CBT in the City Newsletter 34 - 2013

imagine

Experts at your fingertips call now

FORMALLY CALLED CBT MONTHLY

Check out our new services in you local area September 2013 Message from Susie page 1 What is REBT?

page 3 Expert

corner 4 Pit Stop Page 5 How to get disturbed 6 A day in the life of a therapist page 7 an appointment or enrol in a Group CBT Programs you will need to contact us, online or telephone

Established

2006

The journey started in January 2006 in 10 Harley Street when Matt Broadway-Horner was working full time at the Priory hospital in north London. Initially he started part time in his clinic working two evenings weekly for the first year and then gradually growing until now working full time in 4 locations, 3 in London and 1 in St Albans. This has been a dream come true for Matt to work using CBT to help people deal with their problems before it becomes chronic and they are forced to take time off work due to illness.

Indeed the driving force behind the formation of the clinic comes from personal experience of Matt watching a relative struggle with mental illness with no alternatives proposed by the NHS until the conditioned worsened needing the enforcement of the Mental Health Act (1983)

Clinic services Our priority is work with you in finding the right therapist and that is convenient to you.

There are 2 main ways to contact us Call on 020 7467 1508 Contact@cbtinthecity.com

What is CBT?

Message From Susie @ CBT in the City The clinic now offers clients the ability to control how many sessions they want and when to have them by paying on the website. This facility is easy to use and all you need to do is pay for the number of sessions you wish to use. It accepts all major credit cards and once payment is received then all the rest I take care of and ensure an appointment sent with in 24 hours. Also the clinic specialists offer therapy via, telephone and video online to fit into your busy schedule and child care arrangements, so help can literally be at hand at any time and any where! Remember we are here to help with not just mental health issues but physical health as well, try out our well being clinics which specialise in helping people with Long Term Conditions like diabetes, asthma, heart problems, breathing problems, HIV are just some to

name and others too. Through a recent study (Broadway-Horner et al 2013) carried out by Matt and his research team they have found that 2 out 3 people within a local services have a long term health condition which have implication for mental health services today. Physical care needs to be addressed and not be separated into another service. Physical care teams need to also address that psychologically we need help and not just be treated medically.

Our therapists can help with rehab from medical problems as well as the main bread and butter stuff like anxiety and depression, hoarding and obsessional problems. Call Matt or Susie on 02074671508

Cognitive Behaviour Therapy is a tradition that focuses on the way people think and act in order to help them overcome their emotional and behavioural problems. The effectiveness of CBT has been extensively researched more than any other Therapy and has shown that people stay well longer. This positive result is due in part to the educational aspects of CBT which can be applied to help an individual to become their own CBT Therapist

Which one?

Within therapy services we offer different approaches with in the CBT tradition, like REBT, Behavioural Activation, ACT, Mindfulness, CT, Imagery and Rescripting therapy, and Functional Analytic Psychotherapy. All have evidence of working and can significantly improve your life

Social media Join Our Facebook Groups: CBT in the City - CBT in the City for Schools Mindfulness and the City • Follow us on Twitter: CBTDaily - SchoolsCBT - MindfulnessCB

What is Rational Emotive Behaviour Therapy? an approach within the CBT Tradition REBT until recently was previously named Rational Therapy and Rational Emotive Therapy with the field of practicing Cognitive Behaviour Therapy (CBT). It is the practice of comprehensive, activedirective, philosophy and an empirically based psychotherapy which does focus on resolving personal emotional and behavioural problems and disturbances thus enabling the patient to proceed toward and happier more fulfilling lifestyle.

One of the core fundamentals of REBT is that many people and human beings in general do not get stressed and upset with regards to unfortunate adversities but its how they conduct their mind and views of reality via their language, evaluation beliefs, meaning and philosophies about the world and people other than themselves that creates the disturbance A popular REBT framework thus assumes that people have both an innate rational (meaning, selfand social- helping and constructive thoughts) and irrational (meaning, self- and social- defeating and unhelpful thoughts) tendencies and leanings. It is the skill of the therapist that helps point the

individual to this self help. REBT may be used for the treatment of anger, addiction (and withdrawal), anxiety, avoidance, hurt, guilt or shame, self- blame, self-pity, depression and for repetitive behaviours and behaviour tendencies like procrastination, over- compulsiveness. So an example may go like the man who felt rejected and then he demanded that he must not be rejected for if he was then this will mean that he is useless and then feel Anxious/Hurt and along with this emotional consequence are the behaviours of rumination, avoidance to engage in the act of dating or indeed the build up. The thinking consequences are that ‘I am no good’ ‘no one will like me’.

Here the attitude is very much one that demanding thinking places pressure on self that the natural process of selection in dating only goes one way and it will be awful if another outcome takes place. If this type of thinking continues then this could lead to a reduction in lifestyle and feeling stuck to carry out his Valued Direction of wanting to be remembered as a man who wants to love and be loved by someone special. The Value if not being met will then lead the man to not only feel Anxious but Depressed about what he has lost

For more information please contact us

02074671508

For more information regarding REBT please contact us for more information matt@cbtinthecity.com

CBT London and the Home Counties Our head office is based in

Harley Street, London, while we also hold

London CBT Clinics at the

Centre Islington and

Healix Wellbeing

in Southgate, North

London. Highbury and

Brixton, Dulwich, Camberwell

Walthamstowe

. In the home counties we have

Ways to improve your mind “By far the best-­‐established and most thoroughly researched form of treatment, apart from medica9on, is cogni9ve behavioural therapy (CBT),” says Professor Peter McGuffin, director of the MRC SGDP Centre and Honorary Consultant Psychiatrist in Affec9ve Disorders, Ins9tute of Psychiatry,King’s College London.

“This is very much a ‘here and now’ method that focuses on the dysfunc9onal aQtudes (for ex-­‐ ample, nega9ve and self-­‐ defea9ng thoughts) about oneself, one’s place in the world and one’s future that are oSen associated with the ini9a9on and perpetua9on of depressive symptoms,” he explains.

“The success of CBT depends on establishing a good therapeu9c rela9onship between the doctor/ therapist and the pa9ent — but unlike more tradi9onal psychoanaly9c approaches it is usually delivered over a rela9vely short period of 12 to 16 weeks and aims not only to get the pa9ent beZer but to teach the pa9ent ways of fending off symptoms should they recur in future,” Professor McGuffin points out.

“CBT and medica9on is effec9ve” ␣␣ 1 in 6 adults at any one 9me will be affected by mental distress, according to the Office for Na9onal Sta9s9cs (ONS), though some place the figure at 1 in 4 ␣␣ According to MIND, around 300 people out of 1,000 will experience mental health problems every year in Britain; of these: ␣␣ 230 will visit a GP ␣␣ 102 will be diagnosed as having a mental health problem as ‘either or’,as in prac9ce many pa9ents require and benefit from both in combina9on,” he cau9ons. Other types of talking treatment that stand up to rigorous scien9fic scru9ny include interpersonal therapy, which,as the name suggests,focuses on rela9onships and couple or families ␣␣ 24 will be referred to a specialist psychiatric service ␣␣ 6 will become inpa9ents in psychiatric hospitals ␣␣ Mixed anxiety and depression, according to the ONS 2000 survey, is experienced by 9.2 per cent of adults in Britain.

This is followed by general anxiety at 4.7 per cent and depression (without the symptoms of anxiety) at 2.8 per cent ly therapy where the pa9ent is seen with their partner or spouse and, some9mes, other members of the family too.

There is also increasing interest in therapy based on ‘mindfulness’, which has its origins in Buddhist medita9on but which has also much kinship with the ‘here and now’ aspect of CBT. Elizabeth Machnicki,a Cotswolds-­‐ based therapist whose majority of pa9ents referred to her by GPs are suffering with depression as well as anxiety-­‐related condi9ons,prac9ces cogni9ve behavioural hypnotherapy (CBH), which combines the benefits of CBT and clinical hypnotherapy. “ This gives both structure and flexibility to therapy allowing for a more holis9c and tailored approach.

“CBH is brief,ac9on-­‐orientated,solu9on-­‐focussed and psycho-­‐ educa9onal.It is also relaxing and offers the opportunity for imaginal work,e.g.,seeing themselves in the future being as

they would like to be; drawing from past helpful experiences and induces ‘parallel awareness’ so that both conscious and unconscious processes and resources are tapped into.”

Know your enemy Anxiety disorders come in varied forms but the key to making a difference is to recognise it early There are many anxiety disorders, including phobias,OCD,body dysmorphic disorder, post-­‐trauma9c stress disorder and panic aZacks. But the one thread they share is their ability to obstruct daily life – leaving people “trapped by fear”, says Catherine O’Neill, services manager for Anxiety UK,which is run by people with personal experience of anxiety.

Anxiety can manifest itself in both physical and psychological symptoms, and can occur along-­‐ side other condi9ons, such as depression, says Catherine. “In most cases,there will be anxiety and depression but anxiety is oSen over-­‐ shadowed by depression and can be misunderstood and misdiagnosed by doctors,” she says. “Although all anxiety disorders have the same anxiety underpinning them, they present in different forms.

“The treatment with the most evidence is cogni9ve behavioural therapy (CBT).The key component of CBT is challenging the avoidance that oSen occurs with anxiety whether physical or mental – that’s the behavioural component,and the cogni9ve component looks at thoughts, and how best to deal with the bias you start to have in how you think about things and look at the world”.

It’s wise to have your own strategies,says Catherine.“I have found that yoga, swimming and taking nice, warm baths are all helpful – trying to be nice to yourself,essen9ally,works.”

How does anxiety start? “It starts with feeling stress,” says Catherine. “Anxiety is very physical and the first 9me people experience it may be when they start worrying more, or going over things in their head, or can’t sleep.” These are all early warning signs,she says.“Anxiety has a significant impact on your life, and can stop you being able to func9on. If you catch it early, it improves the picture,” Catherine says. “ The problem with anxiety is that it’s self-­‐reinforcing – the more it builds up in the mind, the more firmly it exists. Good recogni9on and management from early on make all the difference.”

Pit Stop Exercise Once you have assessed your Automatic Negative Thoughts (ANT’s) then you need to reduce conviction in them. Rate you conviction level of how much you really believe it out of 100% this being the highest level of conviction Dispute you ANT’s or core beliefs by using empirical, logical and practical disputing questions. For this exercise see how many practical disputes you can discover Let me start you now with the following: How does thinking this way help me?

What are the advantages of thinking this way?

What are the disadvantages of thinking this way?

Now rate you conviction level again and hopefully there will be a reduction. Continue to do this until the level is as low as 30%. Now you need to find an Alternative Realistic Thought (ART’s) or helpful core belief and ask yourself practical questions to develop conviction it. So in the beginning conviction is 0% but then after the exercise then rate again your conviction level. Repeat until conviction level has been built upto 70% For CBT skills lesson pack then contact the office on 020 74671508

The CBT in the City Task force here to help YOU!

For more information please contact us

02074671508

IT IS THE WAY YOU THINK THAT LEADS TO DISTURBANCE

by Matt Broadway-Horner

Rational Emotive Behaviour Therapy or more commonly know as REBT is an approach within the Cognitive Behaviour Therapy tradition. The CBT traditions has many approaches within it.

REBT is an approach that helps individuals to overcome emotional and behavioural dif>iculties.

The REBT approach has many straight forward and common sense principles but the human condition is one that does not follow or see this clearly. A central theme in the theory of REBT is that we as human beings disturb ourselves and want the grass that is greener on the other side of the fence. The self defeating behaviour that are tried and tested many times over can lead to destructive ways of living. In this book the common sense principles highlighted will I hope tap into the common sense side of the brain and with some hard work can aid the reader to live through enhancing behaviours that lead to healthy negative emotions on a regular basis.

Learning your ABC’s This is a framework that is commonly used in REBT and provides the individual an opportunity to assess their own upset.

A= Activating Event, this the a point within the situation in which the disturbance was activated.

B= The disturbance Beliefs about the inference made at A. C= The Emotional Consequence, The Behaviour Consequence and the Cognitive Consequence.

Example 1 A= I imagine failing at an exam B= I must not fail the exam it will be awful, intolerable and if I do fail then this means that I am useless.

C=Anxiety, the behaviour will rehearse over and over to ensure information stays in my brain, the thinking being, I will never make it.

Lets look at situations more closely.

It is generally understood by many that the situation has caused the emotional upset.

However I would like to put forward an REBT idea and indeed the words of many philosophers and scientists within the >ield and CBT tradition that it is the perception of the situation that has caused the disturbance or upset.

Example 2 A= In the Supermarket I will be anxious B= I must not feel anxious and If I do then others will see it and this will be intolerable and I will look crazy C=Anxiety, the behaviour will be to control thoughts, sensations with in the body and the thoughts will be I have gone mad/others have seen me loosing my mind Situations exist in time and can be past, present or future. An inference is made which may then lead to the disturbance made at B. An inference may or may not be true, it is information that the mind gleans in the moment. The information may not be fully informed and the mind may go beyond the initial piece of information. Situations can be internal events such as pain, sensation, memories, personal history, personal experiences. But also personal experiences can be external and outside of our control and therefore no inferential experience may have taken place.

In the A this is a point in the situation in which the disturbance was activated. So when looking at the situation think at which point did the upset begin? I am using the word upset interchangeably with disturbance to hopefully aid the reader. There will be many ABC’s in any given moment but may not lead to being disturbed at B. If you wish to have therapy with an REBT therapist then call us now 02074671508

A Day in the Life of A Therapist

by Matt Broadway-Horner Early to work and rushing down the escalator to the platform which is packed in like sardines. The balancing act to stand near the yellow line is one done with the skill and shear determination to make sure that no one pushes me in Train pulls in and we all squeeze onto the carriage sweating like a pig in an oven,wishing that I could shower again. but instead today my mind was drawn to the argument between 2 men who are demanding the other move. Is it really worth the time and energy to be arguing over space on a tightly packed tube? The argument continues for 5 further minutes by which time all other conversations has ceased due to the raising of the two voices I am getting a little nervous now as the level of verbal aggression is rising and I am thinking about the possibility to move away from the situation but looking down the carriage I can see that the possibility of anyone moving is next to zero Its at this point that I am wishing I had the balls to teach the 4 step anger method but there is nothing worse than a ‘know it all’ butting in. I am likely to escalate than de-escalate the situation. I don’t really want bruised eyes as it does not match my skin tone I look away and just hope that no one gets physical.

It is interesting how territorial one gets with a crowded place like the tube. All sensible options leave us at moments when needed. The demand for space when none really exists in the rush hour would be best serve us all if left unsaid. Everyone is in the same situation and so lets walk away from the angry thought Hot thoughts fuel the anger and cool thoughts calm down like ‘how is this gonna help me’ ‘why spoil a good day’ and ‘don’t get hooked into magnifying the annoyance’. So the next time that a moment can hook you in and lose all sense of proportion…..step back and see the bigger picture and ask yourself, Is it really worth losing my temper on? Would I be angry about this in 1 hour?

If the answer to both questions is no then step away from the angry thought and tap into some cool thoughts

Being in the moment with Mindfulness based CBT

by Matt Broadway-Horner The demands on each of us are increasing and the days are not getting longer. The guilt placed on the city dweller to improve ones mind is constant.

Bookings to the latest private viewing at a gallery, eat at the latest opening of a new restaurant to name a few activities that are carried out to defend against the criticism and keeps us busy But have we lost our way and go through the motions and have forgotten to enjoy the process, and instead look to the end result? The city is full of distractions and can cater all tastes and desires.

But do we need our time to be filled or can we use what is available to us now to bring calm and enjoyment in the simple pleasures. There is a whole array of pleasures around us but they may initially look absurd for us to comprehend the usefulness of such simplicity Have you ever being on holiday and taken 101 pictures of a mosaic that was very interesting at the time but when you collect pictures from the developer most of the photos end up in the bin. It is at these moments that senses were engaged in the moment and then we click away on the camera.

Well lets try this now and go for a walk at lunchtime and act as if you are the tourist and have just arrived and develop the curiosity to smell, taste, look, touch and hear what is around. In Cognitive Behavioural Therapy this is called the Tourist exercise Think about the wind brushing upon the face, the sound of twigs breaking underneath the feet. Look up and around and make a mental note of what you notice around about. You may need to ‘just do’ the exercise before the motivation kicks in

For more What caninformation CBT in the

Easy payments system

please contact us

Mindfulness program

02074671508

Help with medical problems

City offer you?

The opportunity to change

Telephone therapy

Excellent service

Experienced therapists Value for money Accessible

Teaching Supervision and good student services

Great lesson pack for schools Teacher training Skype therapy Great therapy

The broad range that is CBT in the City

It takes both students and teachers to create a reflective classroom. CBT in the City directly affects Student Learning, Attitudes and Behaviors by imparting knowledge of how they can change their current situation by teaching them about how thoughts can create Self Defeating Behaviours and produce low confidence and low self esteem Through the Reflective Classroom as viewed through the lens of CBT in the City teachers can more easily manage the Social and Academic Environment in which they spend the better part of their waking hours. By making Mindful decisions and employing the same skills they teach children, educational professionals become more collaborative colleagues and better listeners and communicators. Ultimately, greater job satisfaction results A CBT in the City Reflective Classroom is characterised by:• Enquiring young minds ready to learn in an environment that promotes academic , personal and private

success• Growth of respect and personal regard as children learn to acknowledge the unique qualities of others, attentively listen to their concerns, and avoid arbitrary or negative reactions• A rise in positive social exchanges among students and adult colleagues• Reduced bullying• Renewed partnerships with parents and families to promote children’s learning and growth• Reduced teacher stress and vulnerability naturally associated with the challenges of the teaching profession Renew the love that teacher has for his/her own profession and have a fresh impact on the students

The attitude that one undertakes in this practice is crucial and will go against the grain. Our normal development is mainly about achieving and doing things with purpose. In Mindfulness practice it is about developing a curious mind and seeing what happens and this may mean not taking control and learning in a different way by noticing.

Mindfulness based CBT for Depression

Testimonial I have multiple sclerosis (MS) and I was very stressed and overwhelmed with normal life stuff really and my doctor told me that if I don’t learn to manage my stress effectively then the MS symptoms will develop more quickly. He persuaded me to seek help and so I contacted CBT in the City and I received help for stress. My therapist was great in helping me understand MS and how I could slow down the depreciation of my spinal column. Now I am more in control, feel less stressed, use positive stress to my benefit as I can sweat the small and larger stuff.

Therapy helped me to see that a new approach was needed and I have to say I have received excellent care and therapy from my therapist. My therapy has stopped and my doctor now thinks that the speed of the MS has slowed down. My decline will happen but I want to enjoy the life I have

and not lose time due to unnecessary negative stress and worry.

All the best Dileep

Services available from Matt BroadwayHorner

Author

Workshops

Supervision

Personal development

Building links

Therapy

Coaching

Module leader

Consultant

Contract development and security

Teaching

Project management

Masters level marking

Medico legal reports

Who is Matt?

Matt is the visiting lecturer & module leader for the module complex mental health problems in the PgDip / MSc CBT program at University of Hertfordshire. Currently Matt is the project leader for the department of health project bid merging Long Term Conditions like Diabetes, Multiple Sclerosis, heart problems etc with IAPT services delivering CBT packages to patients and restructuring it to incorporate health psychology. Another project Matt is involved in is the CBT in Schools which has been running for 3 years and is proving successful in reducing many problems within schools and also empowering teachers to be best they have ever been!

imagine

Matt used to work on a research study as a Consultant on delivering Cognitive Behaviour Therapy to people with Learning Disabilities within Camden and Islington

populations. He is also currently a consultant lead on the CBT in the City Schools Project with the primary objective of delivering CBT to Students in London Schools. The research is supported by Camden and Islington NHS Mental Health Trust, Mental Health Research Network and The National Institute for Health Research Matt also used to work as a Consultant Psychotherapist for the Priory Hospital in North London, working with clients both in group and individual therapy using Cognitive Behaviour Therapy. He also supervises other Therapists, multi-disciplinary team members and trainees. He previously worked as a specialist in the NHS at St George's Mental Health Trust in the Addictions department and acute Adult Psychiatry. He is available for Individual CBT and/or Group CBT Therapy for cash payers and for those wanting to use their private medical insurance

10 HARLEY STREET LONDON W1G 9PF

Social media Join Our Facebook Groups: CBT in the City - CBT in the City for Schools - Mindfulness and the City • Follow us on Twitter: CBTDaily - SchoolsCBT - MindfulnessCB