CBT Today Vol 42 No 3 (Sep 2014)

Volume 42 Number 3September 2014

From the LeadOrganisation for CBTin the UK and Ireland

With this issue:New era for Branches andSpecial Interest Groups

On 10 November 1972, the inauguralmeeting of the British Association forBehavioural Psychotherapy tookplace at Middlesex Hospital inLondon. In its first year, the fledglingorganisation had 195 members.Almost 42 years later - and with the‘C’ for Cognitive added in 1992 -BABCP now has over 10,000members.

On hearing the news, BABCPPresident Professor Rob Newell(pictured) said: ’This is a landmarkoccasion for what started as a smallinterest group in a newly developingarea of psychological treatment. It isalso a great achievement. The Boardthoroughly recognises and

appreciateseveryone’scontribution tothis. I must notethat being amember ofBABCP is notrequired topractise CBT,nor is BABCP Accreditation. The factthat our membership continues togrow, in what are difficult financialtimes, is a testament to the fact thatmembers see what we offer asvaluable and important. Thank you sovery much for your continuingcontribution to the BABCP and CBTin general.’

10k membershipmilestone passed

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Managing Editor - Stephen Gregson

Deputy Editor – Peter Elliott

Associate Editor - Patricia Murphy

CBT Today is the official magazine of theBritish Association for Behavioural &Cognitive Psychotherapies, the leadorganisation for CBT in the UK and Ireland.The magazine is published four times ayear and mailed posted free to allmembers. Back issues can be downloadedfrom www.babcp.com/cbttoday.

Submission guidelines

Unsolicited articles should be emailed asWord attachments to [email protected],except for PWP-related articles which shouldbe send to [email protected] cannot be guaranteed.

An unsolicited article should beapproximately 500 words written inmagazine (not academic journal) style.Longer articles will be accepted by prioragreement only.

In the first instance, potential contributors areadvised to send a brief outline of theproposed article for a decision in principle.

The Editors reserve the right to edit anyarticle submitted, including where copyrightis owned by a third party.

Next deadline

9.00am on 3 November 2014 (for distributionweek commencing 1 December 2014)

Advertising

For enquiries about advertising in the magazine,please email [email protected].

© Copyright 2014 by the British Associationfor Behavioural & CognitivePsychotherapies unless otherwiseindicated. No part of this publication maybe reproduced, stored in a retrieval systemnor transmitted by electronic, mechanical,photocopying, recordings or otherwise,without the prior permission of thecopyright owner.

Volume 42 Number 3September 2014

At a time when many of us are facingever-increasing demands andreducing resources in our workingenvironments, opportunities to reflecton our practice can be scarce.Supervision, as a mechanism to takecare of ourselves, and to ensure weare delivering high quality, evidence-based CBT practice, is vital.

Over recent years, increasingattention has been paid to thecore elements of effective CBTsupervision, and a number of modelshave been developed.

Opportunities for training insupervision are increasing, althoughthe availability of specialistworkshops and CPD events with asupervision focus remain smallcompared to the number of CBTpractice events.

With some of these issues in mind,members with a particular interest insupervision formed the BABCPSupervision Special Interest Group(SIG) towards the end of 2013. With agroundswell of interest insupervision, it is an ideal time to havedeveloped this new group. Moreover,it was encouraging to see so manymembers from across the UK andIreland who gave up their sunnyBirmingham lunchtime to attend ourfirst national Supervision SIG meetingat this year's Annual Conference.

Thank you to all of you who did so.

Lots of interesting ideas weresuggested as to how we might takethe SIG forward. Finding ways tocommunicate and facilitatenetworking seemed especiallyimportant, perhaps by creating aforum, or via local subgroups. Therewas a clear interest in research interms of both contribution anddissemination, as well as hope thatthe SIG could become a force toincrease research in the area ofsupervision within CBT.

Attention was given to an upcomingspecial issue of the CognitiveBehavioural Therapist journal, whichwill focus on supervision. You willfind a call for contributions on page22 of this issue.

A project to develop a supervisortraining manual is also underway atthe University of Newcastle, inassociation with BABCP. Discussionsare already underway with DerekMilne as to how the SIG mightbecome involved with this.

Of course workshops are one way ofmeeting up and we already have anumber of events planned. The firstwill have taken place as this issue ofCBT Today goes to print, with ournext event to be held in Newcastlein November.

Main aims of theSupervision SIG include:

• Promoting and upholding highstandards of evidence-basedCBT practice, disseminatingresearch and good practice by providing workshops of a high calibre

• Helping to make supervisionaccessible

• Offering training anddevelopment opportunities to existing CBT supervisors, aswell as providing a resource for those who have notsupervised before

• Providing support and guidanceto those wishing to becomeBABCP Accredited Supervisors

• Delivering affordable andaccessible training events forCPD in the UK and Ireland

Join the Supervision SIGIf you would like to join thegroup, please contact us [email protected]

SupervisionSpecial Interest Group

| September 2014 3

The 2015 BABCP Annual Conferenceand Workshops will be held at theUniversity of Warwick, with theworkshops held on 21 July and themain conference held from 22 to 24 July.

As usual, the Scientific Committee willbe meeting throughout the year toorganise the scientific programme.We aim to produce the best learningexperience available in the field ofCBT, in all its varieties.

We want to give you the opportunityto learn from a wide range of nationaland international presenters. That isnot enough to grow the field,however. We therefore want to giveyou the chance to present your work.We encourage everyone to thinkabout submitting papers, posters,workshops, skills classes, symposia,and round table discussions.

Our philosophy remains that we wantto combine the scientific and theclinical; the science should berelevant to practice, and clinicalpresentations should be clearlygrounded in research and theory. Wealso welcome clinical ideas that

contribute to evidence generationand theory, as well as evidence-basedwork. A call for submissions is onpage 15 of this issue. Just make surethat you get yours in on time - andremember that there are twodeadlines for different types of work,so make sure you do not miss therelevant one.

A word or two about the facilities. Youwill remember that we have been toWarwick before, and I am happy tosay that they continue to developtheir facilities. The accommodation isall of a good standard, with differentclasses of room, all within a shortwalk from the conference area itself.The meeting rooms are close to eachother. Finally, free wifi is availableeverywhere. Just don’t aim to arrive inthe town of Warwick itself, as theUniversity of Warwick is on theoutskirts of Coventry.

In case you were wondering, we dolook at all the feedback that you give.So, in the light of the (generally highlypositive) feedback following theBirmingham conference this year, wewill be adjusting the conferencecontent and facilities in order to

Warwick, here we come

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address as many of your points as we can.

Some of the major keynote speakersare already lined up, with more yet tobe announced. Keep your eye on theconference website as plans develop,names are announced, and socialevents are planned.

We look forward to seeing you inWarwick. If you are not there, you willnever understand why theconference logo looks so much likea snail.

Glenn WallerChair, Scientific Committee

Submission deadlinesPlease submit your proposals by:

• 5pm on 12 January 2015 forworkshops, symposia, skillsclasses, round table discussions

• 5pm on 27 February 2015 foropen papers and posters

Guidelines will be on theconference website atwww.babcpconference.com

| September 20144

Annual payment Reduced Rate **

UK & Overseas * UK & Overseas *Ireland Ireland

Paid by Direct Debit £70.00 £78.00 £40.00 £48.00

Paid by Cheque/Card £78.00 £86.00 £48.00 £56.00

Fellowship Member £102.00 £110.00 £72.00 £80.00Subscription byDirect Debit

Fellowship Member £110.00 £118.00 £80.00 £88.00Subscription byCheque/Card

** All overseas mail will be by airmail

** The reduced rate is available to those Members who can demonstrate thatthey have a gross income of less than £21,388 per annum.

As BABCP membership tops 10,000 - and with a rapidlyincreasing volume of accredited members - theAccreditation Team is looking to recruit two additionalAccreditation Liaison Officers to increase overall resource inorder to appropriately meet the challenges this will meanfor the services we provide.

Each position will involve a commitment of 22.5 hours perweek working from the BABCP office in Bury. Therefore,please note these positions will only suit someone preparedto be predominantly working from the Bury office.Appointments will initially be for 12 months.

The newly appointed members of the team will assist theSenior Accreditation Liaison Officer and the existingAccreditation Liaison Officer in developing the AccreditationRegister; assisting in overseeing processes for accreditation;being responsible for supporting a team of accreditorsprocessing applications, and providing impartial andinformed advice to BABCP members.

Applicants will have been Accredited BABCP practitionersfor at least two years, and have a thorough understanding ofthe Accreditation process.

An application form and further particulars are availablefrom Company Secretary, Ross White, by [email protected]. If you wish to make any informal role-specific enquiries then please contact the SeniorAccreditation Liaison Officer, Charlie McConnochie, [email protected] or for organisation-specific queriescontact Ross White. Please note that a copy of all questionsasked by shortlisted candidates and respective answers willbe made available to all shortlisted candidates followingshortlisting.

Closing date for applications 7 October 2014

Interviews will be held in Bury week commencing 2 November 2014

Applications are invited from BABCP members for appointment as

Accreditation Liaison OfficersSalary from £43,096 per annum pro-rata - 22.5 hours per week

www.babcp.co.uk

At a meeting on 22 May 2014 the Board decided to remove Mr MikeDavison due to substantial breach of the Trustees Code of Conduct. This is inaccordance with the provision of the Code of Conduct and Article 26 of theArticles of Association.

2015 EABCT Congressin JerusalemAt its AGM in Birmingham earlierthis year, BABCP passed a motionexpressing regret that the 2015EABCT Congress was to be held inJerusalem. Following this, DavidRaines, who proposed themotion, has asked BABCP Boardof Trustees to consider furtheraction in this matter. BABCPBoard will be looking at David’sproposition at its Septembermeeting and will ask forconclusions to be published inthe next issue of CBT Today. Davidwill also be contributing anarticle laying out his view ofsome of the key issues involvedin holding the Congress inJerusalem.

Board noticesSubscription increase

The Board of Directors (Trustees) proposed the following rates of membership subscriptions to apply from 1 October 2014to 30 September 2015. These rates were agreed at the Annual General Meeting held at the University of Birmingham on24 July 2014.

| September 2014 5

Diversity has always been afascinating subject for me, particularlywhen I was working in central Bristol,where there is a large ethnic minoritypopulation. When I first startedthinking about researching this area, Iwas well aware of ethnic minorityissues in mental health. In particular, Iknew about problems involved inaccessing psychological therapies.

I was keen to find out more aboutwhy psychological therapies wereunder-utilised, and questionedwhether many of the treatmentapproaches were equally accessibleby minority ethnic populations. I triedto keep my views and opinions incheck to ensure I was working asobjectively as possible, from theperspective of a scientific practitioner.Although I doubt this has been a 100per cent ‘pure’ quantitative study, as Iam minded that I have beeninfluenced to some degree byresearcher subjectivity regarding thechosen topic.

Further rationale for this study waswhether researchers highlight apaucity of empirical research in thearea of investigating culturalcompetence. This study has beendesigned to add value to the researchin this area. The aim of the researchwas to develop an understanding ofCBT practitioners’ views towards theircultural competence within theframework of awareness, knowledge,skills and organisational support.

Whilst I have been well aware of myown ethnic identity (Mauritian/Irish)throughout the research, I have beenvery careful to emphasise that I amno expert on this subject. Engaging inthis study has made me more

informed on the subject as a resultof consulting the literature andbecoming conscious of other pointsof view in order to form morebalanced ideas around this topic.All this has helped to shape myawareness and knowledge as to whatbarriers are present for clients,therapists and organisations.

Critical to the improvement of mentalhealth services for minority ethnicgroups have been three keygovernment publications, namelyInside Outside, Delivering Race Equalityand Race Equality Training in MentalHealth Services in England. The mentalhealth system within the NHSacknowledges the need to developcultural competence amongst itsworkforce, and there is muchevidence in relevant literature toinform the practice of psychotherapy.

Studies show that, of those who entertherapy, non-white clients are morelikely to terminate therapy than whiteclients. This phenomenon could beexplained by the stereotypicalassumptions that some therapistsmay have regarding minority ethnicclients and discrimination.

The research was important for tworeasons. Firstly, it enabled therapist’sattitudes about their own awareness,knowledge and skills to be measured,as well as the level of organisationalsupport they received in relation tocultural competence. Secondly, Ihoped the study would bridge the gapin the empirical literature with regardto this currently neglected subject.

There also appears to be othercontextual factors that engender alevel of awareness, knowledge and

skills that facilitates culturalcompetence, such as experience ofliving in other cultures and a personalmotivation to learn from and workwith clients from other cultures. Itcould be argued that this is as valuableas being taught cultural competenceon a training programme.

There are many differing viewsbetween therapists, as well as withinthe literature, that support theargument for further research intocultural competency.

I used what was essentially aquantitative method to answer theresearch question; however, I am surethat a mixed-method methodologyincorporating quantitative andqualitative methods would provideother valuable insights into thevariables involved in acquiringcultural competence and into thedynamics of the acquisition process.

My findings suggest that it is possiblefor therapists to work in a culturallycompetent way with ethnic minorityclients without having used CBT for anumber of years; without beingethnically or racially matched to theclient; without having worked withethnic minority clients for a longtime; and without having completeda comprehensive training programme.

Conducting this study involved totalcommitment on my part, as well asthe expenditure of much effort andtime. That said, it has enabled me todevelop my practice further, allowingme to grow as a person. Theknowledge I have gained has meantthat I am now able to read andinterpret the methodology sectionsof other research with fresh eyes.

A study in cultural competenceSomerset-based High Intensity CBT therapist Jason Carombayenin (pictured left)recently carried out research on cultural competence and diversity awareness indealing with patients in a multi-cultural society. Here Jason gives a brief insight intothe findings which he hopes to publish

Diversity mattersDiversity matters

| September 20146

At the AGM held on 24 July duringthe Annual Conference at theUniversity of Birmingham, retiringBABCP President Professor TrudieChalder announced this year’s fiverecipients of the Honorary Fellowshipin recognition of distinguishedservice to the Association and theCBT community.

Professor Paul Salkovskis’contribution to the science andpractice of behavioural and cognitivetherapy has been outstanding. Inparticular his work on models ofpanic, phobias, health anxiety, chronicpain and OCD has provided afoundation for understanding andeffectively treating these disorders.His seminal 1985 theoretical paper onthe cognitive theory of OCDhighlighted the role of appraisal andthe particular importance ofresponsibility in the maintenance ofthat disorder. Paul developed the keyconcept of ‘safety-seeking behaviour’,highlighting its role in themaintenance and treatment ofanxiety disorders. Paul’s extensivework encompasses health screening,medical decision-making and theconcept of evidence-based patientchoice.

Paul’s influential work has led to thedevelopment of cognitive-

behavioural treatment strategies andthe refinement of CBT treatmentformats. He was recipient of the 2006Aaron T Beck Award for hiscontribution to cognitive therapy.Paul has personally contributed tothe teaching and training ofinnumerable therapists as well asproviding seemingly tireless efforts toenfranchise service users to seek andutilise better therapy. Paul has alsoserved BABCP as longstanding editor-in-chief of the journal Behavioural andCognitive Psychotherapy.

His career-long dedication to theeffective understanding and treatmentof anxiety disorders makes him aworthy recipient of his fellowship.

Professor Kate Davidson has made asustained and significant impact onthe delivery of mental health servicesin Scotland where she has largelyspecialised in treatment forborderline and antisocial personalitydisorders. Kate is also recognised forthe benefits her work has brought toprisoners in England. Indeed, as aconsequence of her input, HM PrisonFrankland operates the onlyaccredited therapy programme in thewhole of the UK prison estate. Over adistinguished career, Kate has beenrecognised as a leader, teacher,researcher and innovator in CBT

services in Scotland in academia andthe NHS. Her legacy will includeestablishing and leading the South ofScotland CBT course to accreditation,co-founding the Glasgow Institute forPsychological Interventions,developing the Matrix used byScottish Health Boards to guide themost appropriate psychologicaltherapy to patients, and her role asClinical Psychology Advisor to theChief Medical Officer for Scotland.

Kate’s contribution to BABCP beganin the 1980s when she was electedChair of the Lothian Branch. Last yearshe was co-opted onto the Board,whilst this year she was elected to therole of Honorary Secretary for a three-year term.

The contribution to the developmentand practice of CBT made by Dr JimWhite has been as a practitioner,researcher and innovative leader ofprofessional services in the NHS.

Jim’s patient-focused approach tostress control has been rolled outacross the UK and Europe in bothpublic and private settings throughgroup intervention. The GlasgowSTEPS model has had a profoundlypositive impact on those sufferingmental health issues amongstdisadvantaged communities in thearea. STEPS became a ScottishGovernment Exemplar Project whichled to Jim becoming Special Advisorto the Scottish Government MentalHealth Division.

Jim has maintained a strong focus onteaching and training in his work andhas trained around 1,500 CBTtherapists in stress control and theSTEPS model. As a result stress controlis now widely available on the NHS inthe UK, as well as across Europe, Asiaand the Americas.

Professor David M Clark can claimto have had the greatest impact onthe science and practice of CBT of anyBABCP member. He developed thehighly influential cognitive model ofpanic disorder while his originalpaper on the topic in BehaviourResearch and Therapy received anaward for being the mostoutstanding article published in thejournal's first 30 years since it wasestablished in 1962. With others healso developed highly effective

Jolly good Fellows

| September 2014 7

cognitive models and treatments forSocial Anxiety Disorder, PTSD andHealth Anxiety. A feature of his workis that all these models andtreatments are supported not only byevidence from numerous RCTs, butalso by experimental psychologyresearch on the basic psychologicalmechanisms underlying the disorders.

In 1992 David was elected Chair ofthe Association while, in 2000, he wasvoted the most influential CBTtherapist by its members. This wasbefore he played a crucial role in thedevelopment of England’s IAPTprogramme, which has considerablyincreased access to evidence-basedpsychological therapies. He has beenthe National Clinical Advisor for IAPTthroughout the programme.

Among many other distinguishedhonours, he is a Fellow of the BritishAcademy, a Fellow of the Academy ofMedical Sciences, and an HonoraryFellow of the British PsychologicalSociety. He received a CBE in the 2013New Year Honours for services toMental Health.

As both an academic and clinician,Professor Paul Gilbert is part of along line of dedicated, insightful andbrilliant individuals who worktirelessly to alleviate suffering.Through his career he has beeninvolved in developing and shapingour scientific understanding ofdifficulties such as depression, shameand self-criticism, whilst his focus onthe scientific understanding andapplication of compassion, as ameans of addressing suchdebilitating experiences, has resultedin the development of theinternationally respected CompassionFocused Therapy. In 2006 he foundedthe Compassionate Mind Foundation,a charity whose aim is to promotewellbeing through the scientificunderstanding and application ofcompassion.

Paul was elected BABCP President in2002. He has also been a member ofthe NICE Depression Guideline groupand has been awarded distinguishedhonours including Fellow of theBritish Psychological Society, Fellowof the Royal Society of Medicine anda Foreign Affiliate of the AmericanPsychological Society. Paul was

awarded an OBE in the 2011 NewYear's Honours list in recognition forservices to Mental Health Care.

This year BABCP also bestowedFellowship status on two membersfor the significant contribution theyhave individually made to theadvancement of behavioural andcognitive psychotherapies.

In the CBT world, Professor TommyMackay has played a central role inpromoting therapy within theprofession of education psychologyand in developing the evidence andpractice base for CBT with youngpeople on the Autistic Spectrum.Tommy has also made significantcontributions to servicedevelopment; for instance,therapeutic interventions for children,young people and families inScotland was prioritised after hedefined educational psychology andits impact there.

In 1974,Tommy established theKilmarnock Autistic Unit, the first ofits kind in Scotland.

In a career extending over 30 years,Tommy has always maintained astrong focus on teaching and, in 1998,

he helped set up the postgraduateautism teaching programme at theUniversity of Strathclyde in 1998which he still teaches on to this day.

Kathryn Mannix is recognisedlargely for her major impact inpioneering psychological assessmentand intervention for palliative care,helping patients and their families aswell as palliative care practitioners.The impact of her research has beenextensive; for example, her researchinto ‘Effectiveness of Brief Training inCBT Skills for Palliative CarePractitioners’ led to the roll-out of CBTskills for palliative care staff acrossNHS England between 2009 and2012. More recently her research workhas been focused on CBT fordepression in palliative care forpatients suffering with cancer.

Kathryn has developed training andteaching on a local, regional andnational level, from tutoring at theNewcastle CBT Centre to devising CBTtraining courses responsible forsupplying trainers for five cancernetworks. Her approach to trainingand teaching is by use of a cascademodel so participants are equippedto train new trainers.

Do you have what it takesto be a BABCP Fellow?The Board is inviting self-nominations from BABCP members for the nextround of Fellows.

Nominees should have been a BABCP member for a minimum of five yearsand demonstrated the significance of their contribution to CBT across of arange of domains, such as research, teaching, provision of clinical service, orservices to BABCP itself.

There is a fee of £150, which is payable on application to cover processingcosts, peer review and a small premium to raise funds for BABCP. In theevent of an application being unsuccessful, BABCP will refund the feeless £50 for administration costs.

The deadline for this next application round is30 March 2015, with successfulapplicants to be announced atthe AGM in July 2015.Further information onBABCP Fellowships, aswell as the applicationform, can be found onlineat www.babcp.com/fellows

| September 20148

Louise McHugh (LMc): For those ofus who didn't make it over to theACBS Annual World Conference inMinneapolis, were there any newideas or developments in ContextualBehavioural Science (CBS) that reallystruck or inspired you?

Steven Hayes (SH): There are a lot ofthings happening. The use ofRelational Frame Theory (RFT) as aground for clinical work is increasing.The importance of evolution scienceto CBS is becoming more obvious.The importance of bridge building isclearer and more successful.

The disciplinary focus is expanding. Ihad the sense that CBS is maturingand becoming more self-confidentand that it is growing in a healthyway despite the challenges of rapidexpansion.

LMc: How might these influenceyour own future research andwhat will we be hearing about inyour contribution to theDublin conference?

SH: My research and scholarship ismoving strongly in these generaldirections and I will indeed to talkingabout them in my presentations inDublin. I am doing an intermediateworkshop and plan to explore theimplications of evolution science andRFT as central themes, for example.

LMc: As a leading member of theCBS community, what matters mostto you about the work that you do?What drives you?

SH: I long ago became convinced thatscience was a social enterprise andthe only way to make a long-termdifference was to build a communitythat was supportive of each otherinside a coherent set of philosophicalassumptions.

What matters to me in the long run is

the wellbeing of the humancommunity but what matters in a moreproximal way is building an effectivebehavioural science and practicecommunity that is dedicated to makinga difference there, but is outward-looking, flexible, relatively non-hierarchical, coherent, and supportive.

That is not an easy task but we havedone shockingly well so far, simply byempowering the values-basedactions of researchers andpractitioners, and by sharing oursuccesses and our failures in anopen way.

LMc: The BABCP ACT SIG has abelief and a commitment to bringACT to our wider communities,beyond our clinics. Where wouldyou like to see CBS being put togood use?

SH: I agree enthusiastically with thatidea. The clinic is a window in a muchlarger world. But it is not the onlysuch window. I disagree with the ideathat helping one at a time is a waste.Every one of us moves many whenwe move.

But there are many, many gatewaysto human suffering and humanprosperity. Work, prosocial groups,churches, government, physicalhealthcare, schools, sports, recreation,media, families, and on and on. ACT,RFT, and CBS are inside all of theseareas. We have projects or studiesacross that wide range. That isincredibly exciting.

I think there is room for us to pursuethem all, if the community is largeenough. CBS follows the 'way of theturtle'. It depends on slow, carefulwork that spans basic and applieddomains. The reason it is beginning tofeel like progress is fast is because thecommunity is large, diverse, and

mutually supportive. That is very rarein the history of the behaviouralsciences. We can be proud of it. Butwe dare not rest on our laurels.

There are many basic issues thatwe've barely touched. That meansthat there are very few 'untouchable'issues in CBS. Contextualism isnecessary because it is a pre-analyticassumption and without it CBS is notCBS; empiricism is necessary forscience and we are a science-basedorganisation; the basic purposes ofCBS can be stated but not reallychallenged since they are pre-analyticas well. Everything else is on thetable. I think when really good mindssee that, they are drawn to the senseof freedom inside a coherent andsupportive community.

From there the answer to yourquestion is clear; stay connected andsupportive, but support diversitywithout our core commitments, andput CBS to the issues and domainspeople have heart for. Together wewill make progress by staying true toour deep concerns and passions.

Putting ACTin contextThis December will see the 2014 ACT/CBS Conference in Dublin, to be jointly hosted by theBABCP Acceptance & Commitment Therapy Special Interest Group (ACT SIG), the IrishAssociation for Behavioural & Cognitive Psychotherapies and the UK and Ireland Chapter ofthe Association for Contextual Behavioural Science. Headline speaker Professor StevenHayes (pictured left) talks to ACT SIG member Louise McHugh about his pioneering work

Full details of the Dublin conferencecan be found atwww.actcbsconference.com

| September 2014 9

CBT for psychosisin a high securityenvironment

Members of the UK High SecureHospitals CBT for PsychosisCollaboration Group presenting at theInternational Association of ForensicMental Health Services 14th meetingin June 2014

From left to right: Jonathon Slater(Rampton), James Tapp (Broadmoor),Alison Dudley (Broadmoor), PatriciaCawthorne (Carstairs) and BobCooper (Ashworth)

Jonathon Slater is a Nurse Psychotherapist at Rampton HighSecure Hospital. Here he talks about initiatives in providingCBT for Psychosis in the UK’s high security hospital estate

In accordance with nationalguidance, CBT for Psychosis (CBTp) isoffered to patients in each of theUK’s four high secure hospitals inorder to aid patient recovery andtransfer to lesser secure conditions.A broad and well-establishedevidence base supports CBTpprovision in less secure settings;however, little research has beenpublished relating to delivery withinconditions of high security. Highsecure patients are typically lessadherent and more complex andchronic than their communitycounterparts.

Each high secure hospital in the UKhas therefore developed andevaluated site and populationspecific modes of CBTp delivery inresponse to the complex recoveryneeds of their patients. This has ledto a rich diversity in serviceprovision, such as Group CBTp,Individual Chief ComplaintOrientated CBTp, Symptom Specific

Individual CBTp, Combined one-to-one CBT for Psychosis andPersonality Disorder amongseveral others.

Local service evaluation studiessuggest these initiatives are havingan encouraging impact onpsychosis, recovery, risk andresilience. Whilst thesedevelopments may be consideredinnovations in themselves, however,they existed largely in isolation untilrecently.

The UK High Secure Hospitals CBTpCollaboration Group, which I chair,was set up at the start of 2014 todata share and innovate in order tocomply with NHS CommissioningBoard requirements. These promotestandards of equity and excellencein specialised care contexts,stipulating that patients shouldhave equal access to consistent andeffective services regardless oflocation. This indicates a need to

consolidate and harmonise CBTpacross the UK high secure sites.

Pooling its combined knowledge,experience and study results, theCollaboration Group has developeda CBTp algorithm synthesising thebest of what has been developedacross the sites. The CollaborationGroup was fortunate enough topresent the algorithm alongside thesupporting evidence at this year'sInternational Association of ForensicMental Health Services meeting. Thisis one of the first collaborations ofits type between the UK high securehospitals, which has taken passionand persistence to achieve. TheCollaboration Group now hopes toexplore the feasibility of cross-sitestudies of efficacy.

It has been a real privilege to workwith and learn from the members ofthe Collaboration Group and anamazing opportunity to havepresented with them atinternational level. We are all keen tocollaborate with the aim ofimproving patient recovery andlowering risk.

| September 201410

Ageing: what does this mean to you?Does a particular person come tomind...whether this is a familymember...celebrity or neighbour?What sort of feelings does this termevoke in you?

Christine Padesky suggested that theultimate efficacy of CBT is enhancedor limited by the beliefs of thetherapist. When working with olderadults then, it is crucial to be aware ofyour own ageist assumptions. It isnoteworthy that the editorial in a2004 issue of Behavioural andCognitive Psychotherapy, highlightedthat therapists ought to utilise thecognitive approach in order tochallenge their stereotypical view ofage. It is vital, therefore, to be mindfulof our own assumptions whenworking with this patient group.

In 2002, the Department of Healthstated that a person’s age should notpreclude them from psychologicaltherapies. The proportion of the UKpopulation aged 65 or older

continues to rise, and the question ofhow best to meet the needs of thisclient group is highly relevant to IAPTservices. Referrers often miss thesigns of depression and assume thatolder adults' emotional difficulties arerelated to physical health problems.

Within my service, following on fromthe assessment process, the aim is tobe collaborative with an emphasis onthe therapeutic relationship as well asempathy, warmth and compassion.CBT is active, directive and structuredand this is implemented throughoutsessions of GSH. Such sessions tend tobe planned in advance, whether overthe telephone or face-to-face, and thepatient is given a contract for anoverview of the sessions. The patientis discussed in supervision on aregular basis.

During sessions of GSH with olderadults, we spend time exploring whatCBT is and the five areas model. Oftenan older adult’s response can bealong the lines of 'well that makes

Working with older peopleRaj Saraw is a PWP who offers self-help (GSH) to older adults in Sussex. Here she reveals her feelings andresponses to ageing and how she manages these within her role

”“There are often issues of ill health and loss(such as mortality and loss of role), whichcan bring up strong feelings in a PWP

| September 2014 11

sense... that is obvious... I have to dothings I have never had to do beforesuch as paperwork and paying bills'.As a PWP, I understand that makingadaptations is necessary in order toensure the patient benefits from oursessions. It can become quite difficultto plan and define problems, due to alack of motivation or an inability toengage in strategies which requireeffort. Often there is a lack ofawareness and negative comparisonswith 'old self', which can be exploredthrough learning to become moreself-compassionate.

There are often issues of ill health andloss (such as mortality and loss ofrole), which can bring up strongfeelings in a PWP. I find this affects thesessions of GSH especially when thepatient may have relied heavily ontheir partner or other closefriendships. On the other hand, it canalso enrich the sessions as this allbuilds on the therapeutic alliance.

As I reflect on my experience, I amable to take a step back from thefeelings that were initially evoked. Ican reflect on the way that I initiallyfelt whilst with a patient, as this mayhave affected the therapeuticrelationship. I try to break away fromthe idea that I am the expert with thetools to remedy the patient’sdifficulties, choosing instead to setSMART goals which are reviewedduring GSH.

I have become aware of my ownapproach towards older adults. I havea great sense of respect for the olderadults I work with as a PWP. I believethey have a lot of 'life experience' andI value this as part of their journey in life.

Family and society within my owncultural background value olderadults’ wisdom and guidance, whileyounger generations are expected tocare for elders. This is not the same inthe UK, and therefore those olderadults from other culturalbackgrounds can find adjustment toa new society a tough one.

Older adults often feel that they arewasting NHS time and resources, andthat someone worse off than themmay benefit from treatment ratherthan themselves. When offered thisview by older adults, I use this as a

basis to educate and reassure themthat, at times, we need to offer a littleextra support. This has the advantagethat they can then learn new skillsthat can be valuable if facedwith symptoms of anxiety ordepression in the future. Oneparticular patient that Iworked with was able toaccess basis computer skillsas one of his goals, whichhe found practically helpfuland also led to discoveringnew friendships in theprocess.

In terms of future practice, Ihave adapted my approachby using an easy-to-understand model of the fiveareas which provides casestudies of people that may bedepressed or anxious. I can onlyhighlight, therefore, that thepositives of reflective practiceis, firstly, to be aware of one'sown feelings, and secondly, tobe able to talk and expressthem openly. Taking thisapproach has nourished mylearning and developmentas a PWP. By using reflectivepractice, I can see how

valuable it is to notice and be awareof reflexive feelings that are all part ofthe therapeutic relationship.

Spring Conference

CBT for personalitydisordersKing’s College London9 and 10 April 2015

www.babcp.co.uk

| September 201412

For the past two decades, theemergence and rapid expansion inuse of the internet has quicklypresented clinicians and researcherswith ample opportunities both todevelop and evaluate variousmethods of online mental healthsupport. Interventions and onlineformats vary considerably.

Commonly cited strengths of onlineinteraction include accessibility andconvenience, cost effectiveness,factors such as disinhibition wheninteracting online, as well as simplepersonal preference. Accompanyingchallenges include ensuring safetyand an oft-cited tendency for higherdrop-out rates in some studies whencompared with face-to-face support.

It could be argued that much of thepromising evidence concerningonline therapy and self-directedprogrammes has been accruedthrough the use of CBT for variousdisorders. Perhaps this makes sensegiven that the relatively structuredand active features of the approachmay lend themselves more todelivery online, whether or not atherapist is directly involved.

Some interesting findings byresearchers at Macquarie University inAustralia, for instance, concern thecircumstances under which CBTprogrammes may be successful. Theteam, led by Professor Nick Titov,found not only that CBT deliveredonline holds up well against face-to-face sessions in terms ofeffectiveness, but also that even arelatively untrained ‘technician’guiding and supporting the user’stherapy appears to yield resultssimilar to those of the fully-trainedCBT therapist.

As someone who is both a CBTtherapist and also working at anonline mental health organisation, Iam keen to contribute to the furtherdevelopment of cost-effective,efficacious and easily accessible CBTfor a range of disorders. Indeed, I havebegun part-time doctoral studiesthrough a London university whoseaim is to develop, deliver, andevaluate two 10-week programmes ofstructured online support groups or‘S-OSGs’; one for depression and theother for generalised anxiety disorder(GAD).

Both group programmes will broadlyconsist of two components. The firstof these consists of weekly – butentirely automated – eLearningmodules which focus onpsychoeducation regarding eitherdisorder.

With between 10 to 17 slides permodule, each week’s material has tobe read and a multiple choice quizpassed in order to progress to thenext module. Each module andaccompanying quiz are intended toeducate participants concerning keyfeatures of either depression or GAD.

In addition to the weekly modules,which users can complete in theirown time, they will also beencouraged to attend weekly S-OSGs. Rather than constituting anexperiential, process, orinterpersonally focusedintervention, the S-OSGs arestructured much like a standard CBTsession with initial mood check,feedback from the previous group,discussion of assigned homework,introduction of a new topic ortheme, shared examples frommembers, setting of next week’s

homework and closing with brieffeedback. The focus is placed moreon consideration of, and support inapplying, module content ratherthan extended discussion of specificusers’ life circumstances.

The basic rationale guiding theprogramme is two-fold. Firstly, wemay be able to make the best use ofself-paced psychoeducation byautomatising this component of CBTdelivery, thereby reducing therapisttime and cost involved.

That said, we may concurrently beable to address the somewhat highgeneral drop-out in some onlinetherapy studies, as well as help usersto apply material in the very personalformulation concerning their ownlives by providing a more ‘human’contact and opportunity for inquirythrough the weekly groups.

An attempt to optimise safety will besought through an initial screeningfor exclusion criteria such assuicidality, ongoing self-harm and co-morbid drug or alcohol dependence.Information such as contact details ofboth the user and their primaryhealthcare provider will be requiredbefore participation can proceed.Those scoring in the ‘severe’ range onmeasures of either disorder will beexcluded, but offered information andsupport in accessing moreappropriate services.

It is hoped that both programmes – ifboth effective and acceptable forusers – may then be rolled out on alarger scale. We may also developsimilar combined programmes forvarious other disorders as well asskills-based programmes formanaging emotions for self-harm.

Improvingsupport availablevia the internet

In an ever-expanding online world, the internet is being used more and more by those seeking therapy.CBT therapist Eoin O’Shea discusses his involvement in the development and evaluation of structuredonline support groups for depression and anxiety

| September 2014 13

Continuing our series of articleson women, feminism and mentalhealth, Associate Editor Patricia Murphy meets fourfemale 'game changers' whohave made a significantcontribution both within BABCPand the wider CBT community

In 2013, Radio 4’s Woman’s Hourlaunched its annual Power List of the100 most powerful women in thecountry. The list highlighted theachievements of women working in abroad range of sectors, from politicsand law to the arts and science. Butthe list also revealed some significantgaps, notably the lack of ethnicdiversity amongst women inpositions of the greatest power,with no-one from a minority ethnicbackground making it into the top 20.

This year the spotlight was refocusedspecifically on women who werechanging the way power operates insociety. This produced a moreethnically diverse list, ranging fromhigh-profile whistleblowers tograssroots social media campaigners,and was judged by an equally diversepanel of women, all of whom hadmade their mark in their own right.The Woman’s Hour Power List 2014Game Changers were announced in alive broadcast from the BBC’s RadioTheatre in April this year, with ticketsunsurprisingly sold out.

Woman’s Hour has been broadcastingsince 1946 and regularly attracts

almost four million devoted listeners,44 per cent of whom are men.Attending a live radio recording ispretty thrilling and to be in closeproximity to the show’s formidablehosts - Jenni Murray, who has been atthe helm since 1987, ably assisted byJane Garvey who joined theprogramme in 2007 - guaranteed apalpable sense of reverence andexcitement in the audience.

When Doreen Lawrence wasannounced as the number one GameChanger, the audience erupted. Bythe time she had walked onto thestage, there was an outpouring ofheartfelt emotion and some tearsshed, not least by Murray herself.Doreen spoke movingly andgraciously about her journey whichwas ignited by the most terrible ofpersonal tragedies, the racist murderof her son, Stephen. This theme ofpersonal trauma was repeated in theprofiles of many of the women on thelist; women who had been livingrelatively quiet lives but, in reaction toadverse events, found themselvescompelled to embrace social activismand campaigning.

Successfully challenging some of thenation’s most powerful institutions asDoreen Lawrence has done is not forthe fainthearted and it was clear thatthe personal cost to her had beenenormous. When she told theaudience, for example, about anaversion to public transport andacute discomfort with the publicgaze, one got a sense not of a lifechosen but a life bent out of shape bytragedy. For all the achievements andaccolades garnered this is a womanwho would give it all away to haveStephen alive.

Similarly, Julie Bailey, campaigner andfounder of Cure the NHS, whoexposed the failings at StaffordHospital following the death of hermother Bella in 2007, endured thenegative consequences ofwhistleblowing, including onlineabuse which forced her to sell upboth her business and home becauseof threats to her personal safety.

Despite the clear dangers sometimesassociated with shifting the balanceof power, the audience wereencouraged to think of themselves as

Changing the game

The women’s room

Continued overleaf

| September 201414

having the potential to be gamechangers in their own lives andcommunities. As therapists, weunderstand the potential that therapyhas to transform the lives of ourclients. It is apt, then, as part of Thewomen's room series, to reflect on thesignificant contributions made bysome of the highly distinguishedwomen in both our Association andprofessional community who havenot only advanced our understandingof psychological distress, but alsopioneered the development ofclinically effective treatments.

This, then, is an up close and personalsample of just some of the manywomen in the world of CBT who haveraised the bar.

ROZ SHAFRAN

Roz Shafran is Professorof Translational

Psychology at the Institute of ChildHealth, University College London.She is co-founder of the CharlieWaller Institute of Evidence-BasedPsychological Treatment and is aformer Wellcome Trust CareerDevelopment Fellow at the Universityof Oxford. Her clinical researchinterests include cognitivebehavioural theories and treatmentsfor eating disorders, OCD andperfectionism across the age range.

More recently, Professor Shafran’swork has addressed thedissemination and implementation ofevidence-based psychologicaltherapies, and the interface betweenphysical and mental health. She hasprovided training workshops in herareas of clinical expertise and hasover 100 publications. She receivedan award for DistinguishedContributions to ProfessionalPsychology from the BritishPsychological Society as well as theMarsh Award for Mental Health work.Until recently, she served as co-chairof BABCP’s Scientific Committee.

Patricia Murphy (PM): Is this thework you imagined you would doas a young woman?

Roz Shafran (RS): I always thought Iwould work with children but it justnever happened. My career took me indifferent directions for about 20 years,but I am very pleased that I am nowworking with the population that I

have always wanted to work with.However, I have always managed to doa little bit. For example, my very firstjob was as a volunteer, looking forsome work experience at GreatOrmond Street when I was 18 yearsold.This has led to a life-longassociation with Great Ormond Street.In fact I gave my Inaugural Lecture inFebruary and, whilst preparing, founda report from a careers adviser when Iwas 15 which very accuratelydescribed me as someone who shouldwork with people and who wouldwant to be an expert in their field. Sheabsolutely got me!

PM: When did you become aware ofhuman suffering?

RS: When I was 13, a friend of minedeveloped anorexia nervosa. Iremember writing an essay about itwhich won a Young Telegraph Writersmerit award. I am a very emotionalperson as is my dad, and so I wouldsay that I am probably more aware ofemotion than suffering.

PM: Have you always wanted todo good?

RS: Yes. My dad worked in finance andhe was a regular reader of theFinancial Times, and I promised myselffrom a very early age that I wouldnever read it. I have never beeninterested in that side of things. Mylife had to have meaning. Somewomen give up work when they havechildren but that just was not anoption for me. That is not to say thatmotherhood is not very important tome. But, my work gives my life adeeper meaning and, althoughcombining motherhood with a careercan be a struggle at times, overall Ihave very few regrets.

PM: What three things havecontributed to your success?

RS: You know, I do not feel successful. Ithink it is relative so I would say I amprobably more successful than someand less than others. I guess I couldhave done more if I had given upsome things along the way. I mean I

am okay! I have been very, very luckyparticularly with mentors andcolleagues. Also, I love what I do; I ampassionate about it and I work veryhard. I am a grafter.

PM: When things get tough, how doyou keep yourself going?

RS: That is a really good question. I cryfirst! I try to remind myself of what isimportant. You know, to be truthful,going through the corridors of GreatOrmond Street and seeing whatthese sick children have to cope withis a great leveller, and reminds methat whatever I am facing is trivialand puts things in perspective. I hopeit goes away but I also try to problemsolve.

PM: What are you most proud of?

RS: I think I am most proud of the factthat I have tried to maintain myprofessional integrity and aspired toalways treat others with decency and respect.

PM: Which women have inspired orinfluenced you, and why?

RS: Zafra Cooper, PrincipalInvestigator at the Department ofPsychiatry in Oxford, immediatelysprings to mind as someone I hugelyrespect. She is able to combineintelligence with kindness plusbalance in life; all the things I reallyrespect. Emily Holmes is a peer whomI greatly admire. She has balls and astrategic mind! I would also have toinclude Lady Rachel Waller and theinspirational way in which sheresponded to the tragic loss of herson from suicide aged 28.

I should also mention Rachel Bryant-Waugh, Consultant ClinicalPsychologist at Great Ormond Streetwho was running up and down acorridor when she gave me my firstjob! Isobel Heyman, Consultant Childand Adolescent Psychiatrist also atGreat Ormond Street is another. I amprobably forgetting people becausethere are so many women I couldmention, including my first labpartner Maria. We worked together in

“ ”A report from a careers adviser when I was 15 described me assomeone who should work with people and would want to be anexpert in their field. She absolutely got me!

Continued on page 16

BABCP AnnualConference and Workshops

University of Warwick21 - 24 July 2015

The Scientific Committee invites submissions ofPre-Conference Workshops, Symposia, Clinical Roundtables,

Panel Discussions, Skills Classes, Open Papers and Posters

Deadline for Workshops, Symposia and Skills Classes: 12 January 2015

Deadline for Open Papers and Posters: 27 February 2015

www.babcpconference.com

For more information please visit www.babcpconference.com

| September 2014 15

| September 201416

Vancouver and she helped to changemy view of team working in a verypositive way.

PM: Is there a book that helpedinform and shape your thinking?

RS: It would have to be Rachmannand Hodgson’s Obsessions &Compulsions. That is the one!

PM: What do you see as the majorchallenges women currently face interms of protecting their emotionalwellbeing?

RS: I think the major challenges thatwomen currently face in this field aresimilar to those that men face -becoming over-involved with clients’distress, becoming ‘burnt out’, andtrying to deliver high qualityevidence-based interventions in anera of cost-cutting.

PM: What piece of advice wouldyou like to pass on to the nextgeneration of CBT therapists?

RS: To understand thepsychopathology with which you aredealing and the principles as well asthe practice of CBT, so that it can bedelivered both with fidelity but alsowith flexibility and fun!

MELANIE FENNELL

Dr Fennell is a pioneerof cognitive therapy for

depression in the UK, and a foundermember of the Oxford CognitiveTherapy Centre. As research clinicianin the Psychiatry department ofOxford University, she contributed tothe development and evaluation ofcognitive models and treatmentprotocols for depression and anxietydisorders. She developed anddirected the highly successful OxfordDiploma in Cognitive Therapy, theOxford Diploma/MSc in AdvancedCognitive Therapy Studies (a worldfirst, dedicated to training CBTdisseminators), and MSt inMindfulness-Based Cognitive Therapy.

She has published widely and hasextensive experience of teaching andtraining both CBT and MBCT. She hasa particular interest in cognitivetherapy for depression and low self-esteem. In July 2002, she was voted‘Most Influential Female UK CognitiveTherapist’ by the members of BABCP,and, in 2013, was awarded an Honorary

Fellowship of the Association.

Patricia Murphy (PM): Is the workyou do now the work you dreamedof as a young woman?

Melanie Fennell (MF): Not at all. In mylast years at school, I studied EnglishLiterature, French and Latin. Atuniversity I did my first degree inEnglish, and anticipated finding somefascinating and glamorous job inpublishing. I wished neither to teachnor to conduct research, whichseemed like the most commonoptions following such a degree –which is ironic, given that (alongsidetherapy) those have been my mainactivities and pleasures since theearly 1980’s. The glamorouspublishing job did not turn out, so Iwent into the Civil Service. Good solidbroad management training, which Ithought would come in handy nomatter where I ended up, but I spentmost of my time looking at my watchto see if it was time to go home yet.Then, purely by chance, I met up withan old school friend who had becomea clinical psychologist. I thought, thatsounds interesting, I’ll have a go atthat. What attracted me was the ideaof combining the intellectualstimulation of theory and researchwith the human contact of clinicalwork. And I have not looked at mywatch to see if it is time to go homeyet since.

PM: When did you first becomeaware of human suffering?

MF: From childhood. My father was aprisoner of the Japanese for fouryears. He then lost my mother whodied when I was born.

PM: Have you always wanted to do good?

MF: That is not how I thought aboutit. I was brought up to believe in theideal of service to others, and myfather’s work as a Church of Englandvicar in a small country parishexemplified just that. The school Iwent to encouraged the same values.I think the message was that my lifewas very fortunate, and that it wasright to give something back. I still

fundamentally believe that. I havebeen amazingly blessed to find suchrewarding work, in a place ofexcellence, and with so many people Iboth like and respect. If, along theway, it has been possible to helpsome people, then I cannot really askfor more.

PM: What drew you to yourparticular areas of interest?

MF: In terms of CBT, my clinicaltraining at Birmingham Universitywas in Skinner’s radicalbehaviourism. Anything cognitivewas pretty revolutionary, and indeedoften regarded as irrelevant. When Imoved into my first clinical job insouth London, I duly applied what Ihad learned. But, as time went on, Ibecame increasingly frustrated. Thebehavioural approach was prettygood with anxiety, but at that timepretty hopeless with depression.Then I saw an advertisement for aresearch clinician’s job in Oxford,with John Teasdale. The project wasone of the first clinical trials ofcognitive therapy for depression inthe UK. We had intensive trainingfrom people at the Center forCognitive Therapy in Philadelphia,including Jeff Young. So gettinginterested in depression followedfrom developing skills inunderstanding and treating it, Ithink, and seeing how helpful CBTcould be to people who appearedcompletely stuck. My interest in self-esteem grew out of that work, andthe next project I was involved with– a clinical trial of cognitive therapyfor generalised anxiety disorder withGillian Butler. I became aware thatthere were people who were notsimply either anxious or depressed,but a mix of both, and difficult to saywhich came first or was the mostimportant. Could there be a commonroot?

As to my interest in training, beingthere at the very beginning of CBT inthe UK was a real stroke of luck.Everybody wanted to know how todo cognitive therapy for depression.The other stroke of luck was thatJohn Teasdale was not at all

“ ”What attracted me [to clinical psychology] was the idea of combiningthe intellectual stimulation of theory and research with the humancontact of clinical work

| September 2014 17

interested in training, so I got lots ofopportunities to pass on what I hadlearned to other people - thanksabove all to BABCP for that. Idiscovered that I loved training, itwas great to see peopleenthusiastically learning, and fun tocreate interactive sessions that gotpeople engaged and active. Best ofall, as Seneca said, ‘When peopleteach, they learn.’ So thanks also toall the participants and trainees Ihave been lucky enough to workwith, here and abroad, who havekept me learning and interested andintrigued with all their searchingquestions.


MF: Curiosity, liking people and beingin the right place - Oxford - at theright time.


MF: Good genes - both my parentshad robust, humorous temperaments.My upbringing, which taught me tobe strong and independent. Laughingwith people I love, good food andgood wine. Meditation. And denialand distraction - I am a great believerin both.

PM: What are you most proud of in your career?

MF: Having made a difference inpeople’s lives, through therapy,through training and through writing.


MF: Joan Kirk, head of theDepartment of Clinical Psychology atWarneford Hospital, whose warm,intelligent, facilitative managementstyle gave me the opportunity toextend my training skills, and todevelop the Oxford Diploma inCognitive Therapy and then theDiploma/MSt in Advanced CognitiveTherapy Studies. I remain enduringlygrateful to her. Gillian Butler, forhelping me to see the importance ofremembering that even the mostdistressed and damaged people haveresources to build on. ChristinePadesky for being an innovator andan absolutely wonderful trainer.


MF: The book from which everything I

have done since has flowed is Beck,Shaw and Emery’s Cognitive Therapyof Depression. It saddens me that fewpeople read this seminal text,because it is full of insight andpractical wisdom and, aside from the rather sexist language, remains as relevant now as it did when it was published.


MF: The same as always.‘Post-feminism’ is a myth. Especially if you look outside the Westerndemocracies.


MF: The great thing about CBT is thatit is an ever-expanding field. We neverreach the horizon, there is alwaysmore to discover, more questions toask, more puzzles to solve. Isn’t thatgreat? Remember that the theorybehind CBT is about how humanminds work, not about howdiagnostic categories work. Humanbeings are more diverse, morecomplex and more fascinating thanthat. And remember you are a humanbeing too, and all this applies just asmuch to you. Finally, we arefantastically privileged to do the work we do - enjoy it!

MARY WELFORD

Dr Welford qualified as aClinical Psychologist in

1999 from Manchester University.Whilst training she became an activemember of the North West BABCPBranch. Mary subsequently went onto hold posts as an ordinary memberof the National Committee, BABCPMagazine Editor and ScientificCommittee member for theManchester EABCT Conference.Recognising the need for greatersupport for Branches, she successfullyproposed the setting up of a BranchLiaison Committee.

Clinically, Dr Welford went on to workunder the supervision of Adrian Wellsand Tony Morrison on a number ofCBT research trials and, in a split post,also developed her clinical skillswithin Community Mental HealthTeams. It was here that Mary

developed her practice of individualand group-based CompassionFocused Therapy. She went on be afounding member and chair of theCompassionate Mind Foundation.She is also a trainer in the CFTapproach and, in 2012, wrote TheCompassionate Mind Guide to BuildingSelf-Confidence.

Dr Welford moved to Cornwall twoyears ago where she wascommissioned to provide mentalhealth provision within theGovernment’s Troubled Familiesinitiative. She also heads up aCompassion in Education initiative, isdeveloping workshops inCompassion for Therapists and workswith a number of athletes usingcompassion to improve their livesand performance.


Mary Welford (MW): In preparation formy clinical psychology interview, Irecall a qualified member of staffsaying,‘Whatever you do, if you areasked why you want to do thetraining, don’t say you want to helppeople’. I remember being puzzled bythis and maybe too ashamed to askwhy they thought this was such anegative thing to say. In my interview,I mentioned wanting to conductresearch, study CBT and contribute tothe literature, yet my true motivationwas indeed to help individuals andalso prevent distress.

Alongside this, I suppose I did dreamof working with like-minded peopleand my work being valued by others,whatever my job. I did not dreamabout writing or being so involved intraining others, but I am reallygrateful that I have been given suchamazing opportunities to do so.Maybe because many of the things Ido were beyond my aspirations, thisaccounts for why I am so happy in my work and regularly have to pinchmyself.


MW: I recall my own suffering before Iever had a sense of other people’s. Fora number of reasons, I had times inmy childhood when I had a profound

The women’s room

Continued overleaf

| September 201418 “ ”

sense of being an outsider and, as aconsequence, would strive to fit in. Iwas unhappy at times, would oftenworry and lacked self-acceptance andtrue self-confidence. Of course, atother times, I was blissfully happy and content.

It was only as a teenager that I beganto look around me and realise thatother people in my immediateenvironment struggled, and sufferedtoo. In many ways, this helped. I feltmore similar to other people andbegan to open up to them.

But, as I looked beyond my ownstruggles, I found the pervasive natureof some people’s difficulties moredistressing. Whether it was the imageson TV of the famine in Ethiopia, thegirl who came to school smelling ofurine or the boy who was shamed bya certain teacher and crieduncontrollably in front of his class.

I recall feeling despair that thingswere just not fair for some peopleand, as an adult, felt a deep-seatedmotivation to address this as andwhen I could.


MW: Whilst in Manchester, I wasinspired by the work of AdrianWells,who supervised me for anumber of years. I found hismetacognitive approach,emphasising the way people relate toand interpret the thoughts andimages that occupy their minds, ofgreat assistance to those I workedwith. In equal measure, I was inspiredby Tony Morrison’s work withindividuals experiencing psychosis.His CBT framework and his emphasison harnessing meaningful serviceuser involvement is a great model forall services to aspire to.His service was an amazing one towork in.

However, whilst some individualsbenefited greatly from applying suchapproaches to their lives, I witnessedthat others seemed to be ‘left cold’ bythe approaches. It was then that Iturned to the work of Paul Gilbert toexplain the blocks many peopleexperienced and provide aframework for addressing these. It isthe application of this approach tomy life that has resulted in greatchanges for me personally. It is also

the continued application of thisapproach to my life that allows me tocontinue to approach and engagewith the suffering of others.


MW: My dad was a police officer inthe days when the local bobby wasknown to almost everyone in thecommunity within which theyworked. He spoke about the diversityof his work life. One day he would bedealing with an individual who hadbroken into a car, whilst the next hewas dealing with the driver of aJaguar car who had broken down atthe side of the road. He advised me totreat everyone with the same respectand interest - we are all so muchmore similar than we are different.This gave me confidence to approachothers, no matter what their position,and speak to them as a human beingfirst and foremost. As such I tendednot to be intimidated by others, andthe ability to initiate and haveconversations with others openeddoors for me.

My mum has amazing compassion forothers. She is at her strongest whenshe is ‘there’ for other people andshows incredible courage, strengthand sensitivity. I am sure that hercompassion has had a great positiveinfluence on me. Not only showingme the importance of such qualitiesand modelling them but, mostimportantly, being my ‘safe base’ towhom I can turn throughout my life.

Finally, I have been very lucky to havemet individuals within my career,many of whom have become friends,who have inspired and encouragedme. Surrounded by a network ofamazing people, I am able to be openabout the things I find difficult andempowered to voice my ownthoughts and reflections regardingmy work. All of this means I amforever learning, which I love.


MW: Thankfully I can turn tocolleagues, family and friends. These

days I also choose self-compassionrather than hostile self-criticism. Indoing this I recognise that things aredifficult, rather than underminingmyself, and look towards the futureinstead of ridiculing myself about the past.

I have a number of other ‘props’ tohelp me. For example, I have anecklace that says ‘my life, my rules’that I wear when I feel I need thecourage to stick to my principles orethics. I write to myself, sometimesletters, sometimes single words onmy hands. I listen to specific pieces ofmusic or go and look at a vista inorder to help me gain a sense ofgreater perspective on things.

PM: What are you most proud of in your career?

MW: When I look back, I feel mostproud about specific pieces of work Ihave done with certain individualswho have been on their own withtheir distress. Being able to create anenvironment in which someone isable to connect with the pain of theirdifficulties or experiences is incrediblypowerful. I feel moved when I thinkabout those sessions, privileged but Isuppose proud too.


MW: I suppose my greatest femaleinfluences come in the form of friendsand family. I have mentioned mymum previously, but my sister is anincredibly strong women who holdsand maintains values that I admire.She is a passionate primary schoolteacher, the kind of class and mathsteacher I wished I had.

I also have a lot of female friendswithin the profession and theirongoing support is vital to me.


MW: There are a lot of academicbooks that have helped shape mythinking. But, the book that has hadthe most profound effect on me isHarper Lee’s To Kill a Mockingbird. Thenovel revolves around very serious

I recall feeling despair that things were just not fair for some peopleand, as an adult, felt a deep-seated motivation to address this as andwhen I could

| September 2014 19

issues of inequality, yet is gentlywritten and strikingly warm andhumorous. It makes me reflect thatmaybe this is a good recipe foreffective therapy.

PM: What are the attitudes thathelp to keep you balanced?

MW: A number of mottos werefrequently used in my childhoodfamily home. The top four were:

- There but for the grace of God go I- Remember what matters - Don’t be a sheep- To thine own self be true

Of course, such statements remainrelatively meaningless unless they areassociated with certain attitudes,emotional tone and guidedbehaviour. Another furtherperspective that helps me is my beliefthat we are all part of the flow of life.To me this means we are allconnected. It ensures that I neitherfeel isolated, or get above my station.


MW: The fast pace of life andcompeting roles and responsibilitiesmean that we all have the capacity tooverlook our emotional wellbeing. Inthe past this was maybe truer forwomen who often had specific rolesin the family. I now see less genderspecific expectations and many malesalso struggle for balance too.

I am also struck by so manymarketing campaigns, articles andprogrammes that place increasingpressure on us all to have a ‘perfectlife’, ‘perfect house’ and ‘perfect body’.They indicate that this is the key tohappiness. In actual fact, they canmake us feel inadequate or ashamed.All of this has an impact on ouremotional wellbeing.


MW: Learn about and develop alifelong compassionate practice andinfuse your personal and professionallife with such qualities.

This will help you to recognise whatyou are good at and also warmlyrecognise the things you need towork on. Turn to others for support.

Realise that you are part of a family ofindividuals who are working tochange lives for the better andeveryone’s contribution is vital.

DEBORAH LEE

Dr Lee is a ConsultantClinical Psychologist,

Head of Berkshire Traumatic StressService and South Central VeteransService. She is also an honorarySenior Lecturer at University CollegeLondon. She is a board member ofthe Compassionate Mind Foundationand author of The Compassionate-Mind Guide to Recovering from Traumaand PTSD: Using Compassion-FocusedTherapy to Overcome Flashbacks,Shame, Guilt, and Fear. Dr Lee hasworked in the field of trauma for 20years and specialises in the treatmentof PTSD and complex trauma. Herparticular area of clinical and researchinterest is in shame-based PTSD andself-criticism. She has developed theuse of compassion-based treatmentsincluding the use of compassionateimagery in shame-based flashbacksto enhance clinical practice in thisfield. She has pioneered the use ofdeveloping compassionate resilienceas part of a phased-based treatmentapproach to complex PTSD. She haswidely contributed to thedissemination of her clinicalknowledge through writing anddelivering clinical workshops andtalks in North America and Europe.


Deborah Lee (DL): I cannot quiteremember what I wanted to do withmy life as a young woman, but I ampretty sure I never thought I wouldend up being a clinical psychologistand helping people who havesuffered so profoundly at the handsof others. I think, if I am honest, I hadabsolutely no idea I even wanted tobe a psychologist and probablydreamed of being an actor. I certainlynever thought I would teach and givewhole-day workshops, as I used to beterrified of public speaking. I evenrecall missing double English atschool because the teacher used tomake us read out loud and I couldnot stand that, as it made me sonervous. As for writing books, nowthat did cross my mind, but I think a

lot of us fantasise about writing abook. What I did not contemplateabout when I was younger was that Iwould write about compassion,trauma and shame. I had more of ablockbuster in mind.


DL: When I first started to work withpeople who have PTSD and have beenon the receiving end of the worstaspects of human behaviour. I wentstraight into my clinical training aftercompleting my undergraduate degreein Psychology and I was young andnaïve.When I qualified, I worked as achild psychologist for a couple of yearsbefore taking a research psychologistpost in a PTSD trial. I have really growninto my career as I have got older, andexperienced life and suffering. But itwas working with traumatised peoplethat touched me profoundly, and I wasdeeply moved by people, whothrough no fault of their own, hadsuffered at the hands of others. Iremember the first talk I gave which Ititled,‘There but for the grace of Godgo I’. I realised, very clearly, that it wasrandomness that placed my patient inone chair and me in the other.

PM: Have you always wanted todo good?

DL: I certainly have nevercontemplated a life where I do harmto others or do not serve humanity insome way. Instinctively, I have alwaysbeen motivated to work for thecollective greater good. I rememberthat, when I was younger, I wanted alife that made a difference to others.But I never quite realised what typeof humanitarian work I wouldbecome involved in.


DL: It is interesting for me to thinkabout what drew me to work withshame and compassion. Since mytraining, I was interested in workingwith PTSD and trauma and I have beenvery motivated to work with womenwho have suffered violence and sexualviolence. I really felt the sense ofinjustice, that the women I workedwith loathed themselves because theyhad been abused by others. I wantedto do what I could to help these

The women’s room

Continued overleaf

| September 201420

women learn to like and acceptthemselves again, or even for the firsttime, and to help give them anopportunity to live a life that allowedthem to flourish. So it is probably nosurprise that I met Paul Gilbert andbecame interested in developingcompassion-focused ways of working.It takes such courage to disclosememories of abuse, it takes suchcourage to disclose that you loatheyourself, and it takes such courage todevelop self-compassion.Yet, everyday I see the benefits for my clientswhen they live in their minds with careand kindness for themselves.


DL: Now that really is a tricky questionand my very first thought is passion. Iam passionate about my work and Ilove my job. I really do feel sofortunate to have my job and everyday I enjoy going to work. I think, ifyou are passionate about things, itnaturally motivates you to achieveand succeed. But I also work hard andI am not good at being told, ‘thatwon’t work, we can’t do that or I amsorry this is the way it has to be’. Forsome reason, I always believe we cando that, this will work and there isalways another way.


DL: I find this a difficult question toanswer because I do not really knowthe answer. I just keep going as I donot want to let people down, I have astrong sense of duty and the goodfortune to be able to call on friendswhen in need. My best friend Mhairi isa clinical psychologist too, and sotalking to her is so helpful andreassuring to me. She is a hugeinfluence in my life. I remind myself Iam doing what I can to be the best Ican be and I accept that, at times, Iam not firing on all four cylindersbecause other things are going on inmy life. But I also use my dear friends,family and professional colleagueswhen I need support, reassurance andadvice. When you work in trauma, it isimportant to make sure youremember that human beings are

amazing too, hugely creative,inspiring and capable of great things.

PM: What are you most proud of in your work?

DL: I think I am most proud of my self-help book about compassion andtrauma. I still cannot believe I wrote it,but so much more than that I am sotouched when someone from thegeneral public writes to me and saysthe book has helped them. For me, itis such an honour to have been ableto make a difference to someone’s lifeand I do not think I will ever take thatfor granted.


DL: One is Dr Helen Kennerley. I firstsaw her present a BABCP workshop in1993 and I just thought she wasamazing. She was clever, glamorousand her work with survivors of CSAwas inspiring, motivating and clear.She has always been a heroine ofmine as her contribution to the fieldof CSA and complex trauma isoutstanding and has hugely helpedme in my clinical practice. I finally gotthe privilege to work with her inOCTC for a few years and we becamefriends. To work alongside Helen wasa career highlight for me. The otherwoman who stands out in my mindas inspirational is Dr Mary Welford, myfriend and colleague from the worldof compassion. Mary lives andbreathes compassion asdemonstrated in her clinical practiceand her life. She has shown me suchcompassion and friendship when Ihave needed it in my own life. Sheinfluences my clinical work and mypersonal life in such a good andpositive way.

PM: What are the attitudes thathelp to keep you balanced?

DL: Well, I am a firm believer inevolution. Everyone is equal, no-oneis better than another, and thatpeople can change their lives. Life is

random, no-one is special or better,we are all doing what we can tosurvive the challenges of life, and weall suffer. So we have more incommon that we have difference.


DL: This is an interesting, challengingand worrying age for women. I spoketo my teenage girls and their friendsthis weekend about this question,and they unanimously answered,‘Social media is the biggest ruin ofour contentment’. They said thebiggest threat to their emotionalwellbeing is Facebook, Instagram,Twitter and being taken advantage ofon the internet. I know what theymean because we live in such sociallycomparative times when the focus ison looks, popularity and many femalerole models are fame addicts. It wouldseem that the number of ‘likes’ canmake or break your mental health forthe day. Yet, the daily stresses ofjuggling a passion for a vocationalcareer, family and everyday life do notgo away as opportunities increase forwomen to have it all.


DL: You have a tough and demandingjob so be proud of what you do – youmake a difference to so manypeople’s lives. Empathy, warmth andcare are so important in our work, sowe must not forget that we are in avery privileged position to know themind of another and to see their pain- so treat it with care and always actfrom a place of kindness. The NHS isfacing tough times, and we all feelsqueezed and pressurised. It feels likeeveryone wants something fornothing. But, even if you can onlyoffer a drop in the ocean, that dropcreates a ripple of change and thatmakes a difference to someone.

For more information on the Woman’s Hour Power List, visit www.bbc.co.uk/womans-hour-power-list

“ ”You have a tough and demanding job so be proud of whatyou do - you make a difference to so many people’s lives

The women’s room

21| September 2014

Although there is substantialevidence supporting CBT in thetreatment of perinatal depression andanxiety, less emphasis has been givento the impact of maternal mooddisorders upon the infant.

The Leeds Infant Mental HealthService in which I work sits withinCAMHS, and focuses uponstrengthening relationships betweenparents, usually the mother and herbaby. The team encompasses adiverse mix of skills and modalities,including specialist health visiting,clinical psychology, psychotherapy,cognitive analytical therapy and CBT.

Therapeutic support is offered anytime in pregnancy up until an infant'ssecond birthday. CBT is combinedwith parent-infant psychotherapy,which holds both mothers andinfants in mind. The new mothercannot be treated in isolation; indeedher relationship with her infant isoften integral to her recovery.

Growing evidence demonstrates thenegative consequences of depressedor highly anxious parenting upon theinfant’s developing mind and sense of

Including the baby in the formulationof the mother’s experience ofdepression or anxiety is vital. The CBTtherapist works with the mother toidentify unhelpful feedback loopsbetween mother and baby byexploring how the mother’semotional state impacts upon thebaby and in turn how the baby’semotional state impacts upon themother; the mother’s thoughts andbeliefs about her baby; how themother’s behaviour affect her babyand in turn the baby’s behaviouraffect the mother.

We are helping the mother to facethe reality that the baby’s experienceis not a benign or passive one. Indeedthese first two years of life are criticalfor baby. The CBT therapist mustneither overlook the baby nor thefact that, although the mother’smood may improve, the relationshipwith their baby may not improve inparallel. Equal focus and attentionneeds to be given to the baby andthe mother-infant relationship.Blending CBT and parent-childpsychotherapy has the potential tobe an effective therapy for bothmother and baby.

self. Depressed or anxious parents aremore likely to present in either flat orhighly aroused emotional states.These result in reducing a parent’sability to manage or tolerate theirinfant's emotional state, or to readtheir baby's cues. Even if a depressedor anxious parent can meet theirbaby's physical needs, the infant maystill be at risk if their emotional needsare not being met.

CBT with parents and their infantsdraws upon attachment,psychoanalytical and systematictheory to inform treatment for bothmother and baby. Third wave CBTapproaches, which focus uponmindfulness and compassion, arefrequently utilised in this work.

Assessment considers parentalemotional history, childhoodexperiences, relationships, obstetrichistory and the mother's thoughtsand feelings about her baby. Crucially,close observations of both motherand baby's behaviour and interactionis assessed. Even the newest of babiescan tell us a lot about the currentpresentation.

Perinatal CBTPerinatal depression and anxiety are frequently experienced following childbirth, with shortand long term adverse consequences for both mother and infant. Leeds-based Senior InfantMental Health Practitioner and Cognitive Behavioural Therapist Claire Wild talks about theuse of CBT in these circumstances

Therapy space available atBrackenbury Natural Health Clinic inHammersmith, West London. Light,quiet, comfortable rooms, excellentreception service. Please contact StelyanaSpassova on 020 8741 9264 [email protected]

Using EMDR with Veteran and MilitaryClients – 3rd Dec 2014, London.Matthew Wesson, a veteran of 21 yearsmilitary service, EMDR consultant & CBTtherapist leads this workshop. It will coverrelevant research, clinical obstacles,therapy techniques, interactive exercises& video material. It can count towardsBABCP and EMDRUK CPD hours. Just £99.Contact: [email protected]

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| September 201418 | September 201422

Call for papers: the Cognitive Behaviour Therapist (tCBT)

Special issue: ‘Supporting & developing CBT supervisors’We are delighted to inform you that there will be a 2015 specialissue of the Cognitive Behaviour Therapist (tCBT) dedicated to theissue of clinical supervision.

The guest editors for this edition will be Derek Milne and RobertReiser, who will be considering submissions, supported by theregular tCBT referees.

The angle that we want to take in this special issue is timely, andconcerns the infrastructure that should be in place to support andguide CBT supervisors.

Amongst other things, this includes:

• Educational needs assessments; training/supportobjectives and analysis; competence frameworks

• Supervision (and therapy) guidelines

• Measurement instruments (e.g. satisfaction;learning/development; qualitative options)

• Feedback systems and materials (including clinicaloutcome monitoring; supervisee feedback)

• Training manuals (e.g. video demonstrations; learningexercises)

• Supportive arrangements (peer support groups;‘supervision-of-supervision’ arrangements; ‘meta-supervision’)

• Organisational analysis and development (e.g. consultancy;work environment assessment and intervention)

We are inviting you to contribute a paper for this special issue.

If you are interested in joining us in this effort, please let us have adraft title by 1 November 2014. Your manuscript should be nomore than 5,000 words and submitted by 1 April 2015.

We will be writing an introductory review paper, outlining thecase for increased attention to supervisor support anddevelopment. Contributors will receive a copy, to try and enhancethe coherence of the special issue. Once we know that you areparticipating, we will send you a draft of that paper.

Please email [email protected] with any queries.Queries about tCBT should be emailed to:[email protected] about tCBT can be found at:journals.cambridge.org/cbt

We hope that this is may encourage you to contribute, and lookforward to hearing from you.

Kind regardsDerek Milne & Robert Reiser(Special Issue Guest Editors)emails to: [email protected]

DVD review

Rational Emotive Behaviour Therapywith Dr Debbie Joffe Ellis

In this two-hour DVD, produced mainlyfor psychologists, therapists andstudents of psychology and counselling,Dr Joffe Ellis gives a live and powerfulclinical demonstration of REBT in actionand explains in depth the principles ofREBT to a group of student observersand two of their professors.

Many of us will recall the videofootage of Dr Albert Ellis treatingGloria. Ellis’ wife, Dr Debbie Joffe Ellis,to whom he entrusted his REBT legacy,continues his excellent work some 49 years later.

The DVD begins with Dr Joffe Ellishosting a discussion about REBT andanswering questions from professorsand students. This pioneering cognitivetherapy, which heralded in a revolutionin psychology, empowers the person tochange their attitude aboutthemselves, others and the world.

Dr Joffe Ellis explains to us that, if a

client is committed to work on makinghealthy changes, then REBT can helpenormously. With empathy, rapportand persistence, the REBT practitionerdisplays unconditional acceptance ofthe client and teaches the clientunconditional self-acceptance. Thepractitioner then distinguishes theactivating event from the troublingemotion whilst clarifying anddisputing the irrational, unhealthyshoulds, oughts and musts that createanxiety anger and depression, asopposed to preferences that create thehealthy negative emotions, inresponse to an undesired event, ofsadness, annoyance and concern.

A live, vibrant therapy session is shownwith Dr Joffe Ellis identifying the clientEileen’s therapeutic goals following anextremely upsetting divorce situation.She zeroes in on the unhealthynegative thinking and awfulness theclient believes, which became habitual

following from arigid upbringing and kept active nowwith a shoulding on self and beingover-responsible, harshly self criticaland procrastinating.

Dr Joffe Ellis skilfully and expertlyprovides insight and shows andempowers Eileen towards a moreeffective way of thinking, andtherefore with the client feeling a lotcalmer within a 45-minute period.

An evaluation and summary takesplace afterwards in discussion with thestudents and professors giving furtherunderstanding about the use of REBTand its effectiveness in helping aperson not only to feel better, but getbetter long term.

Robin Thorburn

The DVD is part of the Systems ofPsychotherapy series from the AmericanPsychological Association

| September 2014 23

BABCP Couples SIGpresents

Cognitive-Behavioural Couple Therapy:Addressing Health ProblemsLondon - Monday 13 October 2014Manchester - Thursday 16 October 2014

How to Supervise Couple TherapyLondon - Tuesday 14 October 2014Manchester - Friday 17 October 2014

Presented by: Professor Donald H Baucom PhD,Richard Simpson Distinguished Professor of Psychology, University of North Carolina

Group Supervision and Networking for Couples Therapists27 October 2014Venue: The Royal Foundation of St Katherine, 2 Butcher Row, London E14 8DS

An Introduction to Cognitive Behavioural Couples Therapy27 November 2014Presented by Carla Swan and John Williams

Venue: David Lloyd Conference Rooms, Livingstone Drive, Newlands, Milton Keynes MK15 0DL

www.babcp.co.uk

| September 201424

Putting DBTin to your PracticePresented by Dr Fiona Kennedy

A joint event by the DBT SIG and the Southern Branch

Solent Conference Centre, 157-187 Above Bar, Southampton SO14 7NNTuesday 7 October 2014 - 9.30am-4.30pm

Overview of the workshopA theoretical and practical course for those wanting to know more aboutDBT and how to incorporate it into their practice. The day combines anoverview of DBT principles with case discussion and practical demonstrationof treatment techniques.

What is DBT, who can use it and who is it for?• DBT is a treatment package that was developed for BPD (Borderline

Personality Disorder), and has been adapted for many other problemsincluding substance misuse, suicidal teenagers, eating disorders andtreatment resistant depression.

• DBT techniques can also be incorporated into your style of practice. Eachtechnique is a powerful therapeutic tool.

• If you are not a therapist but come into contact with people withpersonality problems the day will give you new ways of working.

The workshop will cover• An outline of DBT• Engaging Clients in Treatment• Building Acceptance, Alliance and Trust

To register for this event, please go to the BABCP Event webpage atwww.babcp.com/Training/Events.aspx or email [email protected] Fees:BABCP Member: £100, Non-member: £120, Student: £70*Discounts of £50 per head for group bookings of five or more.Price includes refreshments but not lunch. CPD certificates will be issued.* Evidence of student status must be provided with application

www.babcp.co.uk

BABCP West Branchpresents

Acceptance and Commitment Therapy:Introduction and Skills Building

Dr David GillandersChartered Clinical Psychologist, Senior Lecturer andAcademic Director of the Doctoral Programme in ClinicalPsychology at the University of Edinburgh.

Thursday 9 & Friday 10 October 20149.00am-5.00pm (Thursday) 9.00am-4.30pm (Friday)Registration from 8:30am

Bristol ZooThe Clifton PavilionCollege RoadBristol BS8 3HH

Registration feesBABCP Member: £150Non-member: £170Price includes two course buffet lunch, refreshments andentrance to the zoo for both days of the conference.

For further information including how to register, pleasevisit www.babcp.com/cpd

www.babcp.co.uk

Glasgow Branchpresents

CBASP - Innovative Treatment forPersistent Depression: A PrimerPresented by Marianne Liebing-Wilson and Bob MacVicar

Friday 17 October 2014 - 9.30am to 4.30pm

Centre of Therapy & Counselling Studies,8 Newton Place, Glasgow G3 7PR

Cognitive Behavioural Analysis System of Psychotherapy(CBASP) is to date the only psychological therapy specificallydeveloped (McCullough 2000, McCullough 2003, McCullough2006) to meet the challenges presented to therapists whenworking with the persistently, or, chronically depressed patient(Keller 2000, Swan, MacVicar et al. 2014).

CBASP has been demonstrated in a number of studies to offersome benefit to those depressed people most difficult to treat;people who have been depressed for two or more years withless than eight weeks of feeling well in that period. Ourexperience is that ‘standard’ or ‘formal’ CBT does not seem toimpact on the persistently or chronically depressed; hence ourinterest in and use of CBASP.

Registration fees: BABCP Member: £80 - Non-member: £100Lunch and refreshments included and CPD certificates will be provided

North West Wales Branchpresents

Treating Disgustacross the DisordersPresented by Dr David Veale

Thursday 30 October 2014 - 9.30am to 4.30pm Neuadd Reichel, Bangor University,Ffriddoedd Site, Ffriddoedd Road, Bangor LL57 2TR

About the workshop: Disgust is a core emotion and itsderivatives such as self-disgust (shame and contempt) has beena neglected area in research. It is part of the threat system thatkeeps a person safe. Disgust is associated with phobic avoidancebut standard exposure is less effective for disgust than foranxiety. Furthermore, beliefs associated with disgust are ofteninaccessible. Disgust elicitors include eating/food; excreting; sexand death but there is also inter-personal disgust and moraldisgust. We will focus on the treatment of disorders that have alarge component of disgust or self-disgust, namely fears ofcontamination and mental contamination in obsessive-compulsive disorder, specific phobias of vomiting and bodydysmorphic disorder (BDD).

Registration Fees: BABCP Members - £65, Non-members - £70Prices include lunch and refreshments.CPD certificates will be issued.

www.babcp.co.uk www.babcp.co.uk

| September 2014 25

| September 201426

The Compassionate Mind Foundation’s 3rd International Conference

Learning from Experience: Advances inCompassion Focused Therapy26th-28th November 2014Birmingham

Three days of workshops, symposia, keynotes and skills classes plus social events

Topics include:Trauma, Group work, Working within Organisations and Teams,Parenting, Eating related difficulties, Psychosis and Imagery

Over 20 Speakers to include:Paul Gilbert, Rony Berger, Deborah Lee and Chris Irons

For full programme details, fees and how tobook please go to our website:

www.compassionatemind.co.uk

| September 2014 27

Advanced CBT Workshops for 2014-2015

Psychological Therapies @ UEAFaculty of Medicine and Health Sciences

All workshops are held in the John Jarrold Suite, Sportspark at the University of East Anglia, Norwich,NR4 7TJ. *Closing date for applications is one week prior to the workshop taking place*

Cost: 1-day workshop: £130.00 To apply: Please email Helen Sayer: [email protected]

5 December 2014 Dr Kerry Young Mental Imagery for PTSDBased at University College London/Trauma Service Central and North West London

20 February 2015 Professor Marcantonio Spada Metacognitive TherapyBased at Department of Psychology, for Addictive Behaviour London South Bank University

24 April 2015 Professor Adam Radomsky Difficult to treat? NotBased at University of Concordia, Canada anymore! Cognitive Therapy for OCD

22 May 2015 Professor Rob DeRubis Working with CognitiveBased at University of Pennsylvania, USA Processes & Alliance and CBT

26 June 2015 Professor Rick Heimberg Master class in GroupBased at Temple University, USA Therapy for Social Phobia

It is a pleasure to invite you to a one day conference

Improving Access toPsychological Therapies (IAPT)

for British South Asians

1st OCTOBER 2014UNIVERSITY OF MANCHESTER

Keynote address by Dr David Kingdon-Professor of MentalHealth Care Delivery at the University of Southampton, UK

Organisers: Dr Nusrat Husain & Professor Imran Chaudhry,Global Mental Health Research Group, the University of

Manchester and Lancashire CareNHS Foundation Trust

For bookings contact: [email protected]

Delegate rate: £95. Please make cheques payable toLancashire Care NHS Foundation Trust. Cheque and money

orders accepted

| September 201428

CBT Today Vol 42 No 3 (Sep 2014)

Documents

Transcript of CBT Today Vol 42 No 3 (Sep 2014)