Accessing High Quality Psychological Therapy: Where to Begin?
Monday 11th July 2022. Written by Kenneth Finlayson BABCP Accredited CBT Psychotherapist.
There has been an increased awareness of mental health problems, with a rise in such difficulties during the COVID pandemic. The independent and private health care sectors have played a part in addressing that need, but it can be difficult for individuals and businesses to identify the most effective help. This short article offers some advice in doing so.
Cognitive Behavioural Therapy (CBT) is the most widely used psychological therapy to treat common mental health problems and it is used by the NHS. https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/.
The National Institute for Health and Care Excellence (NICE) which provides evidence-based guidance and advice for health, public health and social care practitioners, recommends CBT as a treatment for a variety of mental health problems. https://www.nice.org.uk/guidance/conditions-and-diseases/mental-health-and-behavioural-conditions.
The British Association for Behavioural and Cognitive Psychotherapies (babcp.com) is the lead organisation for CBT in the U.K. and provides the accreditation of CBT Psychotherapists. If you are seeking CBT through private health care insurance, you will likely be given authorisation if you use an accredited CBT therapist listed in the BABCP membership register.
If you are seeking CBT privately you should also check the therapist’s accreditation status through the BABCP website.
The accreditation process is stringent and accredited CBT therapists will have a prior professional qualification, such as in medicine, mental health nursing, social work, psychiatry or psychology.
When you have located a few BABCP Accredited CBT Psychotherapists in your area, speak to them on the ‘phone to discuss your problem, which will give you a good idea if you can work with this person. CBT is a collaborative therapy and a positive therapeutic relationship is often a good indicator of outcomes.
CBT cannot change adverse events or circumstances, but it can teach people to accommodate the reality of them by developing cognitive flexibility, instead of rigid thinking which often drives emotional problems. CBT can, therefore, teach you to navigate life’s vicissitudes in a more rational, balanced and effective way.
BABCP Accredited CBT Psychotherapist.
Anger can be elicited as a result of an individual’s perception of a threat to their wellbeing, property, resources, self-image,
social status or by an interpersonal transgression by another person, where it is deemed to have been deliberate, disadvantages us in some way and it violates a “rule” we have. Indeed, anger can persist for years after the threat has passed. (Di Giuseppe and Tafrate, 2007).
Anger can also be directed towards objects, life conditions, when we have our goals blocked in some way or by random events. (Trower, Jones, Dryden and Casey, 2011).
Being angry about having experienced poor parenting or abusive behaviour by someone will not change that historical fact; accepting the reality that it occurred, whilst addressing the corresponding difficulties that were caused as a result of it, is functional. Demanding that something should not have happened, or someone should not have done something is illogical and it often causes grinding, corrosive and ruminative anger.
Anger management programmes may help you to perceive anger triggers more accurately: identifying negative automatic thoughts about an event, supported by dysfunctional assumptions and core beliefs about yourself, other people and the world.
They may also help you to manage physiological and psychological arousal through breathing and relaxation techniques; hence the intensity of anger you feel decreases. However, it does not fully address the irrational beliefs that are held which drive
the anger. Similarly, although someone can be taught to feel less anger, it does not change the quality of the anger felt.
A more suitable cognitive therapy intervention for anger dysregulation is Rational Emotive Behaviour Therapy (REBT), which teaches people to adjust to adverse events or experiences, which they cannot change.
In REBT we help people to accommodate the reality of an adverse event or action and we aim to change the quality of the anger experienced from dysfunctional unhealthy anger to that of functional healthy anger. These factors are addressed in detail in therapy.
If you frequently find yourself being irrationally angry, there are a variety of ways in which therapy can alleviate this
Di Giuseppe, R & Tafrate, R.C. (2007). Understanding Anger Disorders. Oxford: Oxford University Press.
Trower, P, Jones, J, Dryden, W and Casey, A. (2011). Cognitive behavioural Counselling in Action. (2nd ed.) London; Sage.
What is rumination?
Friday, 7th October 2017 17.00 Written by Kenneth Finlayson BABCP Accredited CBT Psychotherapist.
Rumination involves engaging in repetitive thoughts about the causes, consequences and symptoms of a negative emotional state, particularly depression. Repetitive thoughts may be functional problem solving ones or ruminative dysfunctional ones: asking unanswerable (why me?) questions or focussing on the discrepancy between how you want to feel (happy) and how you actually feel (unhappy) or focussing on how you want your life to be (fantastic) and how it currently is (difficult and stressful). Ruminative thoughts tend to focus on the past and themes of loss, including not attaining our goals; worry tends to be future orientated.
The goals that you wish to achieve may be unrealistic and unattainable; you could also be seeking perfection from yourself. These factors may be related to unhelpful core beliefs that you hold about yourself and the world, such as: I must be a success, people must like me and the world should be fair.
Rumination can become habitual and corrosive, particularly angry ruminations about an event or the actions of someone else. Rumination will very likely produce a negative emotional and physiological response, as though you really are trapped in your circumstances or actually experiencing the unpleasant event. Rumination involves dwelling on past events and stops you from making constructive changes in your life, learning to tolerate negative emotional states and processing difficulties as unpleasant life events.
CBT will help you to spot the warning signs of rumination, undermine unhelpful thinking habits (cognitive biases), develop a different response to factors that have previously triggered rumination, increase problem solving, foster the acceptance of fallibility and process the occurrence of difficult situations or events. It will also help you to develop a more rational, balanced view of yourself and to reduce self focussed thinking.
Smith, J.M. and Alloy, L.B. (2009) A roadmap to rumination: A review of the definition, assessment and conceptualisation of this multifaceted construct. Clin Psychol Rev 29 (2): 116-128
Watkins ER, Mullan E, Wingrove J, Rimes K, Steiner H, Bathurst N, Eastman R, Scott J (2011). Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial. Br J Psychiatry, 199(4), 317-322.
What’s in a name?
Friday, 5th February 2016 17.54 Written by Kenneth Finlayson BABCP Accredited CBT Psychotherapist.
If the word therapy was substituted with “training” or “learning”, would it make you feel more inclined to seek help for an emotional or behavioural difficulty that has been hanging around for too long?
It is common to be reluctant to seek help, especially if we think that doing so will mean that we have “failed” in some way. In CBT language, doing nothing because you think seeking help would make you a “failure” is a maintenance factor - something that keeps the problem going in a self defeating cycle, (Kuyken et al, 2009).
If you were to consider learning about the problem, how it started and what keeps it going, then CBT could give you the knowledge to develop life-long skills in meeting adversity or defeating long standing emotional or behavioural difficulties. It has helped a lot of people to overcome an array of psychological and emotional problems, (Hofmann, et al, 2012).
The word “therapy” lets you know that it isn’t just about having a chat and that CBT is a psychological therapy that has been tried, tested and works. It also lets you know that the person providing the psychological therapy should be an accredited CBT therapist, who has been trained, tested and is qualified to help you learn how to overcome the particular problem.
Once you know what is in this particular word, then you can start learning how to help yourself.
Hofmann, S.G., Asnaani, A., Vonke, I.J.J., Sawyer, A.T. & Fang, A. (2012). The efficacy of Cognitive Behavioural Therapy: A review of meta-analyses. Cog Ther Res 36 (5): 427-440.
Kuyken, W., Padesky, C.A. and Dudley, (2009). Collaborative Case Conceptualization: Working Effectively with Clients in Cognitive-Behavioural Therapy. The Guilford Press: New York.
Only intellectuals need apply: just how clever do you have to be to benefit from cognitive therapies?
Saturday, 05 January 2013 10:43 | Written by Kenneth Finlayson, BABCP Accredited CBT Psychotherapist
Rational Emotive Behaviour Therapy (REBT) and Cognitive-Behavioural Therapy (CBT) have occasionally been misunderstood as therapies that are too “intellectual”. They are not: they are simple, but not simplistic, easily understood and have been used very successfully with children, young people, adults and older adults, with varied intellectual abilities and social backgrounds (Dryden & Neenan, 2004).
The basic principles of CBT have been adapted for use with children and young people (Stallard, 2005) and the age at which CBT can be used varies with a particular young person’s level of development; with therapy being modified accordingly. The National Institute for Health and Clinical Excellence (NICE) recommends CBT for children and young people experiencing moderate to severe depression.CBT is also used to treat various psychological difficulties that people with learning disabilities experience (Kroese et al, 1997).
We can learn the basic principles of how a car works and be taught how to drive it, but we don’t have to be able to design and build an engine to pass a driving test. So, with cognitive therapies, if someone can follow the basic principles and the therapist can teach them in a manner that is understandable, at an agreed pace and suitable for someone’s particular circumstances, then by applying and practicing what they are taught, many people do benefit from therapy. We can also have a look at the engine of cognitive therapies, if someone wants to.
Perhaps the titles of cognitive therapies are a bit clever, but don’t let that put you off enquiring about therapy; even animals think and learn how to thrive - maybe they’ve heard of CBT.
Kroese, B.S., Dagnan, D. & Loumisis, K. (Eds.), (1997). Cognitive behaviour therapy for people with learning disabilities. Routledge: London.
Neenan, M & Dryden, W. (2004). Cognitive Therapy 100 Key Points and Techniques. Routledge: London.
Stallard, P. (2005). A Clinicians Guide to Think Good-Feel Good. Using CBT with Children and Young People. John Wiley: Chichester.
What is the meaning of life?
Friday, 23 November 2012 16:37 | Written by Kenneth Finlayson, BABCP Accredited CBT Psychotherapist
Obviously, no one can completely answer this question and cognitive therapy can’t answer it either. Cognitive therapy can, however, provide you with some rational responses to life’s adversities and vicissitudes.
A significant contribution to managing emotional well-being is the concept of a “demanding” philosophy, Ellis, 1962. This is where we “demand” that someone must or must not do something, the world and life conditions must be favourable and our goals must not be thwarted.
It is this “demanding” that often causes emotional disturbance as the world is never going to be the way that we want it to be, or other people behave towards us in the way that we want them to. Nor indeed can we demand that we must always achieve what we want.
Instead, Ellis proposed that we develop “preferences” about how we would like the world to be, how other people treat us and the goals that we would like to achieve.
So, we would prefer the world and life conditions to be favourable, but unfortunately they don’t have to be, if they are not favourable we can tolerate the discomfort this causes, it isn’t absolutely awful and the world and life conditions are a mixture of adversity and agreeableness.
If you would like to know more about Rational Emotive Behaviour Therapy (R.E.B.T.) or Cognitive Behavioural Therapy (C.B.T.), follow the relevant web addresses in the useful links section, or contact Equanimity CBT.
Ellis, A. (1962). Reason and emotion in psychotherapy. New York: Citadel Press.