THE CBT THERAPIES I PRACTISE

Classical CBT focuses very much on the ‘here and now’ and explores the client’s past only minimally or not at all.  In classical CBT, the first session comprises an assessment which is an opportunity for the therapist to find out as much as possible about the problems the client is experiencing.  On completion of the assessment, the therapist will share with the client their understanding of the presenting problems, the main focus being on what is keeping the problem going as it currently stands and identifying the areas that need to be targeted for change to occur.  Change is then brought about by applying the principles of CBT to the areas identified, typically negative thoughts and behaviours.

Suggested reading: ‘Mind Over Mood’ by Greenberger and Christine Padetsky is an excellent resource that I ask all of my clients to buy.  It is a self help manual that thoroughly explains the model behind classical CBT and how to apply CBT to problems such as depression and anxiety.

Schema-focused CBT is a much deeper form of CBT which focuses on a client’s past in addition to their ‘here and now’ problems.  The premise behind schema-focused CBT is that some people have very deeply embedded cognitive distortions which stem from negative childhood experiences.  Such ways of seeing and experiencing the world are called schemas which are so powerful they are resistant to change via classical CBT.  In schema-focused CBT, clients complete a lengthy questionnaire to help identify the schemas they have.  This is followed by assessment sessions that explore in an in-depth way the childhood origins of clients’ schemas, which are then challenged.  Change is brought about by people questioning both the ‘truth’ of the schemas they developed in childhood and their on-going validity, using evidence taken from across the life-span. Schema-focused therapy uses all the methods associated with classical CBT as well as experiential methods (e.g. role play).

Suggested reading: I ask all clients embarking on schema-focussed therapy to purchase ‘Reinventing Your Life’ which outlines the main schemas and vividly illustrates how they are experienced by individuals who hold them.  The clients who I work with on a schema level have, without exception, found this to be a very powerful read.

ASSESSMENT AND ADVICE SERVICE (A&A)

The A&A service is based on my experience of seeing clients who, prior to my seeing them, have wasted a great deal of time and money on therapies that were wholly unsuited to the problems they were experiencing.  There are many different sorts of problems and many different sorts of therapies which is hugely confusing to people unfamiliar with psychology/therapy.  All too often, this leads to the sort of mismatch described above.

 In A&A, clients commit just to an assessment so that they can get a professional opinion on the problems they are experiencing and advice on what to do about it i.e. whether therapy would be beneficial and if so, what sort.  Although I have chosen to specialise in CBT, my training as a clinical psychologist means that I have experience and knowledge of a range of therapies.  On completion of the assessment, I can give my thoughts on the problems a client is experiencing, a diagnosis if this is apparent and would be helpful, and discuss with them the sort of therapy I believe would benefit them.  If I believe CBT would be helpful, I will offer to treat the client.  If I do not have any spaces available or if I believe the person requires very specialist help, I can refer the client on directly to other clinical psychologists who practice CBT and who are personally known to me.   If I believe the client would benefit from a type of therapy other than CBT, I will help the client find a therapist who practises that form of therapy, if possible.  At the very least, I can point clients in the right direction so that they can find an appropriate therapist themselves.