issues with retention. @ALaville10
The PWP role has come a long way since I completed training in 2010 and exciting developments for PWPs are happening all the time!
”
CBT Today | September 2015 3
Statement from the Board
‘Coercive’ therapy proposals for jobcentres We note recent suggestions in various articles that the proposal to site 350 IAPT therapists in job centres might lead to a coercive approach to unemployed claimants and an attempt to attribute joblessness to the individual attitudes of claimants It is also noted that claimants will be offered online CBT to increase their ‘employability’. Subsequent communications on Twitter have asked what BABCP’s view of these issues might be. BABCP is not aware of the specifics of how CBT is to be offered in these settings. However, the position of BABCP’s Board of Trustees is that BABCP is against any offer of any treatment (including CBT) based on coercion or associated with unfair or disproportionate inducements. This applies to whether CBT interventions are offered as part of therapy, research, or in any other context (for example, corporate training/development). Coercion is defined by BABCP as the threat of punishment, and unfair and disproportionate inducements are defined by us as rewards for participation which are such that an individual is pressurised by the extent or form of the inducement to
“
accept an offer which they would otherwise refuse. BABCP does not have a blanket policy on the offer of CBT in any particular setting, including Job Centres, nor with any reasonable aim, such as increasing people’s fitness for work or any other activity. However, it is BABCP’s view that such an offer must be made in response to an identified need for intervention where the person involved freely expresses a desire for such intervention. BABCP recognises that individuals may have personal needs which will hinder them in finding jobs and for which CBT may be useful. Naturally, BABCP expects such interventions to be evidence based and offered by a delivery method which is likewise supported by evidence of success. Such interventions should be based on the needs of the individual. BABCP supports the rights of people to have adequate access to effective
It is BABCP’s view that such an offer must be made in response to an identified need for intervention where the person involved freely expresses a desire for such intervention
4
CBT Today | September 2015
”
interventions which will help them live all aspects of their lives, including employment. Similarly, people have the right to adequate and appropriate assessment of their personal needs in helping them find work, including psychological assessment. Results of any assessment, including psychological assessment and assessment for suitability for CBT should not be used coercively. BABCP does not recognise the validity or applicability of generalised psychological explanations of social issues such as joblessness. Unfortunately, the evidence so far gathered by the Department of Health in partnership with the Department for Work and Pensions published in An Evaluation of the ‘IPS in IAPT’ Psychological Wellbeing and Work Feasibility pilot clearly indicates that much more work in the form of a larger pilot is required before the programme is rolled out. Furthermore, there is currently insufficient evidence to indicate whether it is effective and such evidence as there is indicates significant problems with the structure and implementation of the programme. President Rob Newell, Elected Member Steve Flatt, and Lay Member Bill Davidson, on behalf of the BABCP Board of Trustees
2016 Annual Conference goes to Belfast The 2015 Annual Conference in Warwick has passed in the now traditional burst of hot weather. A preliminary look at the feedback tells us that there were lots of positive comments about the content and diversity of the meeting, with a lot of people saying how happy they were with the balance of clinical and
research content. We are grateful to all those who submitted the exceptionally large number of papers, posters, workshops, skills classes, clinical round tables and more. We had an embarrassment of riches from which to choose. Now the Scientific Committee begins planning for next year, and we hope
you will make our job just as difficult next time. Let’s see those submissions, and the more we can encourage from new people, the better. So if you are sat there thinking ‘I could do that’, then give it a go. The submission portal is open now, with a closing date of 6 November 2015, so get your submissions in!
Full details will soon be forthcoming. However, there will be some differences next year, so here is what you need to know now: 1. The meeting will be in Belfast next year. If that deters you, then check flights, because they are cheaper than a lot of train fares when we hold the meeting on the mainland. Belfast is a fabulous place, and if you have never been there then you are missing a great city. 2. The venue is a conference hall which is a five-minute taxi ride from the George Best Belfast City Airport, and a short stroll from the city centre, so there will be no isolation from the centre of town. 3. The accommodation will be in local hotels, rather than student halls, so apologies to those who love to be reminded of their student days.
4. The dates will be in June 2016. There are several reasons – particularly the availability of the venue. However, we have had repeated requests over the years that we should have some meetings in school term time to aid child cover, so this is a chance for all the requesters to get to a Conference. We normally cannot do this, because university venues host graduation ceremonies in the weeks we would like to be there, but this is a chance to find out if more people can attend the Conference if we hold it at this time of year. 5. Because the meeting is a month earlier in 2016, the call for papers and deadlines for submissions is earlier too. The closing date for Workshops, Clinical Skills Classes and Symposia is Friday 6 November. As always, fresh ideas from new presenters are welcome.
Notifications about dates and details of the venue will follow by email and post, and you can always check up via the website. Looking forward to seeing you in Belfast. Glenn Waller Chair, Scientific Committee
www.babcpconference.com
14 -16 June 2016
The closing date for Workshops, Clinical Skills Classes and Symposia is Friday 6 November CBT Today | September 2015 5
Michelle Ayres and Carol Vivyan receiving their British Journal of Nursing Mental Health Nurse of the Year Award 2015, presented at Shakespeare’s Underglobe in March 2015
Prestigious award for Guernsey CBT therapists This year Guernsey-based Michelle Ayres and Carol Vivyan were named by the British Journal of Nursing as Mental Health Nurses of the Year. CBT Today Associate Editor Patricia Murphy spoke with them about their innovative work on the island of Guernsey that brought them this award Both Michelle and Carol - each with three decades of mental health work experience - are BABCP accredited CBT therapists with a background in mental health nursing. This year they were named Mental Health Nurses of the Year by the British Journal of Nursing for their innovative work in mental health care and particularly their handbook, The Decider, which blends CBT and Dialectical Behaviour Therapy (DBT) techniques. The Decider was developed in response to an identified need in
6
CBT Today | September 2015
Guernsey’s adult mental health services to provide treatment options for patients where impulsivity was assessed as being problematic. As a fully comprehensive DBT service is expensive and impractical for the kinds of smaller service found in Guernsey to commission, in 2010 Michelle and Carol were tasked with developing a programme for clients who presented with impulse disorders. Michelle explained its genesis further: ‘Our thinking was shaped following feedback from an initial pilot group of clients who told us about their
experiences in mental health services including what they had found helpful and what had been less so. The evidence base for the project was informed by CBT and DBT; in particular, Beck, Ellis, Padesky, Young and Linehan. ‘DBT is probably the best known empirically validated therapy for borderline personality disorder and we felt that the original intensive format, which can be difficult for services to provide, could be adapted. Other studies have found that DBT skills groups can be useful where full DBT is unavailable.
“
This desire to improve the psychological wellbeing of the young is timely. Child and adolescent services are in crisis. NHS spending has been cut and fallen in England by nearly £50m since 2010, while there has been a steep increase in self-harm and inpatient admissions
‘By bringing aspects of these two evidence-based therapies together, we were able to introduce a new CBT and DBT informed Skills Group to our adult mental health service. Both therapy approaches recognise the value of developing effective life skills for complex presentations.’ The Decider consists of client handouts and a therapist manual which provides detailed explanations for the clinician on how to present each skill as part of a structured12session group. The client is able to utilise a reference card showing pictures each of which relate to each ‘decider skill’. Clear pictorial images on the card summarise the 32 CBT and DBT skill sets. Clinicians can adapt the skills to suit individuals or client groups. By drawing on their knowledge of the client, they are able to demonstrate and model skill sets to ensure that the manual is tailored to individual client needs. There is regular training in Guernsey for all mental health staff and client groups are run twice a year. These are facilitated by mental health staff from different disciplines. Clients are also able to attend a monthly graduate group after completion. Michelle and Carol also facilitate workshops in the UK, Ireland and Romania. In order to bring the skills training to life, there is a strong emphasis on therapist modelling and, having witnessed Carol and Michelle in action, I can testify that effective use of The Decider requires energy, action and conviction, and is presented in a fun and engaging way.
Presenting the skills as credible requires a willingness by the therapist to demonstrate alternative behaviours, and a sense of playfulness and good humour are essential requisites. It is unsurprising that following such a rigorous workout Michelle reports that many therapists testify to an increase in their own teaching confidence and clinical skills. Whilst The Decider is being used extensively in adult mental health services in Guernsey, it has also been adapted for use by other service settings on the island. The potential to modify and adapt this teaching aid for children and young people has been recognised by the pair who have been spurred on by feedback from staff and patients routinely commenting,‘I wish I had been taught these skills when I was young!’ This desire to improve the psychological wellbeing of the young is timely. Child and adolescent services are in crisis. NHS spending has been cut and fallen in England by nearly £50m since 2010, while there has been a steep increase in selfharm and inpatient admissions.
”
they are currently conducting a pilot study in a Guernsey girls’ school and the local Les Nicolles Prison has introduced The Decider as part of their rehabilitation programme. It is also being used by staff from the Youth Commission and Children and Young People’s Services.
Their decision to collaborate has clearly paid dividends, and the enthusiasm and passion demonstrated in their work is contagious. They have overcome a lack of resources, apathy and role constraints and have always kept the client at the centre of what they do. Carol said:‘The Decider has almost developed a life of its own. We encourage clinicians to be creative with our work and we get great feedback from them about their success and ideas.’ One of the key messages embedded in the life skills training reminds participants:‘If you always do what you always did you’ll always get what you always got’. I doubt Michelle and Carol could ever be accused of that.
The duo recognise that pre-emptive approaches to improving the psychological wellbeing of the young can help prevent emotional problems developing in later life. In response, they have developed a simplified version of The Decider for use in schools and youth groups for children aged 8 to 11 years. The pair have conducted a pilot study of their work with 50 clients and the findings have recently been submitted for publication. In addition
More information can be obtained at www.thedecider.org.uk
CBT Today | September 2015 7
Helping to heal hidden wounds One of the aims of the Help for Heroes charity is to help military veterans who have encountered difficulties with their mental health, which a recent study has shown is twice more likely to occur with this population than the national average. Kayleigh Hopkins (pictured above) is a PWP working for the charity’s Hidden Wounds service. Here Kayleigh talks about her role with the service
As an undergraduate I set my sights on working towards a Doctorate in Clinical Psychology and spent the years after my study working in different mental health services. Two years after graduating I was involved in the setting up of a new IAPT service in Bristol and worked as an Assistant Psychology Practitioner. It was while I was in this role that I became aware of the position of a PWP. This was something that really sparked my interest, as the idea of working with fidelity to an evidence base meant that the treatments would develop and evolve as a result of research, and that I would be able to actively keep up with these advances. I was also keen on the idea of providing guided self-help and seeing people develop their own
“
understanding of the treatments with their lives improving as a result. I successfully applied for a training position with the NHS service I was working for at the time. This meant I would spend two days a week either at the University of Exeter or studying for just under a year. I continued to work in the NHS for six months after gaining my qualification, when I was made aware of the position available at Help for Heroes, working as part of the team delivering their new Hidden Wounds psychological wellbeing service. Initially I was somewhat resistant to this change, as I had worked at the NHS since graduating and felt compelled to stay with the conventional PWP pathway. However,
I was also keen on the idea of providing guided self-help and seeing people develop their own understanding of the treatments with their lives improving as a result
8
CBT Today | September 2015
”
the opportunity to work for such an inspiring charity and to help shape a ground-breaking new service was not one to be missed. Hidden Wounds was created as a purely Step 2, low intensity, evidencebased service, providing support for veterans, their families and the families of those currently serving. The idea of providing support to the Armed Forces is something that I am very passionate about, so this really appealed to me on a personal level. The military community is notoriously hard to reach when it comes to mental health support, although our beneficiaries have long been telling us that there is a need for it. Often, the problems they are presenting with are very similar to those faced by the general population but it is the context within which support is provided that differs. As a team we are at the forefront of development, working with the University of Exeter to identify and assist in the introduction of new interventions to support veterans with the variety of mental health issues they experience. I am aware that the support we provide could feed into national research into supporting the military population, which is a really exciting prospect. This research could lead to developments and hopefully improvement being made in current services, hopefully resulting in a reduction in stigma around mental health. This is something I feel is a true positive, as this will only help
“
The whole charity buzzes with excitement and adventure, and you feel an instant desire to be involved and test your own personal limits
smooth the transition of service personnel into civilian life and help families feel supported too. I quickly learnt that working for Help for Heroes would mean that I became much more than a PWP. The whole charity buzzes with excitement and adventure, and you feel an instant desire to be involved and test your own personal limits.
�
Prior to leaving the NHS I had been working towards becoming a BABCP Accredited PWP and this was not something I felt I wanted to give up on. Initially this was difficult given that I was now a part of a service that was neither NHS nor a part of IAPT. After some discussion and support from the University of Exeter, I was granted my accreditation and am proud to be the first PWP to be accredited outside of the NHS or IAPT.
To find out more about the Hidden Wounds service, visit www.helpforheroes.org.uk/ hidden-wounds
CBT Today | September 2015 9
back Welcome to the Board V
BABCP members were presented with a selection of candidates at this year's election for the Board of Trustees. This was the first competitive election since 2011.The election also saw the return of some familiar faces Professor Chris Williams was elected unopposed to the role of President Elect, which he will hold until he takes over from Professor Rob Newell as BABCP President after next year's Annual General Meeting. This is a return to the Board for Chris, who was BABCP President in 2001-2. Chris said:‘It is an honour to have the opportunity to be BABCP President for the second time. I am really looking forward to working with Rob Newell, Ross White and the wider BABCP Board and team over the next four years. There are lots to do as the CBT approach grows. ‘We also need to maintain a focus on
people - not just BABCP members but especially those we work with - so that BABCP as an organisation helps more people gain access to evidencebased and hopefully life-changing help’. Gerry McErlane was elected for another three-year term as Honorary Treasurer. There were also two Elected Member vacancies up for election. The successful candidates were Gillian Todd and Tom Reeves. With over 35 years of mental health experience, Gillian is currently employed as a Senior Lecturer and Director of CBT in the Department of Clinical Psychology, Norwich Medical School. This involves being Course Director for two Postgraduate Diploma Courses in CBT, one of which
is for High Intensity Therapist - IAPT training, and the organisation of CBT CPD through annual advanced CBT workshop series. She is also a BABCP Accredited Practitioner, Supervisor and Trainer and, more recently, was appointed as a BABCP Ambassador. Tom is a registered mental health nurse who has worked almost three decades in the NHS and, for the last 16 years, as a Cognitive Behavioural Psychotherapist in adult mental health. He has also worked in education, teaching and supervising on Doctorate courses, CBT diploma and degree courses, and IAPT. Tom is widely known within the BABCP grassroots, particularly as an active committee member of his local Branch, North East and Cumbria. More recently, he has been involved at a national level within BABCP. He currently chairs the Communications Committee and previously chaired the Branch Liaison Committee.
New Board Trustees Gillian Todd and Tom Reeves
10 CBT Today | September 2015
Message from the President As he begins the second year of his two-year term, BABCP President Rob Newell writes about the changes in personnel and the plans moving forward on the Board Since I wrote in this magazine last December to introduce myself as BABCP President, it seems like a lot has happened, and it has been an exciting year. My first pleasant duty is to thank departing Trustees and welcome new ones. Chris Cullen is well known to BABCP, having spent a good many years as Chair of BABCP’s Conduct Committee, before being a Trustee for the past year. His wise counsel will be greatly missed. Trudie Chalder has completed her term as President Elect, President and Past President, but will continue to be involved with us through her work on the Scientific and Conference Committees. I have referred before to Trudie’s great work as President and personal support for me, but I didn’t want to let the opportunity go to thank her again. This year we welcome Chris Williams as President Elect, in what I believe is a first for BABCP, in that Chris has previously served in this capacity, albeit some years ago. I look forward very much to working with him in the future, especially since his work in disseminating cognitive-behavioural approaches fits so well with our current aims as an organisation to increase the public face of CBT. Tom Reeves is well known to the membership through his work with Branches and Special Interest Groups (SIGs), whilst Gill Todd has previously been a BABCP Ambassador. Tom and Gill have been elected as Board members and we as a Board look forward to their experience and expertise. Finally, Gerry McErlane has been re-elected to serve a further term as Honorary Treasurer. During the past year, BABCP has been active in pressing for the appropriate application of CBT during a time of continuing economic challenge, and I noted our activity in BABCP’s Annual Report. Members will be aware of two
particular issues; the possibility that users of our services are receiving treatment to a suboptimal level, and the possibility that CBT might be applied under circumstances of coercion. In the first case, BABCP members raised the issue of inappropriate decisionmaking regarding how CBT was offered. This revolved around the imposition of arbitrary numbers of treatment sessions. BABCP responded with a statement based on the notion of clinical autonomy in response to individual need, and we saw a very welcome joint letter from Norman Lamb and David Clark to IAPT Clinical and Service Leads addressing the issue. Concerning possible coercion, I should stress that this is an issue which is by no means evidenced as yet. However, it has been raised by BABCP members, academics and also in the press. Essentially, the controversy concerns the proposed siting of IAPT therapists in jobcentres. It has been suggested by some commentators that people claiming benefits may be offered CBT interventions in some conditional way which amounts to coercion. Should this happen, such an approach to therapy and to people is deplorable, and BABCP has issued a statement - which is published in full in this issue - reaffirming our opposition to the offer of any intervention in the context of coercion or inappropriate inducement. At the same time, this afforded us the opportunity both to support the right of people to access appropriate, evidenced interventions where they wish it, and to deny the validity of wholesale explanations of social issues such as joblessness in terms of purported individual psychological difficulties.
awareness of CBT, since such an increase in awareness is a key factor in securing protection for the public from any possible inappropriate use of therapy – only through awareness can a large scale defence of the integrity of therapy be initiated. I believe BABCP has a key role to play in this, and we will continue to seek real public involvement in our work. The Board has asked that each Branch and SIG considers how it will appropriately involve the lay public in its activities. At Board level, we will seek to enrol more lay people, either as co-opted or elected members. As a result of CBT’s increasingly high profile in the provision of psychological therapy, we are often asked to participate in high level discussions in a range of forums. Partly as a result of this, we will be looking at making a senior appointment of someone with a CBT background who can drive forward the involvement of BABCP at a national level, both through regular promotion of CBT in key political and clinical arenas and through involvement of lay groups with an interest in CBT. This appointment is important to us because other major therapy organisations all have the capacity to give this kind of regular input, whilst we rely on the goodwill and availability of members. We will consult you as a membership on this appointment as it develops, and I invite you warmly to contact me with comments at robnewell54@gmail.com. Finally, our office staff and members in the Branches and SIGs do a fantastic job, and I thank them on behalf of the Board for all their hard work. I look forward to working with you in the coming year.
For me these two matters emphasise the need for increased public
CBT Today | September 2015 11
Jolly good Fellows At the BABCP AGM held on 23 July during the Annual Conference at the University of Warwick, President Rob Newell announced this year’s five recipients of the Honorary Fellowship in recognition of distinguished service to the Association and the CBT community as a whole Dr Roger Baker's honour is in recognition of his contribution to the early establishment of behaviour therapy and, more recently, to the development and practice of CBT in the UK, as a practitioner, researcher, author and trainer. He was one of the first psychologists in the UK to use behaviour modification with schizophrenic patients, in particular implementing innovative token economy approaches that helped patients' health and functioning, as well as developing the standing of the emerging field of behaviour therapy within the NHS. Later developments in CBT were significantly informed by his work, not only in terms of credibility but also in bringing hope to patients and their families in the treatment of what had previously been seen as intractable conditions. Dr Baker's work has moved with the times and, over the last 25 years, he has investigated, taught and published his work, in both academic and selfhelp formats, on emotional processing in panic disorder and PTSD. Within the Association, Dr Baker has been involved from the outset, helping to lay the foundations for the now thriving BABCP. Professor Chris Brannigan, who has also received an Honorary Fellowship, has been an Association member since its foundation in 1972 and has
Dr Roger Baker and Rob Newell 12 CBT Today | September 2015
contributed his time and efforts to furthering the objectives of the organisation and CBT continuously since then. In his professional life, Professor Brannigan has been involved in child and adolescent psychology, having taught, researched and held honorary posts in the UK as well as Africa, Asia, Australia, North America and various European countries. He has acted as an organisational consultant within the European Union and worked with several UK Government agencies and commercial organisations. He is currently Professor Emeritus in Psychotherapy at the University of Derby. Professor Brannigan has been very active in many capacities in the Association from the start including running introductory workshops for behaviour therapy. He served as Association Chair in 1986-7 and as an Elected Member on the Board from 1996 to 1998, while he continues to work tirelessly on the BABCP committees for Course Accreditation and Conduct. Colin Espie is a clinical psychologist who has made an outstanding contribution to research, training and service development, and is particularly known for his psychological treatment of insomnia. He is a well-known and respected academic speaker and trainer throughout the UK and abroad.
Chris Brannigan and Rob Newell
Currently he is Professor of Sleep Medicine in the Nuffield Department of Clinical Neuroscience at the University of Oxford. He has held several international adjunctive professorial positions at the universities of Sydney, Rome, Laval and at Rochester. He was previously the Chair in Clinical Psychology at the University of Glasgow where he led the course from a two-year to a three-year Doctorate in Clinical Psychology. He established the research portfolio model now widely used throughout the UK in clinical training programmes. He has manualised an approach to small group CBT for insomnia that has been validated by research trials where nurses are trained as therapists and co-founded the award-winning digital CBT programme Sleepio. His self-help packages are very popular in the NHS Books on Prescription scheme and NHS Choices. Colin Espie is highly deserving of a BABCP Honorary Fellowship in recognition of his outstanding contribution to the field. Mark Freeston is Professor of Clinical Psychology at Newcastle University. He has made outstanding contributions to our understanding of Obsessive Compulsive Disorder (OCD) and Generalised Anxiety Disorder (GAD) in relation to intrusive thoughts, worry and rumination. He completed a Doctorate in 1995 at Université Laval, Québec, and after working in Montreal, moved to Newcastle in 2000 to take up the post as Director of Research and Training at the Newcastle Cognitive and Behavioural Therapies Centre (NCBTC). In 2001, he was appointed Professor of Clinical Psychology at Newcastle University where he is Senior
Research Tutor for the Doctorate in Clinical Psychology. He was Course Director for the Newcastle Postgraduate Diploma in Cognitive Therapy from 2000 to 2010 and Chair of the NICE guidelines on OCD and Body Dysmorphic Disorder (BDD) in 2005. He divides his time between NCBTC and the University and regularly provides workshops in CBT for OCD and GAD as well as clinical supervision, approaches to comorbidity, and single case experimental designs. His current research and training interests are in the role of intolerance of uncertainty as a transdiagnostic process. We are delighted to give an Honorary Fellowship to David Veale. David has been a BABCP member since 1987 and has contributed his time and efforts to furthering the objectives of the organisation and CBT. He was BABCP Honorary Treasurer from 1996 to 1999 during which time he helped to set up the Research Fund, and was President from 2006 to 2008. David also established Fellowships in BABCP and the online journal the Cognitive Behaviour Therapist. Even after he ended his presidential term, he has continued to support BABCP, currently as chair of the Research Fund Committee and chair of the Fellowship Committee. He is also on the editorial board of the BABCP journals.
David Veale and Rob Newell
This award may come as a surprise to David as he is Chair of the Fellowship Committee but the committee, behind his back, thought that he was an excellent example of someone to whom the award should be given. He has also made a major national and international contribution to CBT as a psychiatrist. He has carried out research in anxiety disorders and is well known for his work on body dysmorphic disorder and a specific phobia of vomiting. We thank David for his work in aiding the development of CBT in clinical practice and through teaching, workshops, his helpful treatment manuals and research. As well as four self-help books and a treatment manual in BDD, David has over 100 peer-reviewed publications. He is a consultant psychiatrist at the South London and Maudsley Trust as well as at The Priory Hospital North London and a Visiting Reader at the Institute of Psychiatry, King’s College London. This year BABCP also bestowed Fellowship status on Dr Fiona Kennedy for the significant contribution that she has made to the advancement of behavioural and cognitive psychotherapies. Dr Kennedy has extensive clinical experience in mental health (from anxiety through eating disorders and PTSD, to psychosis and personality disorders) and learning disability fields. Fiona’s main orientation for
Fiona Kennedy and Rob Newell
many years has been CBT and she built an NHS psychology and counselling service from scratch with this orientation. She has served on BABCP committees and as a Trustee and is a founder member of the DBT Special Interest Group. She has extensive experience of teaching, including on doctoral training programmes and supervising and teaching other professionals. She has studied dissociation as a psychological process, leading to a new CBT theoretical model and scale, as well as innovative new treatments. The creation of an effective treatment service for self-harming, suicidal, ‘revolving door’ inpatients was quoted as an example of national excellence by the Government’s National Audit Office in its House of Commons report Safer Patient Services in 2005. She has presented her research at many national and international conferences and received an award for clinical excellence from BUPA. With her deep knowledge of the subject and outstanding leadership qualities Dr Kennedy is a truly inspirational tutor. For the past nine years Fiona has taken CBT into a developing world context, working pro bono for an NGO in Bangalore. Here, she has developed psychological measures of programme effectiveness and jointly created and delivered a mentoring programme for ‘street’ children. After receiving this training, Indian volunteers mentor rescued young people. The programme has been adopted by three universities in Bangalore. This model has much to offer as a cost-effective means of addressing global mental health problems.
CBT Today | September 2015 13
In the company of the Becks
Dublin-based BABCP member Eoin O’Shea was one of only 12 scholarship winners invited to attend this year’s Annual Graduate Student and Mental Health Trainee workshop at the prestigious Beck Institute in Philadelphia, USA. Here he tells CBT Today readers about his visit to the ‘City of Brotherly Love’
As a counselling psychologist and CBT therapist, it was an honour and privilege to be accepted to attend training delivered by the Beck Institute in Philadelphia. Held between 3 and 5 August 2015, well over 100 trainees from around the world gathered to receive tuition from Drs Aaron and Judith Beck as well as senior colleagues at the Institute. The workshop focused on the use of CBT for both depression and suicidality. From the outset, attendees were greeted with a warmth and openness later to be discussed as one of the core components of modern CBT itself. Opportunities to role-play attendees’ clients (unrehearsed) with Drs Aaron and Judith Beck were encouraged, and it was intriguing to see how any number of ‘stuck’ clients, or difficult challenges in sessions, were handled with a genuine yet skilled ease by the experts present. Given the large audience present, it was refreshing to have such roleplays (and also group discussions) included in what would otherwise have been a more traditional, lecture-
14 CBT Today | September 2015
based format of instruction. Though specific examples of research studies were touched upon, the workshop was focused far more so on providing attendees – many of them relatively new to CBT – with a ‘hands on’ practical guide to things such as structuring sessions, conducting cognitive and behavioural exercises (both in and between sessions), as well as navigating common pitfalls such as non-completion of homework or exploring and challenging unhelpful beliefs about therapy and clients’ future progress. It was noted that homework is now referred to as ‘Action Plans’ within the Institute, having found the former term to be unfavourable for some clients. Given mixed experiences of school earlier in life, as well as the potential for the term ‘homework’ to be found condescending by some clients in any event, this seems a welcome change. On the second day, Dr Aaron Beck made an appearance and discussed the development of CBT, along with what he views as the major developments of the approach in the coming years. He proposed that CBT –
and indeed clients’ actual problems – seem to have become more complex over the decades of his work, joking that perhaps the most complex clients seen these days are worked with by those least experienced in many organisations - an idea not lost to those who have seen how often front-line (and more experienced) clinicians often find themselves diverted from service delivery and supervision to more administrative tasks. He also discussed his views on where CBT, and therapy more generally, will develop from now. Dr Beck envisages a move towards a single ‘psychotherapy’ – making a comparison to surgery in this regard – and acknowledged the important contributions of various approaches such as mindfulness and ‘third wave’ approaches, client-centred relational focuses, and the development of DBT specifically.
Also highlighted was the relatively modern application of CBT in working with psychosis. Dr Beck discussed an inspiring example of a psychotic patient who, over a somewhat longer course of CBT, came to overcome delusions of grandeur, which, in turn, were formulated as compensatory features derived from core beliefs of unacceptability and isolation from others. Perhaps most refreshing of all was Dr Beck’s underscoring of the importance of working in an idiosyncratic, formulation-driven way with all clients when using CBT. He expressed his own misgivings concerning the way in which there has been an increasing drive towards overly-simplistic manualisation of the approach in recent decades and espoused the importance, instead, of applying CBT through a balance between its proposed structures and
Eoin O’Shea (pictured second right) speaking with the Becks
techniques, but also considerable flexibility on the part of the therapist. Finally, it was an honour to have a private audience with both Drs Beck during which the recipients of this year’s scholarships for the event – 12 delegates selected from over 800 international applicants – discussed their work with the ‘Founder of CBT’. Scholars were involved in a myriad of CBT-related projects and it was inspiring to have Dr Beck respond so positively to our work, suggesting that he saw us as ‘the future of the development of the approach’. To anyone considering a trip to the USA and some intensive, short-term workshops on a variety of CBT topics and client populations, I heartily recommend training at the Beck Institute. I know I will be back myself some day soon.
Scholarship winners (Eoin is pictured standing fifth right) with Judith and Aaron Beck
International recognition for CBT pioneer Professor Douglas Turkington, who has presented at numerous BABCP conferences, has been honoured for his pioneering work in CBT with a prestigious international award. A Consultant Psychiatrist with the Northumberland, Tyne and Wear NHS Foundation Trust and Professor of Psychosocial Psychiatry with the Institute of Neuroscience at Newcastle University, he is the recipient of this year's Aaron T Beck Award in recognition for his outstanding contribution to the development of CBT for schizophrenia. This award is made annually by the Academy of Cognitive Therapy in Philadelphia. Professor Turkington is one of only three other non-Americans to receive the honour, alongside Professors David M Clark and Paul Salkovskis. Professor Turkington has project managed a number of high impact RCTs in CBT for schizophrenia, while his work has strongly influenced the NICE guidelines recommending the routine use of CBT for the treatment of schizophrenia.
CBT Today | September 2015 15
Unmissable opportunity Sophie Pratt, an undergraduate student at the University of Bath, spent a year on placement at iCope, the Islington IAPT service. Here she provides readers, and more pertinently, prospective students with her insight of taking a placement during her studies When faced with a barrage of brochures and a parade of glossy smiles at various open days, the decision about which university to pick can be incredibly tough. Yet, after visiting the University of Bath, my mind was made up. In particular, the opportunity of a year-long placement as a mandatory part of a Psychology degree was too valuable to overlook. Luckily for me, the experience lived up to my expectations and I have recently finished a fantastic placement with iCope, the Islington Psychological Therapies and Wellbeing Service. It may not be immediately clear how a placement student could be useful in a thriving IAPT service in central London. My main worry when starting the placement was whether I would be more of a hindrance than a help; asking questions that I ought to already know the answer to and taking up the time of staff who were clearly working incredibly hard to deliver high-quality care in a demanding environment.
16 CBT Today | September 2015
Yet these worries quickly diminished with the help of a welcoming team, who, from the outset, made it clear that they wanted to enable me to make the most of my time there, and were grateful of anything I did to help them out, however small it was. As my placement progressed, I was able to take a more active role in some of the innovative projects at iCope, one of which involved delivering talks in local schools to demystify psychological interventions and normalise common mental health problems. I feel that my involvement in this project really highlights how a placement student can benefit an IAPT service as, in addition to assisting with the delivery, I took a lead role in preparation, through liaising with the schools, recruiting staff members as facilitators and, on a practical level, attending the talks with all of the relevant materials. While these may seem like simple administrative tasks, they can be
time-consuming, and I was pleased to be able to take this burden off a PWP who would have otherwise had to fit it into their jam-packed schedule. My placement year also gave me the opportunity to observe some of the treatments I had learnt about at university first-hand. It was invaluable to see CBT in action, and gave me a much more holistic understanding of how this treatment can benefit patients compared with trying to grasp its concepts purely from a university textbook. The opportunity to observe various sessions ranging from one-to-one work with a patient presenting with anxiety around a stammer, to a group intervention for insomnia, gave me an appreciation of how the CBT model can be adapted to suit each patient, and the skill of the therapists in delivering this. I was also fortunate that Islington’s IAPT service is involved in many pioneering research projects. This made me more aware of the need for
researchers and clinicians to work as a cohesive team, whereas prior to my placement, I had not appreciated how closely related the two are in everyday practice. It is important that undergraduate students have a realistic idea of the sort of role they could hope to secure after graduation, with many students underestimating how competitive it is to gain a place on a postgraduate course, or being unaware of alternative routes they could take in order to progress in a clinical career. During my placement, I asked colleagues what sort of path they took following university, and it was comforting to hear just how different everyone’s paths had been. There are many job roles that my co-workers
had undertaken that I had not even heard of, which has inspired me to explore more avenues after completing my degree, secure in the knowledge that I can still hope to make a positive contribution in the field of mental health. One of the main things that I will take away from the placement is the level of support that all of the iCope staff had for each other, irrespective of their job title. Working in mental health can be emotionally draining, yet I feel that the strong sense of a team identity and continual peer support that I witnessed and became a part of really helped to alleviate the pressure that comes with the demands of working in an IAPT service. I have been very
fortunate to have begun my clinical experience in such a supportive environment and hope that I am able to join a similar team in future. To any prospective undergraduates out there, I would highly recommend opting for a degree that offers a placement as it provides an invaluable opportunity for personal and professional development. To all services and departments in the psychology world, I urge you to consider opening up your doors to undergraduate students, and give them vital, realistic experience and reaping the benefits of the contribution they may make to your team. Finally, to my wonderful team at iCope – thank you for having me!
Call for papers - Special issue:
Complexity within CBT Therapy, Supervision and Services We are delighted to inform you that there will be a 2016 special issue of the Cognitive Behaviour Therapist (tCBT) on complexity. We will be the guest editors and will consider all submissions which will, of course, be peer reviewed. Details of manuscript preparation for tCBT can be found at http://goo.gl/55KdaV. The special issue will describe and explore complexity as it manifests in CBT. It will attempt to define and model it to increase clarity for therapists, supervisors and clinical leads. The proposed broad working definition of complexity is based on an understanding of interaction:‘complexity consists of interconnected or interwoven parts, where the intersections between different elements influence each other’.
To reflect the breadth of this topic we are seeking papers that will cover, but not be limited to, the following topics: 1. What can CBT as a field learn about complexity from other disciplines? 2. What differentiates a ‘straightforward’ from a ‘complex’ case? 3. How do therapists respond to complex cases (with illustrations)? 4. How can evidence-based practice and practice-based evidence be used to understand complexity? 5. How is complexity dealt with in supervision? 6. What is the best way for psychological services to meet the needs of complex cases?
Complexity can therefore derive from:
7. In what ways can healthcare systems interact with complexity?
• the patient
We are writing to invite you to contribute a paper for this special issue on a relevant topic. The manuscript should be no more than 5,000 words and be submitted by the end of January 2016. If you are interested in contributing, please send a draft title direct to the guest editors at the email addresses below by 30 September 2015.
• the therapist • the supervisor • patient-therapist-supervisor interactions • socio-economic context • the healthcare system, etc
Claire Lomax claire.lomax@ncl.ac.uk Stephen Barton stephen.barton@ncl.ac.uk
CBT Today | September 2015 17
Doing the rights thing Against the backdrop of austerity economics, pursuing the principles and standards of human rights has become shorthand for all that is wrong about a modern, diverse society. In this timely article, Associate Editor Patricia Murphy looks at the work of the British Institute of Human Rights, to highlight why paying attention to human rights should matter to clinicians Around the world human rights are about real everyday lives. As clinicians, we have a duty to ensure that the rights of our patients are protected. Given the importance of human rights, then, it is surprising that there has been little public education about what is contained in the Human Rights Act (HRA), which came into force in the UK in 2000. This state of affairs is one that the British Institute of Human Rights (BIHR) has been working hard to rectify. Founded over 40 years ago, BIHR is an independent body that aims to provide the public with authoritative and accessible information through campaigning, organising community events and awareness training, producing fact sheets and other resources, and issuing legal and policy briefings. The BIHR’s mission statement is clear:
At the heart of everything we do is a commitment to making sure the international promise of the Universal Declaration of Human Rights, developed after the horrors of World War II, is made real here at home. Our innovative work seeks to achieve a society where human rights are respected as the cornerstone of our democracy and enable each of us to live well in communities that value the equal dignity of each person.
Their expertise was critical to the production of Human Rights in Healthcare - A Framework for Local Action, which was the result of a collaboration between BIHR, the Department of Health and five NHS Trusts. Published in March 2007, the purpose of this framework is to support NHS staff and commissioned providers to fulfil their specific duties effectively under the HRA. More recently, in 2014, BIHR issued an open invitation to service providers from every region to work in partnership on the innovative Department of Health-funded project, Connecting Human Rights to the Frontline. The only criterion was that applicants had to have a role in mental health care provision or decision-making on mental capacity issues. This had to be coupled with a commitment to tackle their legal duties under the HRA. The seven project partners that were selected included the North and South Tees Early Intervention Psychosis Teams, the St Aubyn’s CAMHS centre based in Essex, and the NHS-run Windswept rehabilitation service in Bristol. I recently attended a training day in London hosted by BIHR for the third sector, as part of their ongoing commitment to educate and inform. This event provided not only an opportunity to build on existing knowledge of the HRA, but also to consider the relationship between mental health and human rights as well as reflect on the ways in which human rights are relevant to working with people who use mental health services. Delegates were reminded that human rights provide a vital safety
18 CBT Today | September 2015
net that goes beyond the courtroom to transform and improve the experience of those using public services and everyone's quality of life generally. In mental health it means that we have a legal duty to comply with the HRA when making clinical decisions about patient care. It also means that we have a professional duty to ensure that we can identify a human rights issue and use the HRA to frame a challenge. Our excellent trainer Stephanie Davies provided details of real life cases where human rights were found to have been breached, while vignettes were used to facilitate discussion in smaller groups to test our working knowledge of the HRA and identify violations. Examples included: a patient detained under Section 3 of the Mental Health Act (MHA) waiting eight weeks for a tribunal hearing; a man being arrested and detained for more than 72 hours in a police cell coming to harm; and a 51-year-old man with Down’s Syndrome and dementia having a 'do not resuscitate' order placed on his file without any consultation with him or his family. It was sobering to reflect on my personal clinical experience spanning 30 years in mental health and recall all too easily instances when there were clear breaches of the HRA that went unchallenged. Take the common clinical practice of ‘specialing’, or the constant observation of suicidal or other vulnerable patients, which has the potential for human rights infringement, as constant observation often causes conflict amongst patient and staff and can interfere with recovery. Clearly keeping a vulnerable patient safe is paramount but, in order to do so, clinical
decisions may be arrived at that violate a patient’s human rights, so a balancing act is required to ensure proportionality. Evidently the ability to identify a human rights issue requires a working knowledge of the HRA and it is important to emphasise that not all rights carry the same weight. They can be grouped into three broad types: • Absolute rights, such as the right to protection from torture and inhuman and degrading treatment, which the state can never withhold or take away • Limited rights, such as the right to liberty • Qualified rights, which require a balance between the rights of the individual and the needs of the wider community or state interest, such as the right to manifest one’s religion or beliefs, the right to a private and family life, the right to freedom of expression, the right to education, and freedom of assembly and association The BIHR has produced a range of resources designed to support mental health advocacy, which can be found on their website, including a handy eight-step flowchart explaining the steps. Although the work undertaken by organisations like BIHR is invaluable, the HRA does have its share of
“
detractors and appears to divide public opinion. Moreover, the recently elected Conservative government has stated its intention to repeal the HRA, replacing it with a British Bill of Rights and Responsibilities. Omitting the word 'human’ from the proposed Bill has concerned many supporters of the HRA, such as Amnesty International UK and Liberty, both of which have been campaigning to raise awareness that a change in the law could undermine the universality of human rights, allowing governments to pick and choose when they apply and to whom. The fight back from these and other campaigners, such as senior lawyers and even MPs from the government benches, likely influenced the decision simply to detail proposals to introduce such a Bill in this May's Queen's Speech, rather than pursue full-blown legislation at this stage. It is hoped that this will allow for a lengthy consultation period permitting all ramifications to be fully thought through. The rights that many regard as important, even taken for granted, in daily life need to be protected, particularly at times of economic hardship. Within our organisations, then, we need to ensure that the patients we serve are protected from both government policy and clinical decisions that may contravene the HRA. As Rachel Logan, Amnesty International UK’s legal advisor, reminds us:
Governments are just made up of human beings, who are fallible, have opinions, make mistakes. You need to be able to hold them in check. The HRA helps you do that
”
Five things everyone should know about human rights 1 Human rights provide a basic safety net for us all. Human rights are universal, they belong to everyone and set down the standards below which no-one should fall. 2 Here at home the Human Rights Act provides important protections for people, giving legal force to 16 fundamental rights and freedoms and duties to uphold them. 3 Human rights are about the relationship between people and those in power. The law means that human rights should be part and parcel of the way government and services do their job, helping us all to live with equal dignity and respect. 4 Human rights are the cornerstone of a healthy democracy, ensuring the government plays fair. Human rights are an important part of our constitution and help strengthen our democracy by giving people a voice. 5 The UK championed human rights laws as shared international minimum standards in the aftermath of World War II. We should celebrate our human rights heritage and work to make sure human rights are made real in people’s lives here at home.
For more information on the Connecting Human Rights to the Frontline project, visit: www.bihr.org.uk/connectinghuman-rights-to-the-frontline
CBT Today | September 2015 19
Northern IAPT Practice Research Network Jaime Delgadillo is a BABCP member affiliated to the University of York and practises at the Leeds Community Healthcare NHS Trust. Here he writes on behalf of the Northern IAPT Practice Research Network (PRN) to inform the wider BABCP community about its work This PRN was initiated in 2014 as a partnership between northern IAPT services and academic researchers. PRN members share common goals to learn how psychological therapy works in routine care and to generate evidence that will inform and influence practice. The PRN has grown rapidly in the last year, with members representing more than 10 IAPT services and five universities, and is currently conducting two studies. The first study is assessing the effectiveness of stress control interventions, while the second study is supporting the dissemination of psycho-educational seminars across three services. In recent months, the PRN has launched a website that aims to promote debate about IAPT-related policy and practice, and includes brief articles and public opinion surveys. Since the launch of the ‘Debate’ page, the PRN’s website has attracted some 500 new readers, and one of the articles will be presented at an upcoming national conference for commissioners of psychological services. Publications arising from the stress control study are expected to emerge later in 2015, and a new pilot trial of relapse prevention interventions will also be conducted by services affiliated to the PRN.
If you are interested in the work of the PRN, you can visit its website at www.iaptprn.com or contact them at iapt.research@nhs.net. You can also follow them on twitter at @iapt_prn
Are you interested in how technology can be used to deliver and augment CBT? If the answer is yes, you might be interested in joining the recently launched CBT+IT Special Interest Group (SIG). The history of technology and CBT is a short one. Since the first computerised self-help packages were conceived in the 1980s, developers and clinicians have produced a myriad of technological methods of delivering and augmenting CBT. A search of the relevant literature will reveal over a thousand academic papers, examining the efficacy of computerised CBT (cCBT) in all its many forms.
20 CBT Today | September 2015
Technological methods range from generic self-help packages, disorder specific self-help packages, apps, guided self-help, therapist delivered CBT, video conferencing tools, online peer support and virtual worlds. There is very little training or support to guide therapists in how they might utilise technology in their work, which methods are most efficacious and what works for whom. This new SIG aims to help clinicians to learn how to use technology in their work. There will be opportunities to gain hands-on experience of a range of technological methods, including
how to use avatars in schema therapy, how apps can be used to amplify the effect of CBT and how technology can be used to deliver CBT. Drawing from the latest evidence, SIG members can learn how to use these new and innovative methods in their everyday work.
If you are interested in joining the CBT+IT SIG or would like more information, please email it-sig@babcp.com
Accreditation enquiries Most of our members will be aware that the Accreditation telephone enquiry service resumed in April. Since then the service has been available from 2.00 to 4.00 pm each Wednesday (with the exception of 22 July as this was during the BABCP Annual Conference) and, as such, we can now offer some initial feedback on how the service has been used.
us by email and an increase in the ALO resource since early this year, there are now more options and increased availability to have your enquiry dealt with in as short a timescale as possible. It is important that members contact our team in the various available ways for any enquires related to Accreditation.
Whilst BABCP has Branches and Special Interest Groups (SIGs) throughout the UK and Ireland, these should not be contacted about Accreditation enquiries. The role of Branches and SIGs is only to signpost members to the BABCP website or our team should they receive any enquiries related to Accreditation. BABCP Accreditation team
It seems appropriate to begin by stating that most callers have been appreciative of a telephone service resuming. A lot of members have stated the importance of ‘being able to talk to someone’ and, as a team, we are pleased to be able to meet your needs. To date, we have received 134 calls with most seeking clarification on aspects of the Provisional Accreditation process. The recent changes to Supervision Requirements, along with logging annual CPD activities using Reflective Statements, have also been high on the agenda of callers. The third category of calls are in relation to extensions, maternity leave and sabbaticals, where callers have wished to discuss the process and their responsibilities as well as ask an Accreditation Liaison Officer (ALO) to update of their records. From discussions with callers, it is clear that the majority have consulted the website and found the information helpful, but have called to seek that extra clarity or reassurance that their interpretation or perception of the information is accurate. Please continue to consult the website as your first point of enquiry and, if you still require further information or clarity, then by all means give us a call. This reduces call times and enables us to answer as many calls as possible in the timeframe available. With the telephone service resuming, the continued availability to contact
CBT Today | September 2015 21
SCHEMA THERAPY UK
Chester Wirral and North East Wales Branch presents
International Certification Training Program in Schema Therapy 2015/16 Presented by
Vartouhi Ohanian Consultant Clinical Psychologist 3rd-5th December 2015 The Basic Model 14th-16th January 2016 The Mode Model: working with different personality disorders including Borderline Personality Disorder 25th-27th February 2016 Mode work with Narcissism The Friends House, 173 Euston Road, London NW1 2BJ To find out more about this Training Program or to apply visit www.schematherapyuk.com
22 CBT Today | September 2015
An Introduction to Dissociative Disorders (and what to do about them) With Mike Lloyd
14 October 2015 9.30am to 4.30pm Chester Rugby Club, Hare Lane, Littleton, Chester CH3 7DB Registration fees BABCP members: ÂŁ65, Non-members: ÂŁ85 Price includes lunch and refreshments. CPD certificates will be issued.
www.babcp.com
CBT Today | September 2015 23
South East Branch
North West Wales Branch
presents
presents www.babcp.com
www.babcp.com
A talk by Dr Charlie Heriot-Maitland to celebrate World Mental Health Awareness Day
Developing a Compassionate Mind in Daily Life Saturday 10 October 2015
CBT for Clinical Perfectionism: A Transdiagnostic Treatment With Professor Roz Shafran
From 7.00pm
Tuesday 24 November 2015
St Julians Club,Rumshott Estate Ltd, St Julians, Sevenoaks, Kent TN15 0RX
9.30am to 5.00pm
Neuadd Reichel, Bangor University, Ffriddoedd Road, Bangor, Gwynedd LL57 2TR
Registration fee: £50 Price includes drinks, canapés and a three-course meal.
Also at St Julians Club, and presented by Dr Charlie Heriot-Maitland
CFT for relating to voices and emotional selves in psychosis
This workshop is aimed at intermediate-advanced cognitivebehaviour therapists. It will provide a cognitive-behavioural analysis of clinical perfectionism and the factors that contribute to its maintenance. Relevant research literature and current evidence-base for interventions will be provided. The majority of the day will be spent on skills for the effective assessment and treatment of clinical perfectionism across disorders within a CBT framework Registration fees Early Bird: for payment received up to 23 October BABCP members: £65, Non-members: £75 Full fee from 24 October BABCP members: £75, Non-members: £85 Price includes lunch and refreshments. CPD certificates will be issued.
Tuesday 24 November 2015 9.30am to 4.30pm Registration fees BABCP members: £50, Non-members: £60 Lunch and refreshments are included. CPD certificates will be issued.
To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com Southern Branch
Yorkshire Branch
presents
presents www.babcp.com
www.babcp.com
ACT for Insomnia With Dr Guy Meadows
Friday 27 November 2015 9.30am to 4.30pm
Solent University Conference Centre, 157-187 Above Bar, Southampton SO14 7NN Topics to be covered: • Introduction to ACT model and its application to chronic insomnia • Discussion and experiential practice of ACT-I skills including acceptance, mindfulness, diffusion, self in context, values and committed action • Application of ACT metaphors to insomnia • Comparison between ACT-I and traditional CBT-I approaches including cognitive restructuring, sleep scheduling, sleep restriction and stimulus control • Introduction to insomnia including common risk factors, triggers and amplifying behaviours • Insomnia assessment protocol-body clock, sleep drive, sleep and wake brain centres • Interaction between sleep disorders and mental and physical health • Opportunity for discussion of personal or patient case studies • Every attendee will take home a workbook outlining the content of the course Registration fees Early Bird: For payments received up to 27 September BABCP members: £75, Non-members: £85, Students: £55* Full fee from 28 September BABCP members: £90, Non-members: £100, Students: £60* *Evidence of status must be provided on application
Mid-morning refreshments and afternoon tea are included. Lunch is not provided. CPD certificates will be issued.
24 CBT Today | September 2015
Managing Chronic Pain: A Practical Skills Workshop on Using CBT for Persistent Pain With Helen Macdonald
Friday 23 October 2015 9.30am to 4.00pm
Yorkshire Sculpture Park, West Bretton, Wakefield WF4 4LG This workshop is aimed at participants who have existing CBT skills, but not necessarily experience in specific work with chronic pain conditions. The workshop may also be useful for people who have experience in persistent pain work, but wish to refresh their knowledge of applying cognitivebehavioural approaches. Registration fees BABCP members: £55 Non-members: £65 Price includes lunch and refreshments. CPD certificates will be issued.
Dialectical Behaviour Therapy Special Interest Group presents
Manchester Branch presents www.babcp.com
www.babcp.com
Radically Open DBT Introductory Workshop With Professor Tom Lynch
Friday 16 October 2015 9.30am to 4.30pm
Effective and efficient treatments of childhood anxiety disorders: Working collaboratively with parents
Centre for Research & Development, Kingsway Hospital, Derby DE22 3LZ
With Professor Cathy Cresswell
Upon completion of this one-day training, participants will be able to:
9.30am to 4.30pm
• Explain a new biosocial theory for OC • Describe the RO-DBT treatment structure • Describe new RO-DBT treatment strategies designed to enhance willingness for self-inquiry and flexible responding • Describe the RO-DBT treatment hierarchy • Describe a novel treatment mechanism positing open expression = trust = social connectedness • List examples of strategies designed to improve pro-social cooperative signalling via activation of the parasympathetic nervous system’s social-safety system
Registration fees BABCP members: £100, Non-members: £130 Price includes refreshments but not lunch. CPD certificates will be issued.
Friday 2 October 2015 Hulme Hall, Oxford Place, Victoria Park, Manchester M14 5RR This workshop will provide an overview of recent developments in parent-led treatments for childhood anxiety disorders based on research within the Anxiety and Depression in Young People (AnDY) research unit at the University of Reading. Given the high frequency of parental anxiety disorders among highly anxious children and various reports of poor child treatment outcomes in this context, particular attention will be paid to case conceptualisation and intervention in the context of parental anxiety disorder. Registration fees BABCP members: £70, Non-members: £85 Lunch and refreshments are included. CPD certificates will be issued.
To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com Irish Association for Behavioural & Cognitive Psychotherapies
North East & Cumbria Branch presents
presents
www.babcp.com
Trauma Focused CBT for Children and Young People with PTSD With David Trickey
Friday 13 November 2015 9.30am to 4.30pm
Breaking Free of OCD without Pain With Professor Paul Salkovskis
The Lancastrian Suite, Lancaster Road, Dunston, Gateshead NE11 9JR Upon completion of this workshop, participants should:
Friday 16 October 2015 9.30am to 5.00pm
Ashling Hotel, Parkgate Street, Dublin 8 In this workshop a multi-stage treatment will be described with the main focus being on providing practical clinical details of cognitive-behavioural treatment as applied to obsessional problems. This training workshop will describe and demonstrate clinical strategies which allow the application of a personalised combination of several components and stages in each patient. Registration fees BABCP members: £90, Non-members: £100 Price includes lunch and refreshments. CPD certificates will be issued.
• Be familiar with and understand the cognitive model of PTSD • Be aware of how children and young people commonly react to traumatic events, (including PTSD) and how the cognitive model can account for these reactions • Have some understanding of how developmental and systematic factors impact on such a model • Understand how to intervene effectively using TF-CBT, taking into account developmental and systemic issues • Be familiar with the evidence supporting TF-CBT for children and young people with PTSD Registration fees BABCP members: £55, Non-members: £65 Price includes handouts, lunch and refreshments. CPD certificates will be issued.
CBT Today | September 2015 25
Couples SIG
Scotland Branch
presents
presents www.babcp.com
Full-day workshops led by Misa Yamanaka Friday 4 December 2015
Comprehensive Clinical Case Conceptualisation and Treatment Planning for Couples Therapy Saturday 5 December 2015
Infertility: Psychological Aspects and Couple-Based Interventions The Royal Foundation of St Katharine, 2 Butcher Row, London E14 8DS
www.babcp.com
Cognitive Therapy for Social Anxiety Disorder in Adults and Adolescents With Professor David M Clark
Thursday 19 & Friday 20 November 2015 9.30am to 4.30pm
Stirling Court Hotel, University of Stirling FK9 4LA Registration fees BABCP members: £180 Non-members: £210
Registration fees for each workshop BABCP Members: £90, Non-members: £110 Students: £75* * Evidence of status must be provided on application
26 CBT Today | September 2015
Price includes lunch and refreshments. CPD certificates will be issued.
CBT Today | September 2015 27
28 CBT Today | September 2015