CBT Today Vol 45 No 3 (Sep 2017)

Volume 45 Number 3 • September 2017

Believing in yourself Also inside - news from the Annual Conference

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

contents

www.babcp.com

Main Feature

Volume 45 Number 3

16 Believing in yourself - Sian Hullah writes about self-efficacy in timefocused therapy

September 2017

Features 11 Harnessing the energy of Third Wave and beyond - Part 1

“

Well conference is over for another year. We've got all the news from Manchester included in this issue, as well as introducing new members of our office team.

With new intakes of students in colleges and universities, it’s a good time to look at our featured article, with Sian Hullah writing about her experience of developing selfefficacy in a university setting.

As always, many thanks go to all our contributors in this issue, which I hope you enjoy reading.

Peter Elliott Managing Editor peter.elliott@babcp.com

”

Contributors Sarah Bateup, Richard Bennett, Deborah Boyle, Rod Holland, Sian Hullah, Fiona Kennedy, Evgenia Kostaki, Michelle Livesey, Jim Lucas, Lucy Maddox, Ann O'Hanlon, David Pearson, Glenn Waller, Chris Williams

12 Positive signs - developing a specialist service for the Deaf community in Northern Ireland by Deborah Boyle 14 Positive wellbeing for mums and mums to be - Alice Dennison talks about running a pilot group for perinatal patients in primary care 19 Guyana Foundation 21 Making mistakes - it's okay, say Jim Lucas and Richard Bennett

News 5

Welcome to new team members

6

Accreditation

8

New tCBT journal Editor-in-Chief

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Long service recognitions, Membership subscriptions, Research project

Conference photos - Justin Jolly & Richard Jolly 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

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 6 November 2017 (for distribution week commencing 1 December 2017)

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

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September 2017

Also in this issue Conference news Jolly good Fellows Conference review, poster awards Excellence awards 20 BABCP and me - Fiona Kennedy 24 IT Blog - Our regular columnist Sarah Bateup looks at the use of avatars in therapy

welcome

President’s message How was it for you?

Were you one of the thousand-plus BABCP members from 24 different countries who came to our annual conference in Manchester? If you did, it was great wasn’t it? Many people have approached the organisers, Board, local branch and BABCP staff to say how much they enjoyed it and how good a place Manchester is for such events.

I’ve sometimes heard in the past the comment that conference is either too academic (too much about theory, models and research) or too practical (too much on practical skills with workshops, practical presentations and audits). Perhaps a conclusion is that when you hear both sets of opinions expressed at the same event as I did, that the balance is probably pretty much right.

for those experiencing shock, loss and distress. The strength in diversity in Manchester really came over also in the welcome from the Manchester branch and in the welcome by Andrew Beck.

Diversity is a hallmark of the community in Manchester - and also in BABCP. In fact I think it’s one of the most valuable things about BABCP. I hope we can be a unifying organisation - one that brings together practitioners and others with an interest in CBT, and how it can aid our understanding and support, of ourselves and others. For those of you who couldn’t attend conference, we worked hard to create some videos of selected keynotes plus some interviews with prominent CBT’ers which will be available in the members’ area of our website over the next few months.

Those attending certainly thought so by investing their time and hard earned CPD monies to come in such numbers. I’ve also sometimes heard it said that the conference is the same every year - with the same old usual suspect speakers. We have discussed these questions and gathered evidence to see if it is true. Interestingly of the 250 people who made verbal presentations during the conference, more than half were presenting at a BABCP conference for the first time, and for many it will probably have been their first conference presentation.

Now conference is over, the aim is to move on to the year ahead. There are lots of exciting local branch events already advertised - the list seems to get longer and longer with great topics and speakers. It was an honour to present the Chester, Wirral and North East Wales branch with its Branch of the Year award - so well deserved. I loved the comment in their citation that people are welcomed with a smile! It sounds like a friendly and welcoming branch to be part of.

Conference brings so many opportunities. One I enjoyed was meeting the Lord Mayor of Manchester, Councillor Eddy Newman. He has had all sorts of things he has been involved in in the past such as his role as a former MEP for Greater Manchester. But nothing could have adequately prepared him for the challenges in his role this year. He described how in the same week he took up the chains of office, the Manchester Arena bombing occurred. He was proud of the response by the various police, fire and ambulance services and he and others talked about how the community spirit in the city had brought people together.

I’m hoping that this year will be the year BABCP builds further on its membership and branches.

Peter Elliott has done sterling work with Ross White and Debbie Thrush as Chair of the Branch Liaison Committee over this last year. Debbie has now passed Branch lead role on to Lisa Williams.

Michelle Livesey has just started as our new Membership and Branch Liaison Manager. Her role is to link to and help support branches and SIGs, and also discover more about how we can help support members and branches in their work. We are also hoping to make it easier for us each to manage our own BABCP membership via our new website, which we hope to launch soon. Do let us know what you like and what you’d like, about the website - what needs changing or adding.

We were able to discuss the work of BABCP members helping as part of that support network

continued overleaf

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

“

We were able to discuss the work of BABCP members helping as part of that support network for those experiencing shock, loss and distress

” September 2017

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welcome President’s message continued Our new re-accreditation process, now on an annual basis and with significant audit is getting started. Similarly, we have now reviewed and streamlined our complaints process – agreed at the AGM, so that we can appropriately point complaints to regulating bodies or large employers such as the NHS in the first instance, whilst still being able to take into account their findings when we come to consider complaints about CBT practice by our accredited members.

In Ireland the Health Minister has committed to statutory regulation of psychotherapy. The Irish branch is involved in discussions concerning this and as an organisation we are keen to support this.

One consequence of this change is that it is possible that when statutory regulation is available in Ireland some might not see the need to be members. They may find that having paid for their regulation, they think hard about being a member of BABCP if accreditation is no longer offered.

This same truth might apply if in the UK statutory regulation was to occur. I suspect with Brexit other priorities will be the focus.

However the structures are in place via HCPC where regulation could occur by a simple order of council within Parliament.

Might this happen? Should be actively lobby for this? Mental health is most definitely on the government agenda just now. There seems a recognition than mental health and wellbeing has been short served compared to physical health

care across the four home nations. Perhaps now is the time to focus on advocating statutory regulation in possible partnership with other psychotherapy organisations. But why would we? Surely with over 50% of our members now accredited such a move would potentially damaging to BABCP? Surely some who are accredited might not remain as members?

That is true. However there are other truths.

Firstly we should be confident enough that we have an organisation worth joining regardless. As such we need to make sure we offer a great place to be at a reasonable cost (hence the choice not to increase member fees last year, and to have a lower than inflation rate rise this year). But some would leave I am sure.

Even so, the main reason I personally support statutory regulation is that currently we accredit our accredited members only. But the sad fact is you don’t need to be accredited to advertise and practice as a psychotherapist or counsellor.

Our accreditation process is a clear quality mark that those accredited have undergone a credible training, and are committed to ongoing CPD and supervision. However, many hundreds and probably thousands of self-declared CBT therapists and counsellors will continue to practice at present with no such accreditation or external regulation. Going back to first principles, BABCP is a charity.

Our purpose is to both promote CBT but also serve a public interest role.

For me, perhaps the primary public interest role we could serve over the next years is to promote statutory regulation – even if in some ways this also offers a threat to us as an organisation in terms of size and income. But it’s a judgement and decision to make. It’s one of the reasons I also think we should aim to generally minimise future membership fee rises and look to increase efficiencies within the organisation. To do that we need to decide what our primary purposes are – and not perhaps plan to get bigger and bigger, and costlier and costlier as some other large organisations have sadly discovered recently. To me this is pertinent as some within BABCP wish us to develop into a profession - representing a new profession of CBT psychotherapists. All that is possible. But would we want to pay (literally) for that? Also with accreditation so popular and respected, would there be any advantage?

What are your thoughts? Do let us as a Board know.

Finally, welcome to Paul Salkovskis as President–Elect. Also Rita Woo joining the Board. Thanks also to Steve Flatt who came to the end of his term as a Trustee. Debbie Thrush (Branch Liaison Committee), Gill Haddock (Course Accreditation) and Amanda Cole (Accreditation) have also stepped down from their respective committee chair positions. Thank you all.

Chris Williams, BABCP President

Branch of the Year The Neil Harmer Award for Branch Excellence was awarded at this year’s AGM to the Chester, Wirral and North East Wales Branch.

Corinne Barrow (pictured) was invited to accept the award on behalf of the branch from Chris Williams in Manchester.

The award is voted for by members of the Branch Liaison Committee each year, and is recognition of the branch’s work in continuing to provide their members with a range of relevant, high-quality and affordable CPD events, with strong positive relationships within the branch being a cornerstone of their longstanding success since being formed more than 20 years ago.

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September 2017

News

Welcome Lucy and Michelle We have had two new additions to our office staff since the last issue of CBT Today.

Dr Lucy Maddox joins us as Senior Clinical Advisor and Michelle Livesey is our new Membership and Branch Liaison Manager.

As Senior Clinical Advisor, Lucy’s new part-time role aims to help boost public engagement with and understanding of CBT and the BABCP. Lucy trained as a clinical psychologist at UCL and has spent most of her qualified career working in NHS settings with children, young people and families.

She is a BABCP accredited practitioner, trainer and supervisor and also works part-time in a clinical role for Action for Children as well as writing for various publications.

Before taking up her post Lucy’s most recent clinical role was as consultant clinical psychologist for an adolescent inpatient unit in Bristol. Prior to this she worked in a range of child and adolescent services at South London and Maudsley NHS Trust, as a lecturer on child development for Anna Freud Centre, and as a practice tutor for the child IAPT course at the Institute of Psychiatry, Psychology and Neuroscience. Lucy has a longstanding passion for the communication of psychological ideas and has written for a range of publications including The Guardian, Huffington Post, The Times and Mosaic. She is a visiting lecturer on science communication at UCL and was a British Science Association Media Fellow in 2013. She is looking forward to sharing ideas about CBT with a wider audience and encouraging debate and discussion with other therapeutic modalities.

Lucy says:“I am really pleased to have taken up this new role for BABCP. I have used CBT alongside other therapeutic approaches for several years and in several settings with children and adolescents. I am looking forward to thinking with BABCP staff, members and service users about how we can best share ideas about CBT and help the wider public understand what it is and what it can be helpful for.

“As part of this new role I am working with Peter Elliott, Communications Officer and Editor of CBT Today, to create two lists: one ‘media-friendly’ members list, of BABCP members who would like to be able to speak to the media about their areas of special interest when enquiries come in, and one list of BABCP members who are happy to be notified of consultations which the BABCP sometimes get informed about, e.g. NICE guidelines or working groups on specific areas of clinical practice or research. If you are interested in being on either list, or indeed both lists, please email media@babcp.com and ask for a form to give your details.

“I am also looking at the resources which are available on the website both for therapists and for people looking for CBT self-help resources. If there are links you think should be added or if there are areas you think should be represented feel free to get in touch and let me know. This is a new role and there is a real opportunity for it to be shaped into what is most useful for the organisation. If you have particular ideas about areas of public engagement and wider communication that you think would be good for BABCP to think about please get in touch at lucy.maddox@babcp.com.”

Michelle fills a new position as Membership and Branch Liaison Manager, with responsibility for managing the membership team in the office, as well as co-ordinating the Branches and Special Interest Groups.

She previously worked at the University of Salford Students’ Union, an organisation representing the interests of more than 19,000 members. She spent ten years working across a variety of roles covering areas such as membership support, governance and HR, reporting to a Trustee Board and elected representatives.

Michelle says:“I’m excited to be taking on this new role within BABCP, as the organisation looks to develop its profile and build on its recent membership growth record. My role will form part of the senior management team at Head Office with responsibility for the membership team, providing support to the Branches and SIGs, CPD events and overall to drive and develop the membership journey for all those involved in BABCP. “Everyone has been very welcoming so far and I look forward to working with them to ensure that the BABCP community continues to carry out its great work promoting the interests of CBT”.

in brief...

The future of mental health care in Ireland The Irish Government (Dáil) have agreed to establish a new Joint Committee on the Future of Mental Health Care, with the intention of aiming to achieve crossparty agreement on the implementation of a single, long-term vision for mental health care and the direction of mental health policy in Ireland.

In announcing the establishment of the new Committee, the Minister for Mental Health and Older People, Mr Jim Daly TD, said:“This is good news for all those with an interest in how we further develop and implement our mental health services.

“At this time with our ten year policy ‘A Vision for Change’ being reviewed, it is very timely that our parliamentarians will have the opportunity to play their part in feeding into the future policy direction in this area.

“I am keen that the Committee should also have a say on the significant challenges we face in the recruitment and retention of skilled mental health professionals.

“This is a problem to which there is no off the shelf solution so the Committee’s views on this will be very welcome”.

The Committee will make its final report by the end of October 2018.

Lucy

Michelle September 2017

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accreditation

Accreditation Reaccreditation changes update The information here is provided to keep everyone up to date with the changes in the Reaccreditation process so far.

The initial plan was for a name change from re-accreditation to MQSP (Maintaining Quality and Standards of Practice).

This has now become ‘Reaccreditation’ as a stand-alone title - although the process is still designed to assist practitioners to maintain quality and standards of practice.

BABCP President Chris Williams explains the rationale for the name change:“As part of our goal to have simpler and widely understood terminology, we are continuing to use the term Reaccreditation to describe this process.

“The aim of Reaccreditation is to support practitioners maintain quality and standards of their practice”.

Old process

New process

Five year process

Annual process

Paper applications

Online declaration

Submission of five years’ documents at application

Documents relating to previous 12 months only submitted if selected for a random audit

Certificate of five year reaccreditation issued

Reaccreditation now verified via online CBT Register UK

Rationale for the change • Less onerous • Greater emphasis on practitioners becoming more self- accountable for maintaining the quality and standards of their practice • In line with other professional bodies The new process is planned for launch late in 2017. All members will be kept updated, and Accredited members will retain their accreditation throughout the change of process.

• Extensions can be requested through the ALOs • Members must be in practice at the time of making the declaration • The audit will be carried out at random members may not be selected for several years, or could be selected two years in succession • No invitations until at least one year after the first declaration • Online submission of documents anticipated • If auditors are not satisfied with the findings of any audit, they will give members a time period in which to produce additional information Audit Documents for Practitioner Accreditation • CPD evidence for audit - log of CPD • Evidence of CPD eg certificates, Reflective Statements - optional • Collaborative Supervision Summary • Log of supervision sessions • Supervisors report - no change Supervisor and/or Trainer Accreditation Audit Documents • CPD evidence for audit – include S/T CPD in the CPD log • Collaborative Supervision Summary • Log of supervision sessions (label which kind of supervision received eg Supervisory/Trainer) • Supervisors report - clinical supervisors report as well as supervisory and/or Training supervisor report • Supervisee feedback forms • Training evaluation forms Record Keeping The onus is on the practitioners to keep their own records of their CPD and supervision.

The online Declaration will be as follows; ‘As a member of the BABCP I abide by the Standards of Conduct, Performance and Ethics. I am currently in CBT clinical practice in the UK or its territories and I have fulfilled the required standards for CBT clinical practice; CBT supervision and CBT Continuing Professional Development’.

This will be similar for Supervisor and Trainer Accreditation and the CCID declaration (Criminal, Civil, Investigatory and Disciplinary Declarations).

BABCP will supply optional documents and the forms will be supplied for submission at audit.

Please use current forms for now.

Self-removal from ‘The CBT Register UK’ Members will have opted for this if:

How will the online declaration work?

• An email invitation will be sent to make the online declaration one month prior to the anniversary of the last accreditation • If the declaration has not been made after one month, a further email prompt will be sent • Further attempts will be made by the Accreditation team to ensure the declaration is made • There is a two-month window in which to make the declaration – it is not accessible outside this period 6

September 2017

• They fail to make the online declaration after several prompts from BABCP • There is evidence of inaccurate declarations or false statements • Submissions at audit are unsatisfactory and not rectified within time frame given by auditors

New Reaccreditation requirements CPD requirements remain the same but Reflective Statements are now optional Supervision requirements remain the same but live element ‘’highly recommended’’ Reaccreditation fees Annual fee will be paid on anniversary of last award £30 annual accreditation maintenance fee (remains the same) The £72 five-yearly re-accreditation fee replaced by £15 annual fee so £30 plus £15 is now a total of £45 per year.

BABCP Accreditation Certificates update As previously explained in CBT Today February edition, the changes in reaccreditation to an annual online process mean that we also need to change the process of issuing certificates.

• As of May 2017, no further re-accreditation certificates have been issued.

• Only Full Accreditation certificates will now be issued, stating the date of accreditation award.

• An online Accreditation Check on the CBT UK Register on the BABCP website is now the only recommended means of verifying accreditation. A certificate does not denote current accreditation status However, following feedback from members, we are now able to offer the purchase of a certificate to all Accredited members who wish to have a certificate to display, stating the date Full Accreditation was originally awarded.

• There will be a £10 fee for the provision of this certificate.

• Supervisor and Trainer Accreditation certificates will also be available, again indicating the date that the Accreditation was awarded.

• All certificates will indicate that current accreditation status can only be verified through an online CBT Register UK check, and will make it clear that the certificate does not denote current accreditation status.

If you have a query about any aspect of the accreditation process, please email accreditation@babcp.com Best wishes The Accreditation Team September 2017

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New Editor-in-Chief of tCBT journal Dr Richard Thwaites is a Cognitive Behaviour Therapist and consultant clinical psychologist working in Cumbria.

He is currently Clinical Director of a large IAPT adult service and is involved in research into both anxiety disorders and training methods such as Self-Practice/Self-Reflection. He recently co-authored the first published SP/SR manual Experiencing CBT from the Inside Out: A Self-Practice/Self-Reflection Workbook for Therapists and a book detailing the various roles of reflection in the world of CBT from training to therapy and supervision Reflection in CBT.

Why are you a CBT therapist rather than practicing another form of therapy?

Although as a clinical psychologist, I initially received training in a range of therapies, CBT always made most sense to me and I went on to train as a CBT therapist as soon as I could. As a clinician I feel a strong sense of duty to provide treatments with the strongest evidence-base as a first line treatment, and in my area of interest (anxiety disorders) this is usually CBT in some form. I also really enjoy the collaborative style of working that CBT involves; there is a strong fit there with my personal style.

What developments in the world of CBT are currently exciting you?

I am currently involved in a research programme led by Professor Mark Freeston (in collaboration with global colleagues) looking at the role of intolerance of uncertainty across a full range of disorders and trying to understand to what extent this differs from actual perceived threat. It is still relatively new work in CBT terms but I find it really interesting to consider when working with patients with anxiety disorders even when delivering ‘standard’ CBT.

What do you think are the main challenges facing CBT? CBT has developed a strong evidence-base across a wide range of patient groups and disorders. However, this brings with it a range of challenges. Firstly, there is an ethical and global argument for

thinking about how we can deliver evidence-based therapy most cost-effectively, for example in developing countries where health funding can be significantly lower than average and scalability is much needed, secondly we need to better understand the mechanisms of change in CBT and thirdly we need to understand why some people (significant numbers of people) don’t benefit from CBT and whether we can improve or further develop our interventions.

What do you think is distinctive about tCBT as a journal?

Most CBT practitioners are incredibly busy and can struggle to keep on top of the latest research even when they are really keen to base their practice on evidence. tCBT is very much a practitioner journal and I would hope that we can get to the point where for busy CBT therapists in clinical practice, if they only have time to browse one journal – then it would be this one. Whilst it covers all patient groups, the aim is that every article will cause the reader to stop and reflect, and think about their own practice and what potential implications this might have for them and their patients.

The online nature of tCBT means that articles can be published as soon as accepted and also that there are less limits in terms of word counts and numbers of articles. We are in a position to publish innovative work, clinical reviews and what I would see as ‘clinical wisdom articles’ (such as the great piece by Murray, Merritt & Grey in 2015 on how to maximise clinical benefit of trauma site visits when delivering trauma-focussed CBT). While some readers want case studies or research studies, others just want to know what best practice is with relation to specific aspect of CBT interventions or supervision. The ultimate test of success will be whether the articles we publish leads to readers (including myself ) changing our clinical, supervisory or training practice! tCBT is published by Cambridge University Press on behalf of BABCP. You can follow updates on Twitter @TheCBTJournal This article originally appeared online at blog.journals.cambridge.org and is reproduced with kind permission of Dr Thwaites and CUP.

Jo Stace It is with deep sadness that we announce the passing of our friend Jo Stace on 29 July. Jo was Chair of the North East and Cumbria Branch and worked in the NHS as a Clinical Psychologist specialising in CBT for nearly 20 years before leaving to pursue her own endeavours with much success. Jo was a highly-skilled therapist, trainer and supervisor who had compassion and empathy in abundance.

Anyone who met Jo would know what we mean by saying she was always authentic in her approach whether it was Jo the clinician or colleague or friend, the person you met was always Jo. She had a passion for training and supervision and developing the skills of other clinicians and was a very active member of the Supervision SIG. She will be sadly missed by her friends and colleagues and our deepest sympathies go to her parents and sister.

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news

Stress in IAPT therapists: a research project Long service recognitions We said a fond farewell to two longstanding volunteer committee members at the Annual Conference. Gill Haddock and Mandy Cole had chaired the Course Accreditation and Practitioner Accreditation committees respectively.

Gill was a founder member of the BABCP Training Working Party which led to the development of the Minimum Training Standards for CBT Practitioners and then went on to develop a process for course accreditation. She became the first chair of the Course Accreditation Committee in 2002 and as part of the Workforce Development Group in 2006, was also instrumental in developing the accreditation process for the new IAPT courses.

Gill also served BABCP in other roles as well. She was the first BABCP President in 1999/2000 and has also served on the Scientific committee.

Amanda, or Mandy as she is more commonly known, joined BABCP in 1975 – and since then has made an outstanding contribution to the organisation in a variety of roles.

In 1992 BABCP took the decision to establish an Accreditation and Registration sub-committee with Mandy taking over the Chair role the following year and has served to the present day. Mandy’s contribution to the organisation was formally recognised in 2011 when she became the first woman to be awarded an Honorary Fellowship.

Over the years, there have been a number of developments of accreditation services – for which Mandy either directed progress personally, or to which she made significant contribution.

Everyone at BABCP wishes Gill and Mandy the very best!

As we know, IAPT therapists form a relatively new workforce recruited and trained to deliver psychological interventions to individuals with mild to moderate mental health difficulties in high-volume environments. Working as a trainee or qualified therapist can be a demanding and stressful role. Work-related stressors have been linked to physical illness and psychological difficulties and the cost of stress related illness is considerable. Self-compassion, which relates to kindness and care to one’s suffering, can offer a way to navigate difficult experiences and has been linked to psychological wellbeing.

For my Doctoral thesis in Clinical Psychology at the University of Essex, I am conducting an anonymous online study exploring factors associated with perceived stress in IAPT therapists. The term therapist is used broadly and encompasses trainee and qualified staff having clinical contact. The study is made up of four questionnaires relating to stress, work-related potential stressors, self-compassion and demographic information. The questionnaires take approximately 10-20 minutes to complete.

The work is supervised by Drs Leanne Andrews and Syd Hiskey and we hope will be used as further evidence to consider the impact upon therapists as they work in potentially highly stressful environments.

If you are an IAPT therapist and would like to consider taking part in the study please go to: https://essex.eu.qualtrics.com/jfe/form/SV_8iUk9SM5JOn4k9T Many thanks, Evgenia Kostaki ekostab@essex.ac.uk

Membership subscriptions 2017/18 At the recent AGM in Manchester, it was agreed to raise the full membership subscription rate by £1 per annum, with all other categories to be raised by 1.35%.

The rates for 2017/18 memberships are listed below and are effective for new and renewed memberships between 1 October 2017 and 30 September 2018.

Annual Payment UK & Ireland

Overseas

Ordinary Member Paid by Direct Debit

£74.50

£82.50

Ordinary Member Paid by Cheque/Card

£82.50

£90.50

Ordinary Member Reduced Rate* Paid by Direct Debit

£44.10

£52.20

Ordinary Member Reduced Rate* Paid by Cheque/Card

£52.20

£59.50

Associate Member** Subscription by Direct Debit

£20.25

£28.40

Associate Member** Subscription by Cheque/Card

£28.40

£36.50

Student Member*** Subscription by Direct Debit

£25.30

£33.50

Student Member*** Subscription by Cheque/Card

£33.50

£41.60

* The reduced rate is available to those Members who can demonstrate that they have a gross income of less than £21,692.00 per annum ** Associate Membership is aimed at retired CBT practitioners and applicants from developing countries *** Student Membership is aimed at those in full-time Higher Education and IAPT trainees

September 2017

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annual Conference

Jolly good Fellows At the Annual Conference welcome reception in Manchester, President Chris Williams announced this year’s recipient of the Honorary Fellowship in recognition of distinguished service to the Association and the CBT community as a whole.

Dr Christine A Padesky is awarded an Honorary Fellowship of the Association in recognition of her outstanding contribution to Cognitive Behavioural Therapy at an International level. The award also recognised Christine’s longstanding support to BABCP and the UK for more than three decades.

Christine has worked as a cognitive therapist since 1978 and was co-founder, together with Kathleen A Mooney, PhD of the Center for Cognitive Therapy in California which many BABCP members have visited and received their training. Christine first supported BABCP (or BABP as it was then) back in 1988 when we hosted the World Congress of Behaviour Therapy and she was supporting Aaron T Beck in one of the Pre-Congress Workshops. Dr Beck’s sudden illness meant that Christine who at that time was relatively little known in the UK had to step in and run the workshop on her own. The workshop received widespread acclaim and since that time Christine has returned to the UK on many occasions to present workshops and keynote addresses at our Annual conferences in London in 1993, Warwick in 2002 and more recently in Belfast in 2016. Christine has also contributed to many local branch meetings and thousands of UK therapists have benefited from the masterclasses, boot camps and other training that Christine has run and which has helped spread the popularity of CBT in the UK. In 2002 BABCP named Christine as the ‘Most Influential International Female Cognitive Behavioural Therapy Researcher/Practitioner’ and her best-selling book Mind Over Mood: Change How You Feel by Changing the Way You Think as the most influential cognitive therapy book of all time. The award of an Honorary Fellowship confirms the appreciation that BABCP has for Christine, her work and her collaboration with and warmth to BABCP and its members over the past three decades.

This year BABCP also bestowed Fellowships to the following recipients: Dr Gráinne Fadden has been at the forefront of the development and implementation of Family Interventions for more than 30 years. Some of her initial work highlighted the impact of experiencing mental health difficulties on family members at a time when this was overlooked and instead families were often blamed for their relative’s relapse. Since then, she has worked tirelessly to promote and implement family work in routine clinical practice, not only in the UK but internationally.

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Gráinne established and is the Director of the internationally-renowned Meriden Family Programme which has trained more than 5,500 people in Family Interventions. The Meriden Programme has been pivotal in achieving the ambition to improve access to evidence-based psychological therapies for those with psychosis and their families living in the UK, and the programme has been mirrored in other countries around the world, including Japan, Canada, Australia and Uganda.

Although Gráinne is renowned for her training role, her focus on the implementation of family work goes far beyond this and spans a wide range of activities including clinical practice, research, writing books and book chapters and, more recently strategic work to influence organisational change.

She is routinely consulted by the Department of Health and NHS England on matters to do with the implementation of psychological therapies for psychosis. In short, Gráinne has gained the reputation as a world expert and leader in this field. This is demonstrated by the number of awards she has won over the years including the Health Service Journal national award for Mental Health Innovation in 2008 and the prestigious Marsh Award in 2009, a lifetime achievement award for her outstanding contribution to mental health.

Dr Shamil Wanigaratne has worked as a psychologist in the field of addictions and sexual health for thirty years. Throughout this time he has applied, researched and developed novel applications of CBT principles to the compassionate care and support of some of the most marginalised and stigmatised client groups.

He was lead author on the first UK manual of an applied relapse prevention programme for substance misuse based on the work of Alan Marlatt and colleagues. This book has been hugely influential in this country and is in its seventh print.

Although not a feature of this book, he shared an interest with Alan Marlatt in Buddhism and was an early adopter of mindfulness-based practice into clinical work. These ideas provided a basis for the development of a more recent book, expanded to consider a more general CBT approach to addiction, written with his Maudsley colleagues and published in 2010.

Dr Wanigaratne’s contributions to sexual health and in particular the prevention and management of HIV should also be noted. He was part of the Genito-Urinary Medicine team at the Middlesex Hospital in London which pioneered and evaluated

feature psychosocial approaches to HIV counselling, loss and bereavement and safer sex. This group was at the front line of the emerging AIDS crisis and their work has been used to set both national and international standards of care.

Dr Wanigartane has made significant research contributions in the area of applied clinical work and has taught and supported many students and colleagues in their careers.

Professor Sarah Corrie has consistently demonstrated that she is a CBT therapist, supervisor and trainer of outstanding integrity, ability, commitment and dedication. Her contributions to the advancement of CBT theory and evidence-based practice include delivery of therapy, development and provision of trainings in CBT, clinical supervision, authorship of papers, several well-received books and contributions to BABCP itself.

Specifically, as a CBT trainer, she has been recognised as contributing to a high quality learning environment, with consistently positive feedback about the CBT trainings she has developed and delivered, and specifically her leadership and ability to nurture students. As noted by the External Examiner of the Level 2 accredited CBT programme she leads, she is ‘Outstanding’ in this role. Feedback from the course accreditation visit panel also described a very well designed and run programme, and included that students felt privileged to train on the course.

As current Deputy Chair of the Course Accreditation committee, she has chaired committee meetings and course accreditation visit panels on numerous occasions, and has contributed actively to enhancing the service provided by BABCP course accreditation. She has also been closely involved in the development of a new course accreditation process for post-qualification training in Behavioural Couples Therapy, which is a new development in recognising evidence-based CBT training and practice.This is in addition to supporting other committee activities, which she has done since becoming a panel member when the IAPT programme was instigated; and this led to her being invited to join the committee in 2013, becoming Deputy Chair two years later, and now Chair.

In addition, Professor Corrie is known to be diplomatic, calm and patient, with a quality of interpersonal relationships and leadership skills which make her a valuable advocate for CBT in general and BABCP in particular.

Harnessing the energy of the Third Wave and beyond Part I In the first of a two-part series, Fiona Kennedy and David Pearson discuss the rationale for integrating CBT and ‘Third Wave’ therapies, presenting CBT Plus (CBT+), an approach combining CBT, ACT, DBT and CFT. This will be illustrated in the next issue by using a case study from the self-help book Get Your Life Back: The Most Effective Therapies For a Better You which can also be used as a guide by therapists and helpers.

What can we gain from integrating therapies?

A ‘radical behavioural’ perspective (understanding learning and how to change human behaviour) underlies ACT, DBT and CBT and is compatible with CFT. CFT brings the richness of an evolutionary understanding of human behaviour, emphasising attachment, acquisition and survival drives. It also emphasises compassion in our relationships with ourselves and others.These themes can be found in the other ‘Third Wave’ approaches too.

Mindfulness permeates all of these therapies. It is a powerful way to enable us to accept the difficult emotions, sensations and thoughts, which we naturally tend to avoid. ACT adds RFT (Relational Frame Theory), a behavioural account of human language which can add to the insights into cognition offered by CBT. DBT emphasises working with challenging presentations and explicit skills teaching. Both ACT and DBT are explicitly ‘contextual’, finding meaning only when the context of an individual or a problem are taken into account.

Soup not salad Many of us go on courses and absorb new theory and practical skills. We then go on to use them in our therapy work, as of course anyone would. No one therapeutic approach has all the answers. Different approaches have been developed for different presentations, for example ‘standard’ CBT may work better for anxiety, depression and Type 1 trauma, needing adaptation for personality disorders, eating disorders and complex trauma.

We have a duty to our clients to deliver the best possible interventions, wherever they come from. But the way in which we use our knowledge and skills could be in danger of being described as a pick ’n mix or salad bar approach.

The problem is that we may not have thought through why and how we make choices as to what to do from moment to moment in our work. It’s better to have a thought through, consistent approach than an ad hoc, reactive one, so we felt it was a good thing to take time and effort to think this through. We’re making soup, not salad, choosing and blending ingredients to make a satisfying dish.

Starting from first principles, the theory should be clear and the processes which occur during therapy should be clear too.

What does CBT+ look like?

We can use the acronym NAVIGATE as a shorthand for the core processes which need to occur in therapy and as a way to help the therapist navigate their way through therapy from start to finish.

Core processes N Name the problem behaviour(s), work towards doing this without judgements A be Aware of thoughts, feelings, body sensations and behaviour and of the word around you V Values - clarify your values I Identify the function of the behaviour and plan to do something different G Goals -set some small goals to move towards your values A Accept yourself and others, validate and be compassionate T Tackle Trauma E Emotions and Exposure - learn to identify, experience and regulate emotions S Skills training - learn to handle thoughts, urges, flashbacks, images, etc Each step in the table will be illustrated using a case study which will appear in the December issue of CBT Today.

September 2017 11

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Positive signs Deborah Boyle is a Clinical Nurse Specialist in the Northern Ireland Mental Health Service for Deaf People (NIMHSDP), where she helped in developing and maintaining a specialist mental health service in relation to the Deaf community, providing support using British Sign Language (BSL).

This includes knowledge of the client’s culture and norms, their language, common life experiences which can differ significantly from that of the hearing population, the relationship dynamics between Deaf/hearing people, and the strengths and special issues of Deaf people. Achieving this knowledge is often only obtained by being immersed in the Deaf cultural world with its unique social, educational and political constructs.

I qualified as a RMN in 1989 and gained experience working in several areas in mental health care. I was appointed to my current role in 2007 and I attained a qualification in Cognitive Behavioural Therapeutic Approaches to Care in 2010, achieving full BABCP Accreditation in 2013.

Having gained a sound knowledge and level of expertise in Mental Health and Deafness, and a solid grounding in CBT, I decided in consultation with my two supervisors in CBT and the Deafness service, to combine the two strands together and establish and develop a specialist CBT service for this cultural and linguistic minority group. This decision was influenced firstly by the fact d/Deaf* people have historically been underserved in many health services, particularly Mental Health services, and also, to my knowledge no specialist CBT service existed in Northern Ireland for this population.

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Providing therapy to profoundly Deaf clients whose preferred communication mode is sign, places many demands on a hearing therapist

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12 September 2017

In the hearing world, copious amounts of research, psychoeducation materials and other resources exist to inform, aid practice and enhance patient outcomes. Frustratingly, the therapist working in this field is faced with a dearth of these. The therapist is called upon to be highly creative, and needs to be skilled in adapting mainstream materials and tools to a valid and reliable deaf friendly modality, for example, outcome measures and visual rather than written materials. This can be time consuming.

Secondly because, if seen at all, Deaf people were being assessed and treated by professionals and therapists - who through no fault of their own were unfamiliar, unsure and limited in the necessary information and sign language skills to provide a culturally infused approach to therapy.

Potentially this could result in poor conceptualisation, misdiagnosis/wrong diagnosis and inappropriate treatment.

Furthermore, as previously stated, the life experiences and parameters of a Deaf person can be significantly different to that of a hearing person. Coupled with a lack of ambient information, which hearing people take for granted, Deaf people starved of this information are often unfamiliar with basic psychological terms and concepts such as ‘emotions’ or ‘therapy’. Again this requires the therapist to be cognisant of and skilled in translating these terms and concepts for the client, for example by using art or narrative techniques.

Borne out of my experiences to date, I decided to share a few of my observations in relation to this area, in the hope that other professionals who may come across a Deaf client in the scope of their practice, may benefit.

Working with interpreters is another area in which the therapist must be skilled. In each session, for therapeutic continuity and consistency, it is important to be able to offer the same interpreter who will have developed a matched language with the client. As fewer interpreters who possess this ability decide to practice in the arena of mental health, this does contribute to numerous considerations having to be made, such as preference of interpreter, time, date, and venue which will suit all parties, as well as travel to

Providing therapy to profoundly Deaf clients whose preferred communication mode is sign, places many demands on a hearing therapist. It is not just a matter of the client not hearing or not being able to communicate and therefore using an interpreter.

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annual Conference remote parts of the country. The benefits however of using an interpreter and the value of the observations they make cannot be underestimated in influencing and determining the therapeutic pitch.

The therapist must also be aware of the triad that the inclusion of an interpreter creates. Regular pre and post session meetings for preparation and debriefing are invaluable to address any difficulties or uncertainties with the client’s communication.

Accessing appropriate CPD, peer support and clinical supervision can be another challenge faced by the therapist. In a recent article it was identified there are approximately only 30 therapists throughout the UK practising in this highly specialised area of psychological interventions. This can result in the therapist regularly working in isolation, often struggling to find a supervisor with the necessary knowledge and skills, and having to travel long distances to attend workshops and conferences, if held at all.

conference review

In conclusion, as previously stated it is important when meeting a Deaf client to remember that it is not just a matter of the person not hearing. That in fact, when assessing and undertaking therapy with a Deaf person there are many important issues to consider, that shared life concepts may in fact may be radically different for a Deaf person than for those of the hearing therapist.

Consideration of language deprivation or dysfluency does not mean that the person is not intellectually or psychologically unsuitable for therapy, rather, the therapist must either be proficient in the language, or have a close therapeutic alliance with the interpreter, as well as being creative and skilled in adaption. As is often the expectation of hearing therapists, who lack awareness, understanding and knowledge, it is certainly not the responsibility of the Deaf client to try to adapt and match the therapist’s communication and language needs, for example by lip reading, or passing written messages back and forth.

As a result, the therapist can expect therapy to be longer in duration, slower in pace and not without challenges. *The convention ‘Deaf’ is used to denote those who are born Deaf and see themselves as part of a Deaf community and ‘deaf’ for those who have acquired deafness and mainly use oral means of communication.

Those members who were at Manchester in July will know that we had a great conference, with minimal Manchester weather. While it is tempting to list the names of all the splendid speakers and presenters, there are just too many to do justice to them all.

There were a set of extremely well received pre-conference workshops (I learned lots of important tricks from Helen Kennerley's CBT basics workshop), other personal favourite keynotes were Peter de Jong, Steve Kellett, Sarah Halligan and Lars Öst, but my frustrations were that everyone who went to other keynotes told me that I had missed something great (Rachel Calam's presentation for example).

The scientific and clinical quality of the symposia, short papers and posters was very high, too. In short, there was too much to see everything that one would want to see - but better than the other way round. Social events were many and varied, but it was particularly good to see Manchester Town Hall before the forthcoming closure for refurbishment. We were also treated to a wonderful evening of music and partying with a performance from Bedlam (pictured above), the 15-piece band led by David Veale, featuring several other BABCP members.

Thanks to EYAS, Janine Turner, the Scientific Committee, Rod Holland, and also the BABCP Manchester Branch as well as other members in the north west, whose support was excellent. This was reinforced by Manchester Branch Chair Lisa Smart’s welcome to the conference and Andrew Beck’s response to the Lord Mayor’s welcome at City Hall.

We look forward to seeing everyone in Glasgow next year!

Glenn Waller, Co-Chair Scientific Committee September 2017 13

Positive wellbeing for mums and mums to be Perinatal mental health has always been an area which has required somewhat specialist attention.

Such a mix of emotions is reported by new mums and mums to be; joy, excitement, anticipation, happiness. However, there is another range of emotions such as sadness, fear, anger, frustration which is not often reported but is so often the norm for so many perinatal women.

In response to our ‘Being with mother’ feature in the last issue of CBT Today, trainee CBT therapist Alice Dennison tells readers of her experience in running a pilot group for perinatal patients in primary care

Supporting perinatal patients is extremely important as there are two individuals at stake with regards to wellbeing. Developing a secure attachment early on between mother and baby is critical for the mother’s wellbeing and the child’s cognitive and emotional development.

The Five Year Forward Plan for Mental Health states,“One in five mothers suffers from depression, anxiety or in some cases psychosis during pregnancy or in the first year after childbirth. Suicide is the second leading cause of maternal death, after cardiovascular disease.”

The Plan proposes an increase in access to specialist perinatal services across the country with greater emphasis on perinatal patients receiving psychological support. Often the criteria for tertiary services are strict and reserved for severe cases. So who is filling the gap?

Currently, nine out of 10 adults with mental health problems are supported within primary care services. With this being the case, it is common that perinatal clients enter primary care services struggling with mild to moderate mental health problems. Already many services have set about trying to accommodate this demand by prioritising perinatal patients for treatment in line with the NICE guidelines. However, in reality, this can be a struggle due to high demand on services and long waiting lists.

In response to this, myself and a team of counsellors, CBT therapists and psychologists set about developing a group to support new mums and mums to be. After much

September 2017

research, the group was based on CBT principles and compassion focussed therapy which has a strong evidence base in terms of treating perinatal mental health problems. Furthermore, there have been recent studies showing the benefits of conducting group therapy sessions for perinatal patients.

The group was named ‘Positive wellbeing for new Mums and Mums to be’. The ethos of the group was focussing on the mother’s wellbeing in order to help promote the development of a secure attachment between mother and baby. The group took a holistic stance rather than focussing on one particular disorder.

An eight week course was produced and incorporated a number of different areas. The group was facilitated by myself and my counselling colleague and ran on a weekly basis. Each session was an hour and a half long during school hours.

We did not allow babies into the group but ran the group at a venue where a crèche facility was provided. This allowed the focus of the sessions to be on the mother’s wellbeing and helped with regards to group dynamics. Weekly supervision was provided to the facilitators by a counselling supervisor within the team.

Recruitment for the group was tricky. We had aimed to have 10 women signed up but unfortunately only had five with one dropping out after the first session. We allowed women into the group who were 12 weeks pregnant or 12 weeks postpartum. Group members had an initial screening appointment to assess suitability for the group as it was important to asses a patient’s ability to hold and contain their emotion within a group environment. Participants completed the Edinburgh Post Natal Depression (EPND) scale at the start at the end of the course. They also completed the PHQ-9 and GAD-7 each week in line with our service requirements.

With regards to format of the group, the first session focussed on creating a group contract to help ensue boundaries and ensure that the group felt safe and secure. We also explored expectations and what patients wanted to gain from attending.

At the start and end of each session we conducted a mindfulness exercise which helped attendees focus on the present within the session. The next two sessions focussed on CBT skills for depression and anxiety. We tried to be creative in the delivery of these sessions. For example, we asked attendees to draw what anxiety meant to them and the impact this had on them as a mum. We found that this approach really helped generate group discussion and the women were all really keen to engage. It also helped ensure that content was relevant to the challenges faced by perinatal women.

feature Following this, we looked at confidence and the affect motherhood can have on this. We then moved onto do a session on grounding and self-soothing techniques. Next, we did sessions on the birthing experience and attachment. These sessions were particularly powerful as it allowed group members to reflect on their own experiences and share these with the group. With regards to attachment, the focus was on helping women understand the different attachment styles and the importance of developing a secure attachment.

The ending of the group was really important in terms of consolidating and reflecting on the course. We provided resources and information about further support that the group members could access. The ladies had bonded well throughout the course and actually exchanged numbers in order to continue to support each other. The feedback from the group was very positive and there was evidence of recovery particularly on the EPND. This group was very much a pilot but there is a lot of potential for development across primary care services. In particular, a group of this nature allows perinatal patients quick access to mental health support and a chance to share this experience with others which is an extremely powerful and validating experience.

My experience of running this group was very positive and rewarding. Been able to be guided by the women regarding their experiences and psychological wellbeing helped me gain a greater understanding of the challenges facing perinatal patients. I hope that in the future, more groups like this emerge in primary care to continue to support perinatal patients during such a critical period.

CAF SIG (in conjunction with the Anna Freud National Centre for Children and Families) presents

CBT strategies for working with emotional regulation and self-harm with Dr Katrina Hunt and Dr Lucy Taylor

Friday 13 October 2017 London

Registration fees BABCP members: ÂŁ106 Non-members: ÂŁ130 To register, or for more information, please email davina.metters@annafreud.org

in pictures

September 2017 15

Believing in yourself Sian Hullah is a CBP at Newcastle University’s Student Wellbeing Service. Here, she considers the development of self-efficacy in providing time-focused therapy.

Due to the time-limited nature of academic terms, there is a need to deliver high-quality CBT within a time-limited framework. Due to the flexibility in its application and the various levels at which treatment can be aimed, CBT has gained a lot of popularity in services working within a brief therapy framework.

In an environment where we are striving to help people feel better able to live their lives with value and meaning in a quicker time, it seems more important than ever to feel able to deliver CBT professionally and compassionately. As CBT practitioners in an ever-changing environment, we are often working alongside targets and requirements for our services. This can often prove stressful and challenging, making it important to not only ensure the therapy provides appropriate help and support, but also that it allows us to feel safe and competent as therapists.

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I feel as though self-efficacy has become central to the work I do with my clients because they need to be able to develop a sense that they can carry out the required actions to work towards their goals

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I am privileged to work in such an exciting and dynamic service, with students experiencing a range of anxiety and low mood-related issues who turn to us for support during their academic pursuits.

Our service focuses on supporting students in getting the most out of their time at the university, as well as signposting to appropriate evidencebased treatment providers where students can get longer-term treatment for formal mental health problems. We focus on the delivery of brief interventions - usually up to six sessions. We want to deliver high standards of care, but we have the reality of needing to do this in a short space of time.

When I first started at the service, I was concerned at how working within a time-focused model might impact on clinical outcomes and this was something I took to supervision. I wanted to ensure the best therapeutic care was delivered, but I also needed to make sure I felt confident in my work while looking after myself. I realised it was vital that as a therapist I maintained a sense of competence and that I didn’t start to feel brief work wasn’t doing something good.

So instead of thinking about what might not be done in six sessions, I began to focus on what I could do. This is the same for many of our clients, the need to be guided as to what they can do in six sessions helps build self-efficacy, which became a real focal point of supervision.

A significant challenge within time-focused therapy can be establishing a shared goal for therapy which is attainable for our clients within such an environment. The collaborative nature of CBT means we want to develop a shared plan for treatment, but we are mindful of the time-focused nature and the potential barriers this can cause to our therapeutic relationship if a formulation is rushed, or not collaboratively created. If we are then struggling to find an attainable goal, what can we help our clients get from time-limited therapy, which also allows us to feel we have offered appropriate support and care?

On this journey, I feel as though self-efficacy has become central to the work I do with my clients because they need to be able to develop a sense that they can carry out the required actions to work towards their goals. If a goal requires a longer period of time to work towards, it can help empower a client to seek further support, to be more aware of the specialist - or longer-term treatment they might require, and why this is helpful for them to pursue. If a client's goals for CBT need further work beyond the time available in our service, helping develop a stronger sense of selfefficacy can allow them to feel equipped to continue with what they have learned once CBT comes to an end.

As a therapist, self-efficacy has been important to enable me to feel that I am able to carry out our work in a safe, timely and effective manner. I can then also develop and strengthen my own awareness and confidence in my practice. Using

feature brief therapy as a way to help a client formulate and understand their difficulties is in itself an intervention if it can inspire or to motivate change for people. It shows that time-focused CBT can make a real change to the people we work with by allowing them a good insight and understanding of their difficulties. This in turn has helped me feel that despite the restraints of time within academic terms, my practice can still be a positive therapeutic experience.

There is then an importance of an open and wellconceptualised formulation that allows both the client and therapist to really understand the contributing and maintaining factors to their presenting difficulties. A strong formulation helps provide a foundation from which work can continue to develop long after sessions end. This allows the client to build a relationship with their formulation, to help develop their own understanding and awareness so that they can continue to reflect on their difficulties, the causes and the ways in which they can help themselves.

I find myself no longer feeling apologetic for the time-focused nature of my work, and more confident that time-focused work can in fact be empowering and proactive. Reflecting on cases where work has been positive for clients is really important and I think supervision is invaluable. I find balancing time to review what has gone well, and to reflect on success and positive feedback helps build my confidence as so much of the time we can focus on barriers and difficulties in our work. I find it helpful now to take time to prepare well for supervision, to take a case each time that allows me to reflect on how a brief piece of work has been significant.

When I receive good feedback from a client, or there have been successful outcomes, I think showcasing these cases in supervision is as important as to work on more complex presentations. I like to review all my discharges in this way. What has the client been able to take from the work, what did we both learn?

Looking at a piece of work after it is finished becomes as important to me as reflection during the therapeutic process. After a final session even a few minutes to recap the key learning points, a useful metaphor, a good idea a client presented, it might be just as useful in another situation.Timefocused therapy really has taught me a lot about using time in between and after sessions to engage with reflection.

I continue to strengthen my belief that timefocused work can produce positive outcomes and this helps me feel inspired and motivated within my service. I believe by being open and transparent with people about the time we have, focusing on the goal of the work, the motivation that a client brings, and a strong encouraging relationship really does allow for a therapeutic journey to start, and to feel completed. I try to see the possibilities and opportunities that six sessions can show someone and I feel encouraged and confident in what I see in return.

I would like to thank my clinical supervisor Dr Joanna Stace for her continuous support in my clinical practice, and her contributions to this article.

September 2017 17

Annual Conference

excellence awards • Best Newcomer (Open Paper or Symposium): Linda Solbrig • Best Poster: Syreeta Vyas • Best Case Report: Julie Attwood

The Scientific Committee is pleased to announce the winners of the 2017 Annual Conference Excellence Awards. As always, it was a pleasure to review the potential prize winners this year. It was also a pleasure to see the huge ranges of topics covered and methodologies used, from single case studies through to an extraordinary number of randomised. The judges were three members of the Scientific Committee - Andrew Beck, Jon Wheatley and Glenn Waller.

The Open Paper and poster prizes are awarded to early career researchers and clinicians. Our winning Open Paper presenter was Linda Solbrig, who is undertaking her PhD at the University of Plymouth.

Her paper was entitled ‘Functional Imagery Training: RCT of a new motivational intervention for weight loss’. This presentation revealed that Linda had undertaken an extraordinary amount of work, including the interventions and the research itself. However, the best thing about the paper was the way in which she demonstrated positive outcomes for weight loss that appeared substantially better than most existing studies of CBT for weight loss. Keep an eye out for the longterm follow-ups of this approach, as it might represent a substantial advance in the field, showing that weight loss programmes can be effective, despite years of our failing to find effective approaches.

While there were many more excellent papers, we chose two other presenters to commend for the clinical relevance and the quality of their papers.

Manveer Kaur of Combat Stress presented on an adaptation of imaginal exposure used within trauma-focused CBT for veterans. Katy Sivyer of the University of Oxford (a poster winner from last year) presented on the role of whether regular eating is a key element in the treatment of binge eating, using CBT. Both authors were noteworthy for being willing to try something new, and to test our existing beliefs about what should work.

The winner of the Best Poster award was Sareeta Vyas, of North Bristol NHS Trust. She presented her poster on ‘Health professionals and patient tutors co-delivering ‘self-management programmes in cancer recovery’, which showed how 100 patients who entered their Living Well Programme showed

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substantial clinical benefits, using both qualitative and quantitative data.

While not winning this year, other posters also showed high quality research and clinical work. We were impressed by Melissa Black’s poster outlining the protocol for the HARMONIC trial, run from the University of Cambridge and the local NHS Trust – we hope that she and her team will come back and tell us the findings of this transdiagnostic intervention for mood and anxiety when the trial is done. The other poster that took our fancy was by Christina Marie Pannington Hansen, of the University of the Arts, London, who examined the effect of exposure to fashion blogs among young females. While data were presented only for the first of the two studies, the findings of lower selfesteem and lower positive affect are consistent with the existing literature on the impact of other forms of such exposure.

The number of Case Report posters continues to grow, year on year, showing how many innovative CBT ideas are being tested systematically at this early level. It was very hard to distinguish between the submissions, as there were many excellent ones. Therefore, we will focus only on the winning submission this year – Julie Attwood’s presentation on ‘Cognitive Behavioural Therapy for distressing visual hallucinations in Lewy Body Dementia: a case study’. As you can tell from the title, this paper had something for everyone… In this poster, Julie presented on ten sessions of CBT for an 84-year-old man with distressing hallucinations, showing significant reductions in distress as a result. Most importantly, this poster represented an excellent integration of therapeutic interventions, based on and interpreted within theoretical viewpoints.

We were delighted with the standard of submissions this year. Don’t forget to nominate your eligible presentations for consideration at the Glasgow meeting next year - it could be your turn…

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Guyana Foundation Mental illness affects nearly one in four Guyanans, with women, the unemployed and young adults accounting for more than 60 per cent of that figure. Fewer than ten per cent are treated, while suicide is a major problem, with the country ranked second in the world with a rate of 46 deaths per 100,000 people according to WHO figures from 2015.

Access to mental health services is limited, with fewer than ten full-time psychiatrists and limited options for those seeking psychological help.

The Guyana Foundation is a charitable trust that has been created to contribute towards the rebuilding of the country.

One of the Foundation’s senior counsellors, Haimraj Hamandeo (pictured), was invited to the BABCP Annual Conference, where he presented a poster about the need for support in Guyana. He explained the need for improved access to mental health services, as well as the cultural barriers to that access:“Persons who have mental health problems have been categorised as demon possessed. That, coupled with the reality that we have limited access to mental health services, leads people to alternative methods of dealing with mental health issues, and not getting the right professional help,“he said.

“The Guyana Foundation are in the process of educating the population about mental health. If they are educated, they can make informed decisions.

“It is now for the government to come on board with us, to see what we are doing, it is important for the population. We have 750,000 people, and you see where we stand in the world with suicide rates. The need is there.

“The BABCP is the first major organisation that we have linked up with. Krish Nath is a special advisor and also an ambassador with Guyana Foundation, and he has organised a sports tour to Guyana in October. This will include visiting more than five administrative regions and will be making presentations and workshops on mental health while they are there.

“The Guyana Foundation is making a conscious effort, we recognise the magnitude of the problem, that citizens of Guyana need help, and that any help that can be provided for us, we are grateful for.

“On behalf of the Guyana Foundation I would like to thank the BABCP Board for affording me the opportunity to be part of your Annual Conference”.

You can find out more about the work of the Guyana Foundation at www.guyanafoundation.com and follow them on Twitter @GYFoundation

“We are putting services in different parts of the country, so that people can access free of charge. If the government doesn’t cover somewhere, the Guyana Foundation is trying to provide access.

“We have a Sunrise Center at the moment in Region Two, and are expanding in September in Region Three. The idea is to have one in every administrative region in Guyana.

poster awards

“We are working in schools, with health institutions and with other communitybased organisations. Ultimately it comes down to having the right people equipped with the skills to treat people who suffer from mental health problems.

The Scientific Committee awards three prizes for best presentations. The Best Newcomer Paper was given by Linda Solbrig, reporting on a trial of functional imagery training as an intervention for weight loss. The Best Poster was presented by Sareeta Vyas, who presented a poster on self-management courses in cancer recovery, co-delivered by health professionals and patient tutors.

“Coming here, getting some knowledge, making some recommendations, ultimately, the Guyana Foundation will not be able to do it all. We will require collaboration with the government and other mental health agencies.

Finally, the Best Case Report Poster was presented by Juliette Attwood, addressing CBT for distressing visual hallucinations in Lewy Body dementia. Many thanks to everyone who presented Posters and Open Paper presentations, it was wonderful to see so many excellent presentations on a range of topics.

September 2017 19

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

Pavithra herself. As she revealed this at the end of her clear, well-structured speech I was entirely bowled over.

A. As a teenager I was described as ‘troubled’. You know, drugs, alcohol, self harming, running away, bad boyfriends. I came very close to being admitted to an adolescent residential unit and at 15 I was sent to see a psychiatrist in Manchester. This involved an afternoon travelling from Blackburn by train every Wednesday for six months. He wrote down everything I said for half an hour and never spoke a word back to me.

Looking back now I see that he was very young and didn't have a clue what he was supposed to do with me. Anyway, I thought maybe I could do better!

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

Q. What other job might you have done?

A. I would have enjoyed being in

advertising (psychology without so many ethical constraints, so one can be as creative as one likes) or an actress. I think delivering training is a bit of a performance art and it would be good to have more skills in that area. I am always amazed that people want to spend time learning with me and I want to make it fun.

Q. When did you join BABCP and why?

A. I came along to a conference a long time ago and found myself in a branch liaison meeting by accident. A really charismatic woman next to me managed to recruit me as a Branch Liaison Rep just like that. That was the onset and development of my BABCP behaviours.

The maintenance is different. What keeps me here is the diversity of people and professions, the quality of CPD and the huge support of the BABCP community.

Q. What advice would you give someone starting working in CBT? A. Join the BABCP! It is a good place to belong and you’ll get to meet people of all levels of expertise and experience.

You’ll also get the best CPD around. Work towards getting accredited even though it’s a pain. And don’t be afraid to submit something to the conferences.

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A. I hope that talking therapies will grow

BABCP and me

Dr Fiona Kennedy is a Consultant Clinical Psychologist who has served on the BABCP Board and is currently Branch Liaison Rep for Southern Branch and the ACT SIG. Q. Who is your biggest hero?

A. Got to be Nelson Mandela. He says in his autobiography “I’m no saint” which is no doubt true, but he lived his values to the limit.

Q. What has been your best working moment?

A. This year Dream A Dream, the Indian NGO I volunteer with, held a conference. A woman named Pavithra runs the Mentoring Programme, which pairs Indian volunteers with rescued ‘street’ children.

For the last 11 years I have helped design and run the training for these volunteers.

She made a speech about five different young people who had benefited from the programme. One of them was a 14 year old girl with an alcoholic father, whose mother and five younger brothers and sisters were destitute. She got involved with Dream A Dream and a mentor, Manisha, who was marketing director for a large company. The girl and Manisha have been friends ever since, crossing boundaries of class and caste.

The amazing thing was that the girl was

in influence and accessibility around the world.That we will find ways to make everything we know available through new means, for example mentoring schemes.That we will move further away from a ‘medical’ model and towards working with wellbeing and resilience. And that we will begin to integrate different theories and approaches to produce even more effective interventions.

Q. And fears?

A. That none of the above will happen.

Instead, we will be caught up in the frightening fundamentalism of all kinds that seems to be sweeping the world and be made into the servants of a new dystsopia!

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

A. My Nana would be the first choice, for her endless kindness and love. My headmaster, Father Cassidy, who always had faith in me. Mandela, mentioned above, in the hope he could explain to me how he managed to live the way he did.

I worked with an extraordinary psychology assistant, Scott, who was tragically killed in his youth - I would invite him and give him many more decades of life as a gift. Sandy Toksvig, Helen Mirren and Helena Kennedy - oh but that’s seven, sorry. I never can manage small dinner parties. Can I bring all my children too? And my wonderful husband Dave Pearson. And my fab supervisor, Helen Kennerley. Thank you.

Q. How would you like to be remembered?

A. I don’t imagine being remembered, I’d rather be cherished in the here and now by the people I love. If I had a tombstone (which I won’t) I’d like it to say “She did her best”.

feature

a We all make mist kes, but are you brave enough to admit them?

V

If I had been one of Kevin Spacey’s victims in the film Seven, writes Jim Lucas, I think it would have been pride that killed me. It remains my Achilles heel. It is an echo from my youth where I always felt that I needed to look the part, have the kit, and to impress people. When you’re too proud, you limit your ability to learn from mistakes. And, mistake-making is both inevitable and essential to your professional development.

It is interesting to consider the words we use to think about mistakes. We say things like,“Did you admit to your mistake?”. It tends to ally mistakes with the idea of committing a crime or being naughty. It is not the most helpful of metaphors, since it can lead to shaming and humiliation as people are singled-out or publicly reprimanded for their blunders. A fear of making mistakes can have a repertoirenarrowing effect on behaviour.

When children are penalised for making mistakes, slowly and surely, their natural inclination toward creativity is stifled. Like other fears, you naturally focus on what can be done to avoid the mistake.

Alternatively, you focus on making sure you don’t get found out. If your workplace or supervision does not feel safe, you are less likely to talk about mistakes. This limits your ability to get support, receive feedback, and reflect on your practice.

Let’s talk about our mistakes Several years ago, my good friend Richard Bennett first mentioned that he would like to run a training event about making mistakes in the therapy room. In March 2017 after working on this idea, he and I delivered an evening workshop to around 70 West Midlands BABCP members entitled ‘Our Ten Worst Therapeutic Mistakes’.

Why focus on our mistakes?

As well as not being easy, talking about mistakes tends not to be the focus of CPD. Most workshops focus on improving skills.

Whilst this is necessary to help people develop, our aim was to discover what could be learned if we focussed primarily on our experiences of mistake-making.

When I am in a trainer role, I can overlook what it feels like being an attendee. We all hope that the trainer will be able to teach us something new. This can set up a relational frame of comparison i.e. he (the trainer) knows more than me. Whilst this may be true in certain respects, this perspective can also lead to delegates feeling unsafe and guarded.

Learning is more powerful when you can be vulnerable If I think about when I have benefitted most from training events, it is the times that I have allowed myself to be vulnerable. In doing that, I have learned how to do something intellectually, and I remember the emotional experience of it.

This has made it infinitely more powerful.

Albert Ellis was always keen to remind us that fallibility is intrinsically human. When I see someone can make mistakes or be imperfect, it makes it easier for me to do the same. It helps me to step over my pride. It helps me to make space for my disappointment, frustration, guilt, and shame. It helps me to learn to a better therapist.

This was our aim in running a workshop about our worst therapeutic mistakes.We wanted to model being open to talking about mistakes and we wanted to see what learning opportunities it would create.

What happens when you are open about failing your clients?

Some of the mistakes that we addressed included talking about interventions instead of doing them, blaming our clients for a lack of progress, protecting clients from difficult emotions, and being overly critical of ourselves. An evening workshop has pros and cons. It is more accessible, but we had less time to get into detail. Time permitted us just 15 minutes to explore each mistake.

Just like the workshop, this article does not allow a full and deep exploration of all the mistakes we highlighted. However, I can share with you an observation from my own experience. As Richard and I practiced being open with examples of when we had failed our clients, there was a connection between the audience and us. I remember noticing people looking back at me with smiles and nods. I felt warmth and understanding in the audience. Some were even willing to publicly share their own mistakes with the

group. My guess is that by modelling our own fallibility in terms of making mistakes and feeling terrible about letting people down, it helped others to feel safe enough to be open.

Love Yourself as a Person and Doubt Yourself as a Therapist A 2015 study entitled Love yourself as a person, doubt yourself as a therapist? by Nissen-Lie et al. showed that therapists who did both these things had better outcomes with their clients. Thus, it would be a mistake to get complacent and stop investing in ourselves via ongoing CPD…and, it would also be a mistake to allow self-deprecatory thoughts to dictate our behaviour.

The invitation of course, is to practice what we preach and do for ourselves what we promote with our clients. CBT has a culture of self-practice and selfreflection whereby we are encouraged to ‘try-out’ techniques on ourselves before taking them into the therapy room. It would be a mistake to apply a doublestandard where we treat our clients as more deserving than ourselves. My experience of our workshop suggests that openness about our fallibility is okay.

Talking about it helps.

If you would like to hear Richard and I talk about it, please get in touch by emailing me jim@openforwards.com.

Jim Lucas is a teaching fellow at the University of Birmingham, a private practitioner at www.openforwards.com, and is Chair of the BABCP West Midlands Branch. Jim’s co-presenter Richard Bennett is the Course Lead for the High Intensity CBT Diploma at the University of Birmingham and private practitioner at www.thinkpsychology.co.

You can follow Jim and Richard on Twitter @jimlucascbt & @thinkpsychol

(Photograph) Richard and Jim presenting their Ten Worst Therapeutic Mistakes September 2017 21

South & West Wales Branch

ACT SIG

presents

presents

Working effectively with anxiety: Flexibility within fidelity with Dr Nick Grey

Friday 10 November 2017 Swansea

Advanced exposure skills workshop: A masterclass at the cutting edge of research and clinical practice with Dr Eric Morris

Monday 2 October 2017 London Tuesday 3 October 2017 Chester

Registration fees BABCP members: £70 Non-members: £80

Registration fees BABCP Members: £130, Non-members: £140, Students: £80* *Evidence of student status must be provided with application

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

South East Branch

presents

presents

Assessment for learning: How to use the Assessment of Core CBT Skills (ACCS) as a tool for feedback within supervision with Dr Sarah Rakovshik

Thursday 19 October 2017 Oxford

ACT for Teens

Registration fees

with Dr Em Perera

BABCP members: £75, Non-members: £90

Friday 13 October 2017

ACT and Insomnia Introduction to a new manual for evidence-based CBT supervision

with Dr Guy Meadows

with Derek Milne and Robert Reiser

Registration fees (each event)

Tuesday 12 December 2017 London

BABCP Members: £65 Non-members: £75

Registration fees

Both events will be in Sevenoaks

BABCP members: £70, Non-members: £80, Student: £70* *Evidence of student status must be provided with application

22 September 2017

Thursday 2 November 2017

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

Equality & Culture SIG presents www.babcp.com/irish

CBT for Generalised Anxiety Disorder (GAD)

Culture Café

with Dr Kevin Meares

Developing cultural competence for CBT therapists

Friday 13 October 2017 Belfast

with Naomi Ford and Aneet Sehmi

Registration fees

Friday 17 November 2017 Reading

BABCP members: £90 Non-members: £100

Registration fees BABCP Members: £70 Non-members: £90

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

Eastern Counties Branch

presents

presents

A compassionate approach to building resilience in therapists with Dr Mary Welford

Taking experience seriously in psychosis

Friday 6 October 2017 Colchester

with Isabel Clarke Registration fees

Friday 24 November 2017 Newcastle upon Tyne

BABCP Members: £80 Non-members: £90

Registration fees BABCP members: £50 Non-members: £70 September 2017 23

IT Blog

Experiential learning:

Using technology in a face-to-face session.

Formulating, schema work and more…

By Sarah Bateup, BABCP IT SIG Chair

The most commonly used forms of Internet-based CBT are self-help (cCBT) products such as Beating the Blues, Mood Gym Fearfighter.com and apps such as Headspace. Equally well-used are products such as SilverCloud, and MindDistrict.

These products use web-based, interactive materials that the patient reads and works through in their own time, supported by weekly contact from a therapist, usually by email or phone. These products are widely used as services seek ways in which they can increase access to CBT without increasing the need for additional therapist time. They are widely established and have become ‘household’ names for CBT therapists.

Perhaps less widespread are tools and products that can be used to augment face-to-face therapy. Whilst many therapists may encourage their patients to use a smartphone app, such as the mindfulness app Headspace, or visit a website to gather information, very few therapists use technology within their sessions.

However, it might be argued that some patients would really benefit from new and different ways of working with their therapist. Many of us will have had the experience of struggling to enable a patient to elicit their thoughts, engage with activity scheduling, or consider how others may perceive their behaviour etc.

Faced with these types of situations in my face-to-face sessions I have always found it really helpful try something behaviourally different. For example, trying an experiential activity can sometimes make a difference between feeling completely

24 September 2017

stuck and moving the session on. Using technology in a session is one way of using an experiential exercise to help a patient engage with a change mechanism.

Some examples of technologies that I have used directly in a face-to-face session include web products such as wordcloud.com and Survey Monkey, smart phone apps such as Songify, Talking Tom, as well as using photos and videos and voice recordings. I have found the latter to be extremely useful when conducting behavioural experiments with a patient.

In these situations (and always with the collaboration and consent of the patient) I have asked bystanders or observers to provide feedback on what they may have noticed. This semi-structured interview is then recorded and used later, with the patient, to gather information, test the patient’s prediction and synthesise learning.

I have found that many patients engage more readily with the recording than they might do with a traditional survey, where we might ask our therapist colleagues to complete a questionnaire. Another method that can also promote engagement and facilitate learning in a session is the use of avatar software.

Avatars The Oxford English Dictionary defines the term avatar as ‘an icon or figure representing a particular person in a video game, Internet forum etc, where the conversation is depicted in a balloon over the avatar's head’. Avatars became more common in the 1990s particularly in gaming and non-gaming virtual worlds such as Second Life have been used in

mental health to promote peer support.

Avatars in products such as Second Life are highly customisable whereby the user can select eye, hair and skin colour, gender, clothing and body shape. It has been argued that these representations of humans enable users to be less inhibited and therefore more likely to be honest about how they are feeling. Second Life has since gone on to provide virtual mental health centres where users can drop in and get advice and support.

The use of avatars in mental health is becoming more widely used. Professor Julian Leffat at University College London has been successfully using avatars in his work with helping people with schizophrenia manage auditory hallucinations. In his study patients are asked to create a personification and voice of their hallucination in the form of an avatar.

Working with a therapist the patient is taught to confront the avatar. Leffat reports that because patients understand that their avatar is not real and cannot harm them that they feel safe and are able to practice confronting the avatars voice.

These sessions are recorded and the patient is able to view the recording whenever they are struggling with fearful or overwhelming hallucinations. Gradually patients learn that they can manage auditory hallucinations and live a more fulfilling life.

This type of experiential learning using avatars can be used to help people understand and work with other types of thoughts, feelings, sensations or behaviours. The web-based platform

branches and special interest groups

Proreal enables patients and therapists to work together in a virtual environment to explore a range of concepts including; recent examples of a difficult situation, practice exposure to a feared stimuli or test out new behaviours in a social situation.

Web-based avatar products can be used with almost every change mechanism from developing a formulation to exploring barriers to behavioural activation. Figure 1 illustrates how the product can be used for to formulate. In this session the therapist and patient begin by creating the backdrop for the situation being described.

Avatars are then placed in the environment to represent the patient (in this case Mark) and others who may be present in the situation.

Unlike Second Life the avatars in Proreal are featureless and androgynous. However, the avatars can be created in a range of colours and sizes. Each avatar can move and behave in any way the patient feels corresponds with the situation being explored.

As the patient creates the situation the therapist encourages them to explore thoughts and feelings that may arise as they work on the platform.

Figure 1 Formulating using avatars

Patients often find it easier to recall a situation once immersed in the virtual representation of the situation they are recalling and so thoughts, feelings, sensations and behaviours are all added to the scene as they are elicited. Once complete the session can be recorded so that it can be watched again or compared to previous formulation recordings in order to explore similarities, themes or synthesise learning.

Avatars can also be effective where more complexity is present. For example, in schema therapy we can work with patients in order to identify specific modes by playing them out on the platform. Figure 2 illustrates a session where John is identifying a schema mode that has been activated by his partner’s request (whilst out on a walk together) that he slows down and takes time to talk to her about something other than the argument he has had had at work.

Figure 2 Identifying a schema mode

Working with his therapist John is able to identify that he feels that his partner does care about his problems or him and this makes him feel vulnerable and angry. The therapist helps him identify that in these types of situations he believes that his partner does not love him and that he might as well leave her. John labels this mode ‘angry and hurt John’. Further on in this session the therapist is able to help John begin to think about how his partner might perceive his behaviour.

This process becomes easier when John is able to view his own avatar from the eyes of his partner’s avatar, as in figure 3. This type of experiential exercise can be extremely helpful to help patients quickly identify triggers, consequential patterns and explore potential new behaviours that might become more workable in similar interpersonal interactions. As each session on the platform is recorded this learning can be reinforced and consolidated. This is particularly helpful as patients often find these ‘light bulb’ moments a little slippery and hard to hold onto.

Figure 3 John is able to view himself ‘though his partner’s eyes’

Want to learn more?

If you want to get some hands on experience of how to use Avatars to undertake experiential learning in your CBT sessions you might want to think about joining the IT Special Interest Group (IT SIG). We will be running a workshop in 2018 which will enable participants to get hands-on experience of a range of products and processes that are used to be deliver and augment cognitive behavioural therapies.

To join the IT SIG, please email it-sig@babcp.com. You will receive all updates from the SIG on their meetings and events.

September 2017 25

Manchester Branch

East Kent Coastal Branch

presents

presents

Focussing on emotion: Using change procedures from DBT

Imagery in CBT: Basics and beyond with Tobyn Bell

with Dr Michaela Swales

Tuesday 21 & Wednesday 22 November 2017 Manchester

Tuesday 26 September 2017 Whitstable Registration fees BABCP Members: £65, Non-members: £75

Registration fees BABCP members: £150 Non-members: £170

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

Devon & Cornwall Branch

presents

presents

Masterclass on behavioural interventions for working with couples

Complex OCD

with Dr Marion Cuddy and Dan Kolubinski

Monday 4 December 2017 Registration fees

with Dr Blake Stobie

Thursday 9 November 2017 Registration fees Early Bird (up to 29 September) BABCP Member: £60, Non-member: £70 Full fee BABCP Members: £80, Non-members: £90

BABCP Members: £80, Non-members: £90

Working with interpersonal trauma in relationships with Dr Marion Cuddy, Dan Kolubinski and Dr Michael Worrell

Monday 22 & Tuesday 23 January 2018

CBT Supervisors’ Forum with Debbie Williams

Friday 17 November 2017 Registration fees BABCP Members: £50, Non-members: £60

Registration fees BABCP Members: £180, Non-members: £200

Both events will be in London 26 September 2017

Both events are held in Buckfast

September 2017 27

28 September 2017

September 2017 29

Mastering the Clinical Conversation using RFT to supercharge your experiential practice Dr Matthieu Villatte Thursday 8th and Friday 9th Feb, London Would you like to be more experiential as a therapist; less talky and more active in session? And would you like to do so in spontaneous, free-flowing, naturalistic ways, responding to the moment-to-moment ebb and flow of the session, (instead of sticking to standard scripts and “canned interventions”)?

If so, you just can’t afford to miss out on this unique workshop with Matthieu Villatte. Co-author of the ground-breaking book, “Mastering The Clinical Conversation”, Matt is unequalled in the ACT world in his amazing ability to help practitioners “step outside the box”; to stretch their boundaries, to unleash their creativity, and help them develop more flexible ways of working.

The training, based on Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT), will allow you to develop skills in: • Doing experiential work - without using scripted, formulaic or pre-prepared exercises - through natural conversations with your clients.

• Grounding your clinical practice in a stance of curiosity, openness, and non-directiveness.

• Selecting, building, and delivering experiential exercises and metaphors “on the fly”, through flexibly responding to what the client is saying and doing.

Mastering ACT - Advanced Skills Dr Robyn Walser 5th & 6th March, 2017, London • In ACT, the combination of acceptance, mindfulness and values has a unique way of touching both the therapist and client’s lives in the service of positive life change.

• Doing this in a truly experiential way is a challenge.

• This workshop will unlock key processes to learn how to do this skilfully.

Learn about: • Defining and moving toward more process and experiential work in ACT. • Bringing the ACT core processes into natural conversations with your clients.

• Connecting to multiple therapeutic processes rather than relying on techniques and metaphors to carry your sessions.

• Selecting, building, and delivering experiential work linked to the client’s experience and housed in the therapeutic relationship.

Robyn D. Walser, Ph.D. is Director of TL Consultation Services, staff at the National Center for PTSD and is Associate Clinical Professor at University of California, Berkeley. Don’t miss this opportunity to see one of the most gifted ACT trainers in the world present. Robyn is renown for her warmth, strength and passion as a trainer. If you are ready to be challenged and stretched, to take your ACT skills to the next level, then this workshop is for you!

High quality training, supervision and therapy in Acceptance & Commitment Therapy and Contextual Cognitive Behaviour Therapies.

30 September 2017

Check out our other upcoming 2017-18 Workshops!

ACT for Young People 23rd and 24th November, London, with Dr Louise Hayes

Supercharging Your CBT Practice: Integrating the best of DBT, ACT and CFT for maximum effect 7th & 8th December, London, Dr Fiona Kennedy

ACT Introductory Workshop, 26th January, London, Dr Joe Oliver

September 2017 31

32 September 2017