Can therapy be helpful?
In past decades we had enormous extended families and people to talk to. We took on the wartime spirit of ‘just getting on with it’ and had no idea that our mental well being played a part in our lives. For example postraumatic stress disorder (PTSD) was in the First World War interpreted as cowardice and as a result those soldiers who were suffering were often shot. Therapy was for Americans not for the British, who of course should be strong enough to take care of themselves.
Sounds familiar doesn’t it? Whilst times have changed in so many ways and therapy has become widely recognised as something that can be helpful and is now commonly sought out, in reality it often feels like the historical stigma is still there. Although 30% of people who go to their GP are attending with psychological difficulties (Goldberg & Huxley, 1992) , it is rarely the first issue mentioned, which means that very often they run out of time before they get the chance to disclose what’s really bothering them.
It takes a great deal of nerve to admit that you need help and to take the first step into therapy, so it is important to stress that it really is worth it for many people.
• Therapy gives you the chance to understand and resolve the causes of a problem rather than just put a sticking plaster over it (such as with medication alone) or ignoring it and hoping it will go away. It’s known that if you have suffered with depression once you are far more likely to experience a second episode and that the underlying causes of both are likely to be linked.
• Therapy is the only opportunity that many people have to spend a concentrated period of time on themselves (one hour per week plus homework). In therapy the social norms of friendship and conversation do not apply. The therapist is not part of your everyday life, is not going to tell other people you know what you have said, is not going to talk about themselves and will be able to cope with your distress without you having to worry about them.
• Therapy is a completely safe environment where you can show the real you (warts and all) and know that someone, who is completely on your side, is going to help you to face your issues and hopefully make changes in your life.
Why cognitive behavioural therapy (CBT)?
CBT is a problem-focused and structured therapy, which allows the therapist and client to work actively and collaboratively together in order to find a way out of difficulties. The basic premise of CBT is that our emotional reactions and behaviour are strongly influenced by our thoughts (cognitions). In other words what we think and believe about the world, ourselves, other people and the future will affect how we interpret the situations we find ourselves in and the meaning we give to our lives. If we interpret them in a way that makes us feel okay then that’s fine; sadly though one in four people will experience depression or anxiety during our lives and at that point in time our thoughts can appear very bleak and frightening.
Unlike some other therapies CBT is time-limited and usually involves on average between six and twenty five weekly sessions depending on the complexity of the difficulties. For example recent onset panic attacks can often be treated very quickly, whereas long-standing and chronic depression that relates back to a difficult childhood will probably take much longer. CBT is about changing the way you live your life. As such in order for any change to happen, it needs more than just talking – it needs doing as well, both in the sessions and outside as part of agreed homework.
Why I like it:
Being a clinical psychologist means that I have been trained in a number of different therapeutic approaches. However I have chosen to specialise in CBT and this is my treatment of choice with most clients. CBT has become well known in the media over the last few years and there is considerable evidence for its effectiveness as a therapeutic treatment. As such it is now recognised by the National Institute for Health and Clinical Excellence (NICE) as the treatment of choice for most anxiety and depression related difficulties (for more information see the Useful Links page).
In addition I feel that CBT offers the following benefits:
• It’s about active change in your life; it is not enough to just talk about something, rather change happens when you start to take action.
• It is not a long-term therapy, which can for some people end up becoming a barrier to making change.
• It operates from a ‘formulation’ perspective; in other words it doesn’t fit you into a box for a particular disorder, rather it helps you to make sense of your individual story and how it has led to your current distress and then it uses this story to choose the best way to make changes.
• Whilst it often uses the past to help make sense of the present it doesn’t dwell in the past, rather once the formulation has been completed the treatment is very much focused on the ‘here and now’.
• It emphasises the importance of ‘homework’ (work done outside the session). In reality there are 168 hours in the week so it is unlikely that anything would really change if only the one hour from the session was dedicated to the problem.
• It creates a very safe and containing environment which allows for as much ‘challenge’ as ‘support’.
• CBT research has developed effective techniques, which has been shown to help specific difficulties and give a clear direction when starting therapy.
If you have found the above interesting and you feel you could benefit from some therapy then it’s now time to take the next step.
1. Step one – make contact
You can do this in a number of ways. You can make contact with me personally either by phone or by email (see contacts page for all the details). Alternatively I am very happy to accept a referral from your GP, other mental health professional or intermediary organisation. Whichever way, it would then be important for us to speak by email or phone to find out a few more details and to check that I can help you. You will need to be an adolescent or older (anyone under 16 years old must have parental consent) and be experiencing difficulties similar to the list of examples opposite.
2. Step two – attend an assessment
If having talked we both feel that pursuing therapy could be useful to you, then you will be invited to meet up for a face to face initial assessment. This would last up to 1.5 hours and it is an opportunity to speak about your difficulties in detail, identify some goals to achieve, formulate a general plan for treatment and explain more about the therapeutic process. Whilst you would need to pay for this assessment, it is not until the end of the meeting that we would need to make a decision about whether to continue with therapy or not.
3. Step three – commit to therapy
If having had the assessment we both feel that therapy would be of use to you then we would make a commitment to engage in therapy. This would be weekly to start with and would last 60 minutes per session. Whilst we would have a very rough idea about how many sessions you might need from the assessment, I operate a policy of having regular review sessions (usually every sixth session) so that we know that we are both happy about where things are going and how they are progressing.
Fees have been designed to keep things as straightforward as possible and as such even though the assessment lasts longer than treatment sessions the price remains the same. I am registered with a number of private health companies including Bupa, AXA PPP, Aviva and CS Insurance. Registration is reasonably easy to arrange so please let me know if you are covered by private insurance that you wish to claim on.
Initial assessment – £100
Treatment sessions – £100