Category Archives: CBT

Ongoing Continuous Professional Development

Ongoing professional development and improvement

Stuart is dedicated to ongoing professional development and improvement. As part of his professional registrations he is required to complete around 20 hours a year of CPD training. Stuart however regularly completes far more than this.

For example this year (2017) so far:

By June 2017 over 14 hours face to face CPD, over 100 hours university learning (Open University), Over 10 hours nutrition CPD learning, over 20 hours mindfulness refresher CPD learning.

Later in the year a complete post qualification Compassion based therapy course is booked and another 100 plus university hours expected.

This is a fairly typical year, and should demonstrate the level of service improvement Stuart expects from himself.

Key words

Ongoing professional development, continuous professional development, service improvement, CPD, OPD, additional training, post qualification training, standards and qualification.

Back in Glasgow

Psychotherapy in Glasgow

Glad to announce that after an absence of running clinic in Glasgow for a couple of years due to other commitments, Stuart is now back from the 15th June 2017.

Psychotherapy, psychoanalysis, counselling, hypnotherapy, mindfulness in Glasgow

A full range of therapy models and integrative multi modal therapy work will be available again in Glasgow.

Glasgow City Centre Therapy

Therapy will be provided from the Consulting Rooms in Glasgow City Centre, near the Queen Street rail station.

 

Key words

Glasgow, psychotherapy, psychotherapist, hypnotherapy, hypnotherapist, counselling, counsellor, hypnosis, hypnotist, mindfulness, MBSR, MBCT, CBT, CBASP, depression, anxiety, psychoanalysis, psychoanalyst, NLP, analysis, psychoanalyst, bipolar, eating disorders, holistic therapy.

Ongoing Mindfulness and philosophy service expansion

Development of existing service continues….

Both Stuart and his colleague and Scotlandtherapy partner Denise are dedicated to ongoing learning and development, and therefore complete additional university based and practical Ongoing Professional Development training each and every year. This is all on top of existing professional qualification training.

Mindfulness and Philosophy

Stuart in particular has completed additional trainings this year in MBCT (mindfulness based cognitive therapy), CBT (cognitive behaviour therapy) for depression and additional training in general mindfulness. He is booked to attend additional specialist training in the use of philosophical models in psychotherapy later in the year, which should nicely complement his nearly completed BA (Hons) in Psychology and philosophy of the mind. This is on pause at the moment since the last university model will not become available until late 2017.

Additional University based learning

Both Stuart and Denise has multiple university awards. Stuart has two University Certificates of Education (Undergraduate) from Lampeter and Edinburgh Universities, Bachelor degrees from City of Birmingham University and the Open University, and a Masters Degree from the Open University. He is about to begin a new degree alongside completing a Psychology and Philosophy of the Mind degree, this time in International Relations, specialising in the effect of ecology and politics on people, with specific regard to mental health issues and disability issues. This ties in with his work writing a regular political column for Self and Society professional journal and other publications and articles.

Denise has completed an undergraduate certificate of Education from Edinburgh University and two bachelor degrees from the Open University. She is about to embark on a third degree, focusing on Business, in particular human resources.

Keywords
Business studies, psychology, psychotherapy, psychoanalysis, mindfulness, MBCT, CBT, politics, human resources, mental health, disability issues, social studies, social policy, social environment, depression, anxiety, bipolar, environmental psychology, Edinburgh, Falkirk, psychotherapist, hypnotherapist, counsellor, psychoanalyst

New Book Launched

New publication on future of psychological therapy

 

Colleagues and clients alike are recommended to take a look at the new book Edited by my colleague John Lees. It has contributions from several other colleagues of mine, and I wrote Chapter 3. It looks at the future of the profession through a critical lens from several perspectives and would be very useful for a student therapist or new graduate.

 

The Future of Psychological Therapy: From Managed Care to Transformational Practice

Prelaunch order at Amazon HERE

Swedish National Audit Office report on CBT

Swedish National Office Report on CBT

In a study of the outcomes of using CBT as a primary and almost exclusive method of treating mental health issues such as depression and anxiety, the Swedish National Office has published a damning report. See here

Main findings of report on CBT

  •  The widespread adoption of the method had no effect whatsoever on the outcome of people disabled by depression and anxiety;
  • A significant number of people who were not disabled at the time they were treated with CBT became disabled thereby increasing the amount of time they spent on disability; and 
  • Nearly a quarter of people treated with CBT dropped out.
    From Swedish Audit Report. accessed HERE

Application and conclusions in the UK

CBT or cognitive behavioural therapy is the darling of the NHS, many charities and NICE. This is primarily because it claims to be evidence based.

CBT leads itself to being “evidenced based” through gathering self assessed feedback from clients. This is unreliable for a whole range of reasons, including:

  • Subjective self assessment does not permit one controlled stand across subjects. Introspective grading of experience is not possible.
  • Assessment reduces responses down to highly simplistic responses, often statistics and does not reflect human experience or allow for situational or environmental difference.
  • There is an influence on “wellbeing”, “getting well” or feeling “happy” when therapy is not always about these, we often feel “unhappy” for good reason”.
  • CBT often plays into the biomedical model of being “sick” and needing to feel happy despite this, rather than considering other explanations for symptoms such as psychodynamic, cognitive behavioural analysis, developmental or humanistic explanations or social and environmental causes / factors.
  • CBT is often highly simplistic. It has been termed “the art of the blindingly obvious” since it often leads subjects through exercises that reveal what they already new, providing little empowerment for change.

Illogical to use one method

Reducing provision down to one method is akin to only using one class of medical drugs, it simply does not make sense. Clients are complex and unique individuals going through a unique combination of social, biological, psychological, interpersonal and developmental processes, any of which alone may seem common or typical, but which form a vast array of potential combinations.  With that variety and complexity, thinking “one size fits all” is simply illogical.

Furthermore CBT is a simplistic method formed out of other methods, making it a method within an array of methods. For example it was developed in response to psychodynamic and humanistic thinking, and provoked revised psychodynamic, humanistic and cognitive behavioural analytic thinking. It makes no sense to home in on one incomplete stage of the ever changing face of psychological therapy and prioritise it at the expense of other methods.

Its just a tool (CBT)

Cognitive Behavioural Therapy is just ONE tool in the toolbox of multi-skilled psychotherapists.  Many therapists use CBT when it is appropriate, but “if all you have is a hammer, all you see is nails”. Why would anyone throw away all the other tools.

Integrated work for the unique client

Stuart uses CBT where appropriate, along with the deeper and more complex Cognitive Behavioural Analysis methods (including CBASP for long term depression). Stuart also uses psychodynamic psychoanalysis, humanistic and philosophical psychotherapy, mindfulness and clinical hypnotherapy. The approach is integrated and employs a kind of critical psychotherapy, in other words questioning what the outcome “should” be, and working with the client to determine what their desired outcome is going to be. Therapy is then tailored, incorporating methods such as CBT, CBA, IPT and psycho-education with research evidence and NICE recommendation behind them.

Key Words
CBT Cognitive Behavioural Therapy, Cognitive Behavioural Analysis, CBASP, Psychotherapy, Psychoanalysis, Psychodynamic therapy, Counselling, Psychology, Psychotherapist, Counsellor, Psychoanalyst, Analyst, Hypnotherapist, Mental health, Depression, Anxiety, Personality disorder, Edinburgh, Falkirk, Stirling

 

 

Dis-associative Disorders

Psychological therapy for Dis-associative Disorders

Dis-associative disorders are conditions where the sufferer dis-associates for periods of time. What this means in basic terms is they mentally “switch off” or “blank” in a way that may either appear to be day dreaming, or which may just resemble a silent few moments. In more severe cases two other presentations may occur: dis-associating into a different personality, or with a loss of consciousness.

Short blank disassociations

This is the most likely version to be seen, the person reacts to stress or an anxiety trigger by “being elsewhere”. it can also be the result of a flash back being triggered where a historical event is being recalled. The person may appear inattentive, distance, and seem to be ignoring you. This can lead to misunderstanding, conflict and accusations of laziness or inattention, especially in adolescents in education or when it occurs in the workplace. Depending on whether a task is under way at the time, it is possible for this task to be interrupted for a moment, or even, for example, for a cup of tea being made to be split or dropped.

It should be noted that it is very hard to tell these short blanks apart from epileptic “absence” seizures and  it is important to discuss them with your medical doctor and not assume they are psychological in nature.  It should be remembered however that it is more usual for psychological disassociation to be misdiagnosed as epilepsy.

Personality change disassociation

In more severe cases the personality of the sufferer undergoes a change in the disassociated state and a person may appear to have changed in their behaviour, attitude and even in what they believe and remember. What occurs in this state may not be remembered afterwards.

It is a matter of debate whether this is related to schizophrenia or not,  with some sufferers of disassociation adamant that it is a different condition entirely, and some sufferers of schizophrenia claiming that their condition is itself a form of disassociation.

Loss of consciousness disassociation

Often called Non Epileptic Attack Disorder (NEAD) or pseudo-epilepsy,  this is the ultimate disassociation response. The person will loss consciousness and will often shake or spasm as one would expect to see in epilepsy. NEAD is often initially misdiagnosed as epilepsy.

Most people are aware of flight and fight responses to danger. The third response however is that seen in the humble possum. The person loses consciousness, lies still playing dead, the body is flooded by natural pain killers, and for the predator the sufferer / possum appears to be a long dead and unpalatable prey. This state is often associated with loss of bowel or bladder control, again to make the prey smell “off”.  This is a highly primal response to extreme danger.

Causes of disassociation

Disassociation occurs when the sufferer has a history of being faced by traumas such as abuse or rape which can not be coped with at their mental state or age. Thus it is common for these conditions to be present in adult survivors of child sexual abuse or domestic violence. Essentially the subject learns to “opt out” of the situation they are incapable of handling.

Treatment of disassociation

There are two main strategies for addressing disassociative disorders:

1. Increase the sufferer’s ability to cope with stressful situations. This may involve cognitive behavioural therapy to reduce stress response with methods like stress inoculation therapy. It may also involve analysis of interpersonal relationships to adjust perceptions and behaviours which may otherwise lead to conflict. Interpersonal psychotherapy methods, CBASP, CAT or other analytic cognitive behavioural methods might be employed. This is therefore an attempt to use psychoeducation and personal analysis to better manage the condition day to day.

2. Addressing any history of abuse. Addressing PTSD (post traumatic stress disorder) as a condition may reduce the underlying effects presented as a disassociative disorder. Psychoanalysis, cognitive behavioural analysis, trauma debriefing such as specialist hypnotherapy “trauma runs” can all be used if appropriate.

Co-morbid presentation

It is common for persons with disassociate disorders to have a history of different diagnosis, and to have elements of different mental health conditions. These might include depression, anxiety, self harm, mood disorders or OCD.

Key words
Disassociation, disassociative disorder, disassociative seizures, NEAD, non epileptic attack disorder, possum response, flight and flight, PTSD, post traumatic attack disorder, sexual abuse, domestic violence, survivor of childhood abuse, child abuse survivor, personality change, mood change, mood disorder, anxiety, depression, OCD, self harm, multiple personalities, multiple personality disorders, loss of memory, stress response, psychotherapy, psychoanalysis, cognitive behavioural analysis, cognitive behavioural therapy, CBASP, CBT, hypnotherapy, counselling, psychotherapist, psychoanalyst, analyst, hypnotherapist, couhsellor, therapy, therapist, psychology, psychologist, Edinburgh, Glasgow, Falkirk, Stirling

Group therapy

Group therapy and mindfulness in Edinburgh

Group therapy on Saturdays in Edinburgh at the South Side Centre will provide support for persons with mental health issues including anxiety, depression, stress and anger.

A combination of CBT, CBASP, Coaching and mental health support methods like WRAP and Mental Health First Aid processes will identify problems and responses, while mindfulness, meditation, visualisation and hypnotherapy processes will be taught to reduce stress and enable relaxation.

The group will be led by Denise, with support and cover from Stuart

Key words
Mindfulness group, group therapy, group self hypnosis, group coaching, stress management group, anger management group, stress and anger therapy Edinburgh