The Bury Practice for Counselling & Psychotherapy

Stephen J Scott BACP

What do I work with?

Low mood and depression, adjustment reactions, chronic pain, anxiety problems, general anxiety, social anxiety, panic disorder, phobias, obsessive compulsive problems, work stress, health anxiety, sleep problems, low self-esteem, perfectionism, self-depreciation, addiction problems, relationship problems, post-traumatic stress disorder, chronic fatigue, bulimia nervosa. I would consider other issues on an individual basis.

Who am I and how do I work?

I have been developing a private practice as an independent counsellor for the past 10 years alongside a parallel career in higher education and supervision training.

I take an approach to counselling using both psychodynamic approaches and cognitive behavioural therapy approaches to help people experiencing psychological distress to understand, explore and overcome a range of difficulties.

During my 20 years' experience in mental health practice within and outside the NHS I have work alongside a wide range of people experienced both major life changing illness and less severe but equally distressing mental health issues and common psychological disorders. My experience has allowed me to develop a broad and inclusive understanding of mental health need and mental health assistance. This understanding continues to extend, inform and support my counselling practice.

I completed an Undergraduate Diploma in Cognitive Behavioural Therapy in 1997 allowing me to apply my psychological learning more fully to help people with mental health problems. This followed an extended period of experiential learning within psychological therapy services between 1991-1996. The key competencies in cognitive behavioural therapy continue to inform my practice, structuring the therapy experience you will receive. Using CBT principles you can expect an active partnership involving mutual exploration, idea generation and experimentation both within sessions and between sessions.

Formal counselling training between 1997 and 2001 gave me a broader set of principle that now underpin my work. My work acknowledges that we do not always have the capacity as human beings to understand our feelings and interpersonal responses particularly as early experience often intrudes into the present. During counselling I would explore these issues with you as well if we both agreed that this was an area that needed addressing.

The recent resurgence of CBT as a treatment of choice for a range of mental health and wellbeing issues has led me to return to post graduate study within the IAPTs programme. I have completed a postgraduate Certificate in CBT IAPTs and will complete the diploma by end 2012. This additional study allows me to increase the currency of my practice and offer you the most up to date evidence based treatment possible.

My practice as a counsellor now includes three main approaches; pure cognitive behavioural intervention; interpersonal work and less frequently an integration of both. This flexibility in approach allows me to more fully meet your needs should you decide to use my services.

Stephen Scott

What is CBT and will it be helpful?

CBT has been developed alongside the expanding cognitive and behavioural knowledge in academic psychology both learning from this research based and feeding into its development. Cognitive behavioural therapists are active and inquisitive engaged in experimentation and learning both in their practice and about their practice. The interventions we use are empirically based and subjected to rigorous testing with real people like you before they are accepted as mainstream treatment approaches. Therapists then work to use those techniques that are most effective and that most closely fit your need. The therapy approach is therefore part of a solid clinical science and continuously develops and evolves as our understanding of human psychological health and wellbeing progresses making use of the most effective and most up to date approaches to overcoming psychological distress.

Cognitive behavioural therapy is the treatment of choice for many forms of psychological distress in the UK. The treatment approach is derived from psychological understanding of human cognitive and behavioural processes. It is recommended by the Department of Health for first line intervention in both common and more complex mental health issues. You may find your GP will recommend CBT to you this is because the national institute of clinical excellence NICE, who advise NHS GPs have increasingly recognised the research based that supports CBT as the first line treatment of choice for a range of anxiety related problems, depression, OCD, bulimia and other conditions. In addition to these medical conditions evidence based approaches, derived from psychological research, have also been developed to help people overcome the difficulties associated with a lack of self confidence, high levels of self expectation (perfectionism) and high levels of guilt and self punishment.

What conditions have been evaluated in this way?

Low mood and depression, adjustment reactions, chronic Pain, anxiety problems including: General anxiety, social anxiety, panic disorder, phobias, obsessive compulsive problems, work stress, health anxiety and sleep problems, dependency, addiction problems, relationship problems, post-traumatic stress disorder, chronic fatigue and bulimia nervosa.

Newer models of cognitive behavioural therapy are also available to help people overcome more complex issues associated with childhood learning (trauma) and severe mental ill health (psychosis). The evidence base for these interventions is growing significantly and practitioners with these expertise are becoming more available.

What would you be expected to do as part of your cognitive behavioural therapy?

CBT is based on an active working alliance between you the client and the therapist. Unlike other therapies CBT works best when you as a client are actively engaged in learning and requires you to gather information, experiment with ideas you generate in the sessions and record your learning between sessions as well as talking to the therapist. Through this collaborative alliance we actively identify, understand and respond to the patterns of thinking, feeling and doing that maintain your psychological distress or discomfort in the present. During therapy you would actively work with a therapist to development an explanatory model of your problem (an understanding), actively experiment to test out the value of that understanding, actively experiment to change aspects of your behaviour and thinking that may be unhelpful to you and actively learning.

Rather than a talking therapy CBT can therefore be considered an experimental therapy which involves exploration with the therapist in session, clarification of learning and experimentation in your life. Through this process you learn the best way to overcome your own problem and the skills necessary to ensure you can deal with any symptoms that may emerge in the future before they become a problem for you again.

The active experimental approach means that CBT can lead to changes in your present symptoms and presentation over relatively short periods of time.

Some therapists talk about...

How brief Is brief CBT?

Non- complex problems such as depression, anxiety, bulimia and OCD may be addressed in 8-12 sessions and some specific phobias more quickly. Complex problems associated with deeper levels of learning in childhood may require a significant time to reach a therapeutic outcome. This may be 12- 24 months dependent on the problem.

During the assessment of your issues a CBT therapist will help you identify the type of problem you are experiencing, the likely treatment tasks and goals needed to address this problem and the likely time it will take to achieve the goal. These are discussed and a contract for a specific number of sessions is then made at the beginning of therapy. The time your treatment is likely to last is therefore negotiated and made clear early in the therapy. Progress towards your goals is regularly monitored and discussed. This process allows CBT therapists to offer you timed and goal-orientated (rather than specifically brief) therapy interventions.

The word brief as applied to CBT is therefore a misnomer and although CBT can offer brief interventions for specific problems other problems may need a longer period of therapy.

Summary

CBT is a clinical branch of cognitive and behavioural psychology that offers evidence based, active, goal orientated and targeted treatment to help you overcome the cycles of thinking and doing that are maintaining your present psychological distress. Treatment requires you to join the therapist in active exploration and learning right from the start of the sessions that begins in session but continues in your ever-day life. This allows you to achieve maximum benefit from therapy in the briefest possible time. Although CBT is focused, goal and time orientated it is not always a very brief process. Achieving your goal my take as as little as 3 sessions or two years. The goals, tasks and timing of therapy will be made clear during the assessment session so you can make an informed choice.

Hopefully this clarifies issues for you about CBT as a treatment approach but if you would like more information please consider visiting the BABCP web site which includes a good range of general and specific treatment information and an overview of the CBT profession as a whole.