CBT Today Vol 44 No 2 (April 2016)

Volume 44 Number 2 | April 2016

Valuing Low Intensity CBT - Page 6

Volume 44 Number 2 April 2016 Managing Editor Peter Elliott

Inside 4

President’s message Chris Williams’ update on the organisation

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Situating Low Intensity CBT in today’s society

Contributors Wasseem El Sarraj, James Hawkins, Helen Kennerley, Patricia Murphy CBT Today is the official magazine of the British Association for Behavioural & Cognitive Psychotherapies, the lead organisation for CBT in the UK and Ireland. The magazine is published four times a year and posted free to all members.

Back issues can be downloaded from www.babcp.com/cbttoday.

Submission guidelines Unsolicited articles should be emailed as Word attachments to editorial@babcp.com. Publication cannot be guaranteed.

An unsolicited article should be approximately 500 words written in magazine (not academic journal) style. Longer articles will be accepted by prior agreement only.

In the first instance, potential contributors are advised to send a brief outline of the proposed article for a decision in principle.

The Editors reserve the right to edit any article submitted, including where copyright is owned by a third party.

Disclaimer The views and opinions expressed in this issue of CBT Today are those of the individual contributors, and do not necessarily reflect the views of BABCP, its Trustees or employees.

Next deadline 9.00am on 15 August 2016 (for distribution week commencing 16 September 2016) Advertising For enquiries about advertising in CBT Today, please email advertising@babcp.com. © Copyright 2016 by the British Association for Behavioural & Cognitive Psychotherapies unless otherwise indicated. No part of this publication may be reproduced, stored in a retrieval system nor transmitted by electronic, mechanical, photocopying, recordings or otherwise, without the prior permission of the copyright owner.

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Wasseem El Sarraj writes for CBT Today with his thoughts on the value of Low Intensity CBT

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Something’s got to give

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Obituary - Dr Joan Kirk

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Good medicine

Patricia Murphy considers the current stresses on practitioners

Helen Kennerley pays tribute on behalf of the OCTC

James Hawkins’ look at recent research literature

ALSO IN THIS ISSUE: 8

Professional bodies scrutinise Government ‘therapists in jobcentres’ plans 9 The interact study 11 Charter for psychological staff wellbeing and resilience

www.babcp.com

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Notice is given to all BABCP members of the 2016 Annual General Meeting Time: 12.45pm Date: Thursday 16 June 2016 Venue: Meeting Room 1, Belfast Waterfront, 2 Lanyon Place, Belfast BT1 3WH CBT Today | April 2016 3

President’s message It has again been an eventful few months, with a number of changes and challenges, however it is becoming clearer what the main issues are that we face as an organisation Accreditation BABCP has its history as an interest group. It aims to be the natural home for anyone who is interested in CBT. Over time the organisation has taken on new roles like accreditation, complaints and membership disciplinary issues.

There is a tension between our role as an interest group, and the widening roles we have taken on as an organisation such as individual accreditation, and accepting complaints about members. There is a concern that these functions lead to a widely held perception that BABCP is a professional regulator.

I wish to encourage a wider debate in the National Committee Forum (NCF) and Board to clarify what role we wish our organisation to take. One concern I have on a personal basis is that it seems easier to reaccredit as a doctor than as a BABCP accredited practitioner. I am concerned that many of us do not regularly maintain our CBT CPD logs or supervision notes, and then have a mad rush to complete them and reflective learning commentaries many months or even years after the events in those logs and notes.

Rob Newell had started an important debate about the complexity of our current accreditation process. As a medic I’m aware of the model adopted by the GMC. Their final approach is interesting because early on when reviewing their own processes there was a call for more and more detail of clinical practice, possible exams, recordings and competency checks and so on, but that was put aside because it was decided the focus should be not on overly testing the majority who are practicing safely, but instead picking out those who are a danger to the public. This was achieved predominantly by emphasising an ongoing commitment to CPD and clinical supervision groups discussing 4

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learning and practice, and annual review. It is timely to discuss the balance of checks and evidence within the BABCP accreditation processes to see whether we currently have the best balance in our own procedures.

The accreditation process links to whether BABCP should be acting as a professional regulator, for example taking complaints against its accredited (or indeed non-accredited) members. Complaints about members who are regulated by a statutory regulator are already told to take their complaint to the statutory regulator first, or where there is an issue regarding employment then the complainant is referred to the employer. However, we have taken varied stances on this in the past.

There is clearly a need to support our members who have no core profession and those who are not employed within likes of the NHS, and for whom accreditation is important (such as self-employed practitioners).

It is clear that BABCP accreditation is highly valued by our members, employers and many other critical stakeholders in the accreditation process. However, it needs to be clear what accreditation represents without the value of accreditation being undermined.

Reassessing these processes will ensure our approach is reasoned, consistent and delivered well.

Staff and Office We have committed significant funds to develop a new IT system which will be owned by BABCP and run inhouse. This will allow us for the first time to integrate various key sets of membership information and intuitively automate many functions that are currently manually driven, and will allow us – once complete - to provide really useful resources like CPD online logs for members that can be easily updated to act as a summary of learning.

We are currently moving to advertise a new Membership and Branch Liaison Manager role, a Finance Officer post as well as the role of a Senior Clinical Advisor. Finally, I’d like also to report that Ian Preston is leaving his post as Finance Manager.

Ian worked hard over his time with the organisation during which the membership and complexity of the organisation has increased significantly. Now with over 10,000 members and 20 staff, Ian has managed the finances of the organisation and helped us negotiate that time of growth. His departure will be marked by the considerable loss of his knowledge and skills to the organisation. He will be missed.

Other news We are looking at ways of building speed and responsiveness within the organisation, with work underway to delegate decision-making powers more clearly to the main committees.

Also considering how we balance the need to value and use the skills and experience of the often very small number of volunteers willing to join committees, with the need to refresh membership and leadership from time to time to allow new ideas, energy and variety of views.

These issues have been discussed at a recent NCF meeting (unfortunately print deadlines prohibit details being published in this issue of CBT Today).

One approach we are looking at is to improve our governance and communications links by having Board members work alongside committee chairs as co-chairs. The aim is improved communication, plus clear lines of responsibility for decisions and spending as we seek to devolve decision-making and delivery more clearly to committees.

See you all in Belfast!

Chris Williams, BABCP President

www.babcpconference.com

BABCP Conference 2016 Belfast Waterfront, 14-17 June Register now Full Day Workshops - 14 June Workshop 1: Emotional Schemas in CBT Robert Leahy, The American Institute for Cognitive Therapy, USA

Workshop 5: CBT for complicated PTSD - improving your practice Kerry Young, Central and North West London NHS Foundation Trust

Workshop 2: Target Mood-specific Skills Using Mind Over Mood 2 Christine Padesky, The Center for Cognitive Therapy, USA

Workshop 6: One session treatment of specific phobia (including live treatment session) Lars Göran Öst, Stockholm University

Workshop 3: How to Become a More Effective CBT Therapist: Mastering Metacompetence in Clinical Practice Adrian Whittington, Sussex Partnership NHS Trust and Nick Grey, South London and Maudsley NHS Foundation Trust

Workshop 7: Brief Behavioural Activation for Depressed Adolescents Shirley Reynolds and Laura Pass, University of Reading

Workshop 4: Exposure therapy for beginners, experienced therapists, supervisors and just about everyone else Carolyn Becker, Trinity University, USA and Glenn Waller, University of Sheffield

Conference - 15-17 June Keynote speakers include: • Trudie Chalder, King’s College London • David Clark, University of Oxford • Michael Duffy, Queen’s University Belfast • Andrew Gumley, University of Glasgow • Richard Hastings, Warwick University • Merel Kindt, Amsterdam University, the Netherlands

• Freda McManus, University of Stirling • Rory O’Connor, University of Glasgow • Christine Padesky, The Center for Cognitive Therapy, USA • Paul Ramchandani, Imperial College London • Dave Richards, University of Exeter • Jennifer Wild, University of Oxford

Plus Clinical Skills Classes, Symposia and Clinical Roundtables and Debates

Early Bird registration closes 1 May For more information and to register visit www.babcpconference.com CBT Today | April 2016 5

Situating Low Intensity CBT in today’s society Wasseem El Sarraj is a Londonbased PWP in training who takes time out to give CBT Today readers his thoughts on the value he places in Low Intensity CBT to help cope with the hectic life we lead

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Humans overcomplicate. It’s a tendency that speaks to our oversized brains. Occasionally, like when a great novel is written, or scientific breakthroughs are made, we can all revel in human genius. However, quite often we are walking around dreaming, making up complex stories about ourselves, about others, about the world in order to justify our behaviours - behaviours which can be wonderful, but can also be deeply destructive.

much of mental suffering down to:‘I don’t feel I can cope’.

Now what it is that the person cannot cope with can be an event, a thought, a feeling, or of course some combination. For example the dentist; she can’t cope with the thought that she has done something wrong. She goes to great lengths to protect herself from the thought:‘what if my last action was wrong, and the patient I just saw becomes very unwell?’

I work in Low Intensity CBT. Many people accuse this therapy as being over simplistic, of not being able to provide insight, of taking the meaning out of life. I understand why people might think this, but in fact CBT can provide insight, meaning and much more.

With that thought comes a whole raft of emotions; uncertainty, fear, incompetence, worry - none of which sound very pleasant. No wonder she is triple checking and calling her patients once they have left anything to avoid that internal agony.

I see patients from all walks; junior doctors, advertising executives, bus drivers, students, single parents; the list goes on. What unites all of these people is their inability - or felt perception - to cope. When you strip away the technical jargon, the complex theories, you can reduce

Or let’s take the 58-year-old bus driver; he can’t cope with rude passengers; he can’t cope with long shifts, the traffic, his demanding boss, his small pay check that has to feed his family, the rapidly changing London that he once knew. All of these things leave him feeling

worried, unsure, uncertain, anxious and angry. What does he do next?

He stops.

These overwhelming negative emotions and thoughts force him to go on sick leave. More often than not, and we all do this; immediate comfort, respite, distraction are better than reality, and sometimes that solitude is needed. Next time you reach for your phone try and think what thought you had, it might be one you are trying to avoid.

But what also unites these patients, indeed all my London patients, is the stressors of modern life. We have created a magnificent city here in London. But the huge downside is that from all angles we put enormous amounts of pressure on ourselves. In the past you’d know your threats; wild beast, disease. Today we are pushed and pulled in all sorts of outrageous directions.

travel an hour to see someone you barely like, the cost of cinema ticket and that accompanying feeling of being ripped off, a lifetime of debt and this eternal feeling that there is always something else to do. All of this is pressure. All of this brings the prospect of negative emotions, negative thoughts - many of which stay around, wear us down.

Low Intensity CBT is not going to solve the systemic causes of the social conditions specific to London ones that work against our collective wellbeing. Low Intensity CBT is a set of robust skills to make us ‘mentally fit’. These skills learnt with the support of a considerate, warm, encouraging and understanding person can - at its best - be tremendously helpful as well as insightful. They can provide us

with the skills to make us more resilient, and can prevent our health getting much worse.

The hard part of course is maintaining a ‘mentally fit’ life when we are being battered from all directions. All we - and I mean not only our patients - can do, is stave off the effects of our increasingly uncertain, atomised, society; a society that can from early on in our lives conspire to deplete our internal resources.

Learning CBT skills is important but let’s also try to make good friends and strive for a more just, more equitable, more compassionate society so that we don’t have to try so hard to be ‘mentally fit’.

We rush to work on overcrowded buses, at work we have the pressure of targets to meet, then we have the pressure of making sure we stay in employment, the prospect of renting forever and never feeling secure, then we may - depending on our fortune in life - have the pressure of choice which may leave us aching inside for making the wrong one (think food, holidays, concerts), then via social media we have the pressure of constant social comparison (my friend is engaged, I’m lonely and single or my friend is on holiday, I’m poor and stuck in the rain).

How about living with strangers in a flat-share, or how about having to

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Joint statement on Government ‘therapists in jobcentres’ plans In recent months, the British Association for Behavioural and Cognitive Psychotherapies, British Association for Counselling and Psychotherapy, British Psychoanalytic Council, British Psychological Society and UK Council for Psychotherapy have met with officials from the Government’s new Joint Health and Work Unit to scrutinise Government plans to help jobcentre clients who experience mental ill health Last year, concerns were raised in the media when the Government stated its intention to co-locate therapists in jobcentres. These concerns were principally that: • The underpinning rationale was not for improving health, but rather for ideological purposes

met with staff working in a job centre evaluating the feasibility of one of the proposed Government approaches.

We have asked many questions, drilling down into the minutiae of the Government plans, and advocating above all that:

• Employment was being considered as a clinical outcome

• Plans must be aimed at improving mental health and wellbeing rather than as a means of getting people back to work

• People would be coerced into therapy or face sanctions on their unemployment benefit payments

• There must be no conditionality or associated sanction on unemployment benefit

• People would have to access therapy in an unsuitable therapeutic environment

• Clients must be treated compassionately

• There would be a lack of privacy in a job centre environment.

In August 2015, we took the decision to engage with the Department for Work and Pensions, to ascertain the facts and to try to scrutinise and, if necessary, to influence plans. Our priority is patient or client health and wellbeing and the need to examine the underlying socio-economic causes of people suffering from mental illhealth, rather than stigmatise people suffering from mental ill health who happened to be unemployed.

We have relayed the above concerns and more to officials based at the Department and have additionally

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• Clients must have their privacy respected • Client choice must be central to the method and location of delivery of therapy.

We have been consistently advised that the Government has: • Ruled out any use of coercion or sanctions in relation to therapy

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• Opted to pursue a small-scale colocation feasibility trial which, importantly, will thoroughly evaluate privacy issues and mental health outcomes comparative to those achieved by therapy in other settings.

In addition, following our discussions, the Government has agreed to also trial a number of alternatives, such as providing jobcentre clients with access to therapy in alternative community based, non-job centre settings.

We are acutely aware of the sensitivities around this issue and will continue to engage with the Joint Work and Health Unit to critically examine their ongoing work, to ensure that the full range of potential co-location options trialled are in the best interests of clients, and that the evaluations will be thorough and robust enough to pick up on all of our areas of concern. We are particularly aware that for the Government plans to be ethical, employment must at no time be seen as a clinical outcome, staff must not be involved in coercion, and client attendance must not be mandatory.

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We took the decision to engage with the Department for Work and Pensions, to ascertain the facts and to try to scrutinise and, if necessary, to influence plans

The

Study

A new approach to delivering CBT: integrating online CBT materials with therapist led CBT for depression CBT is an effective treatment for depression but we know that there is a lot of variation in the availability of one-to-one high intensity CBT across the UK. CBT-based computerised interventions were designed to make CBT widely available at low cost.

However, engagement with computerised CBT is poor and, in the absence of therapist support, effects are modest and short-term.

In previous research published in The Lancet we showed that delivering CBT in real-time online via instant messaging with a therapist improves depressive symptoms and represents good value for money from the perspective of the NHS. Technological advancements now make it possible to look at reducing therapist time and incorporating online materials as an integral part of therapy.

The INTERACT study is a new six-year programme of research funded by the NIHR Programme Grants for Applied Research (NIHR PGfAR) programme. The INTERACT study will

develop and evaluate a new intervention that will integrate the use of online CBT materials with therapist led CBT for depression for use within the NHS. It will blend high intensity therapy with innovative use of technology to maintain the effectiveness of face-to-face CBT. It will increase the general availability of CBT and include groups for whom access is difficult (those in full-time employment/living in remote areas/with caring responsibilities and hard-to-reach groups). The novel intervention will be developed so that it can be easily incorporated into existing NHS psychological services.

How you can get involved

depression. We also want to find out therapist views on how effective these materials are in bringing about clinically helpful change.

Accredited BABCP members will receive an email or letter inviting them to complete our questionnaire, or you can go directly to: http://www.bris.ac.uk/psychiatry/ research/interact-study/ This is your chance to contribute to the development of a novel intervention that may transform the way in which CBT is delivered within the NHS. We want to hear from you.

Further information about the study and is available online at: http://www.bris.ac.uk/psychiatry/ research/interact-study/

The first part of our research focuses on the development of the online CBT materials that will be an integral part of the intervention. In order to develop these, we want to find out what are the materials that therapists most commonly use to supplement one-to-one CBT with clients with

Alternatively, please contact the INTERACT team at bris-interact@bristol.ac.uk or 0117 331 3357, or write to INTERACT, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN

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Charter for psychological staff wellbeing and resilience Findings from the British Psychological Society and New Savoy staff wellbeing surveys in 2014 and 2015 have shown that psychological professionals are working under stress. They are reporting burnout, low morale and worrying levels of depression. We need to take action to improve the wellbeing and resilience of our psychological staff.

We know good work promotes good wellbeing. We know good psychological therapy services promote good wellbeing.

Psychological professionals who are delivering frontline services should expect to be well supported in their important work. We need clinical leaders, managers & commissioners who understand the nature of this work, who value the dedication and sense of vocation of staff, and who support their staff wellbeing and work-life balance.

more sustainable and will make the most difference to the lives of those they are helping.

We commit to promoting effective services through models of good staff wellbeing at work. We will do this by engaging in reflective and generative discussions with colleagues, other leaders, and frontline staff to co-create compassionate workplaces and sustainable services. The organisations that support this charter will monitor and improve the wellbeing of our own staff. We will share this learning with the Charter Network. We commit to a collaborative effort and shared responsibility to fulfill the aims of the Charter.

This charter aims to re-set the balance in the drive to improve access to psychological therapies. It calls for a greater focus on support for their staff wellbeing to sustain the impact that we know these services can have when delivered effectively.

Services with good staff wellbeing are

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Something’s got to give - don’t let it be your psychological health “I can’t believe I’m getting paid for something that gives me so much satisfaction”, is not something you’re likely to hear a psychological therapist working in IAPT say anytime soon, writes Patricia Murphy According to findings from the British Psychological Society and New Savoy staff wellbeing survey in 2015:“46 per cent of psychological professionals surveyed report depression. Almost half reported feeling they are a failure. One quarter consider they now have a long-term, chronic condition, and 70 per cent say they are finding their jobs stressful.

doesn’t make for pretty reading.

“All these findings are increased from 2014, with reported stress at work up by 12%. Incidents of bullying and harassment had more than doubled.

The overall picture is one of burnout, low morale and worrying levels of stress and depression in a key workforce that is responsible for improving the mental health of the public.

• It is invigorating to work in a team where thoughtfulness, understanding, support and compassion are central to what we do, not seen as an optional extra or a luxury

“Whilst the majority of respondents made negative comments about their work environment, 10% of comments were more positive.”

Here is a selection of feedback comments from participants, and it 12 CBT Today | April 2016

• Being target driven is the bane of our lives • IAPT is a politically driven monster, which does not cater for staff feedback/input in any way. All we are told is TARGETS!!! And work harder.

• I am so disappointed I have just resigned • I carry my resignation in my diary now as I feel that I’m on the verge of giving up battling.

Reading about the alarmingly high rates of stress and burnout took me right back to a rundown NHS car park in 2000. The kind of place where you

needed to check your car still had all four tyres before driving off. I was working in a CMHT that was suffering the negative effects of excessive workload, limited resources and an ever-increasing pressure to restore patients to full psychological health in six sessions. By the way does anyone know when six became the magic number?

It was the Friday before a long anticipated two-week holiday with my family. As I tidied up my desk and waved goodbye my exit was barely acknowledged by colleagues. They were busily tapping in their days activities into a recently introduced handheld brick like device that would have made a good door stop but was instead used to monitor staff activity.

As I walked to the car my eyes began to sting.‘Have a great holiday would have been nice’ I muttered. As I opened the car door I heard the hurried footsteps of a colleague behind me. Aw, she remembered.

Well, no she didn’t actually.“Would

you mind administering these depot injections on the way home?”Well, yes, I would mind.

In fact I minded so much that the resignation letter I had rehearsed in my head for so many months was written that night and the rest as they say is history. When colleagues are so demoralised and distracted that even the most basic of common courtesies is completely eroded it really is time to move on.

What surprises me is that it has taken so long to recognise something that was so widespread fifteen years ago.

However, better late than never and in response to this crisis leading mental health charities, mental health trusts, the CQC, the Royal College of Psychiatrists, the BAPCP and others, are all committing to support a collaborative effort to improve the wellbeing and resilience of psychological staff who deliver key services.

The launching of a Charter aims to reset the balance and asks for a greater focus on support for staff wellbeing.

Now I love a Charter. The Magna Carta amusingly described by Eddie Izzard as ‘the big card’ is famous for setting the foundations for freedom of the individual against the arbitrary authority of the dictator and it doesn’t bear thinking about the injustices over turned or avoided as a result of the British Human Rights Act. But hang on a minute, aren’t many of these hospital trusts sporting a shiny gold plaque proclaiming their investment in staff training and people? I know mine was?

If your employer was awarded Investors in People (IIP) status you might recall having had a conversation with an independent assessor during the assessment period. No? How about regular briefings, frequent feedback and review meetings about your performance. Still no? Surely it was made clear to you how your job helps your organisation achieve its goals?

Me neither.

Here’s a quick revision class on what employers following the IIP standard should have been doing:

• Demonstrating a commitment to developing their workforce • Running induction programmes for new staff and existing staff changing roles • Making their goals clear and show staff how they help to meet them • Giving part-time staff the same access to training as full-timers • Encouraging staff to develop skills that will help them do their job and progress within the company. This could be through courses, shadowing, mentoring or other training opportunities • Evaluating training and development through appraisals, meetings and feedback • Recognising hard work • Keeping staff informed of what is happening and why in the organisation, through meetings, newsletters or intranets • Listening to staff and encourage them to express their opinions What a lot of verbiage posing as verbs this turned out to be. The fact that it has been deemed necessary to

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launch a Charter suggests that any value attached to IIP status in some health service trusts has not been worth the plaque those little laurel wreaths are etched on.

We all have to hope that the laudable sentiments expressed by Professor Jamie Hacker Hughes, BPS President, in endorsing the Charter translate into concrete action not least because the effects are not just confined to staff. The implications for service delivery and patient care are too numerous to mention.

Suffice to say, a demoralised, depressed, unmotivated therapist is not going to be able to get out of bed in the morning let alone be in a position to offer high quality, effective psychological interventions to patients.

Fortunately working as an independent practitioner offers some protection from the threats to psychological wellbeing that so many of my friends and colleagues endure in NHS positions.

What I can say now is that as I get older I realise how important it is to do more of what makes you happy. I am just relieved that 16 years ago I didn’t lose sight of what those things were.

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It is invigorating to work in a team where thoughtfulness, understanding, support and compassion are central to what we do

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Acceptance and Commitment Therapy/ Contextual Behavioural Science Conference

Building Bridges Edinburgh International Conference Centre, Edinburgh

22 - 25 November 2016 Pre-conference workshops - 22 & 23 November Two day advanced/intermediate workshop Dr Robyn Walser, TL Consultation Services/University of California, Berkley and National Centre for PTSD Beyond the Basics in Acceptance and Commitment Therapy: Advancing Through Use of the Therapeutic Relationship and Implementing the Processes with Flexibility and Effectiveness Two-day Introductory Workshop: ACT for CBT Practitioners - Dr Joe Oliver, Contextual Consulting and Dr Richard Bennett, Think Psychology One-day workshop: Adapting ACT for people with Personality Disorder - Dr Helen Bolderston, Bournemouth University A further one-day workshop to be confirmed

Two days of conference - 24 & 25 November The conference theme is ‘Building Bridges’ and we will bring together people from research and practice, across a wide range of topics and interests. In addition, we hope to attract people from diverse orientations, including, ACT, but also the mindfulness, MBCT, MBSR, Compassion Focussed Therapy, CBT and humanistic psychotherapy traditions.

The open call for submissions of symposia, in conference workshops/skills classes, posters, panel debates, will be available via the website below.

Key note speakers include: Dr Robyn Walser, Dr Mary Welford, Compassionate Mind Foundation others to be confirmed Follow for updates on Twitter at #ACTCBS

For registration and submissions visit www.actcbsconference.com

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Dr Joan Kirk

Clinical Psychologist, FBPS 1945-2016

Former Head of Adult Clinical Psychology Services in Oxford and Founder of OCTC Dr Joan Kirk died peacefully at home on January 16 2016 with her husband Professor Keith Hawton and daughters Jane and Kate by her side. She had endured a long illness, and had done so with remarkable humour, grace and fortitude.

Dr Joan Kirk was, indeed, always remarkable. She was an innovative and energetic clinical psychologist who studied in Liverpool, trained in Edinburgh and took her DPhil in Oxford, where she then settled. At the Warneford Hospital she built a large and diverse NHS Clinical Psychology Department. She led by wise example and inspired those around her, creating a real sense of community and vision within her departments. In 2004, she retired and rapidly built up a thriving and much valued private CBT practice.

She was an early pioneer of CBT and

turned a time of NHS financial crisis into an opportunity in the 1990s when she founded The Oxford Cognitive Therapy Centre (OCTC) to promote CBT excellence and in the process created new opportunities for psychologists to become dedicated CBT therapists and trainers.

In collaboration with the University of Oxford, she helped to establish one of the UK’s earliest CBT Diplomas and later did the same for the world’s first Diploma and MSc in Advanced Cognitive Therapy Studies. She coedited one of the best–selling early CBT texts, Cognitive Behaviour Therapy for Psychiatric Problems: A Practical Guide and co-authored one of the best–selling contemporary CBT texts An Introduction to Cognitive Behaviour Therapy: Skills and Applications.

As a psychologist, a cognitive therapist and a manager she furthered research, training and specialist services. She was, deservedly, made a Fellow of the British Psychological Society for her

significant contributions to the field.

She was also uncommonly astute in recognising potential in her staff and unstintingly generous in supporting others in developing their careers and interests. So many of us owe her so much.

Her energy seemed boundless and extended to many activities even throughout her illness: bird watching, opera, rock concerts, world-wide trekking, climbing mountains, canoeing the Amazon, and all this she did with great and infectious enjoyment and often alongside lifelong friends.

When we think of Joan Kirk we will recall many achievements and significant accomplishments but those who were fortunate in knowing her will best remember her kindness, warmth and humour - and that she was simply an exceptional person.

Helen Kennerley, on behalf of OCTC

CBT in Ireland Save the date!

The inaugural ‘CBT in Ireland’ event has been confirmed for Friday 31 March 2017, to be held in Dublin.

As well as using ‘CBT in Ireland’ to promote the practice of CBT across Ireland, the organisers hope to increase IABCP membership through increased recognition of IABCP in Ireland.

The event will be a great opportunity for networking and will be an opportunity for delegates to earn CPD points.

Speakers at the event are still to be confirmed, with more information being released in future issues of CBT Today and on the BABCP website.

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goodmedecine Edinburgh-based Dr James Hawkins writes prolifically on his blog about his most recent research findings. Here he has kindly agreed to share them with CBT Today readers

I read a lot of research. When I find an article of particular interest I download it to my bibliographic database - Endnote - which currently contains nearly 23,000 abstracts.

I also regularly tweet about emerging research, so following me on Twitter, Facebook or Google+ will keep you up to speed with some of what I am finding interesting. Additionally you can view this highlighted research by visiting Scoop.it.

At Scoop.it, I stream publications into five overlapping topic areas: Cognitive & General Psychotherapy, Depression, Compassion & Mindfulness, Healthy Living & Healthy Aging, and Positive Psychology. Here you can scan through abstracts, follow hyperlinks to the original research papers, and search by keyword.

Every couple of months or so, I also provide overviews of this research.

Clicking on the topic heading Cognitive & General Psychotherapy downloads a hyperlinked PDF list of 36 good recent research articles (mostly from journals published over the autumn & winter). There is so much of value here.

If you are a therapist do please look at these studies. There are the encouraging results reported by Brent on continuing benefits from eight weekly group preventive CBT sessions at six-year follow-up in adolescents at high risk of depression. Bockting reports similar benefits at 10-year follow-up with adults.

Wouldn’t it be interesting to run a comparative four arm study of preventive CBT, MBCT, an active control condition, and treatment as usual!? Conklin reports that "Patient engagement (effort & completion) with homework assignments (in CBT for depression) appears to be an important predictor of early sessionto-session symptom improvements."

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There is Erekson’s study on the importance of session frequency, Fernandez’s meta-analysis of CBT dropouts, Guo’s important work on the benefits of “measurement-based care”, Kontunen’s work on IPC versus IPT for primary care depression, Mansson’s fascinating finding of anatomical brain changes following CBT, and Tajika’s wake-up call on the poor replicability of highly cited psychiatric research papers.

Click on Depression for an overlapping list of 36 relevant studies (this covers medication too). These include Appleton’s Cochrane review of the value of omega-3 fatty acids for depression; three papers - by Arabhadeh, Felger and Kiecolt-Glaser - on the importance of inflammation in depression; three papers - by Akoubad, Malm and Vazquez - on drug side-effects; Goddard’s helpful work on the value of simple screening for personality disorder in IAPT treatment; Hallgren and Murri’s papers on exercise for depression; Sanchez-Villegas’s reminder that poor diet quality is associated with increased incidence of depression; and Weitz’s challenge to the widely held view that medication is indicated over psychotherapy for severe depression.

The Compassion & Mindfulness link brings 36 recent abstracts. Both Bilderbeck and Gothe have papers exploring benefits linked with yoga practice. Mindfulness has had such a positive press recently, it was predictable that more critical studies would start to emerge. Huljbers research shows that adding MBCT to maintenance antidepressants sadly does not seem to produce increased relapse protection.

Michalak’s work suggests that group CBASP is more effective than MBCT for chronic depression, and similarly Veehofab’s meta-analysis indicates that ACT is preferable to MBSR or

MBCT for anxious or depressed chronic pain sufferers. Possibly most challenging is Shallcross’s research comparing MBCT to an active control condition (rather than the more standard, but less satisfactory, treatment as usual or waiting list comparisons).

There are also a series of interesting papers on compassion, self-criticism, and even emotional intelligence - see, for example, Duarte on imagery for self-criticism, Lim on personal suffering and compassion, Mikolajczak on emotional competence, and Robinson on touch.

Clicking on Positive Psychology downloads abstracts and links to 30 papers including Coffey’s longitudinal study on infant happiness and adult life satisfaction, Coulton’s paper on the benefits (and cost effectiveness) of encouraging more community singing, Jetten’s further underlining the importance of membership in groups, Mulse’s intriguing work on sexual frequency and wellbeing, and Ye’s very significant demonstration that social inequality and gender

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At Scoop.it, I stream publications into five overlapping topic areas: Cognitive & General Psychotherapy, Depression, Compassion & Mindfulness, Healthy Living & Healthy Aging, and Positive Psychology

discrimination are major factors in decreasing well-being across different countries.

Finally, I have rather gone ‘over the top’ with 50 abstracts in the Healthy Living & Healthy Aging section - as Pascal wrote “I have made this letter longer than usual because I have not had time to make it shorter.”

There is Appleby on mortality in vegetarians, Baker on ways of stopping smoking, Castelnovo on the commoness of post-bereavement hallucinations, Chen on the benefits of Tai Chi, Copen on sexual behaviour

in the US (probably not so different from many other countries), Richard on fruit/veg intake and lowered mental distress, Rowe on successful aging 2.0, Sani with more on the benefits of group membership, and Vachon’s review paper on the harmful consequences of different kinds of child maltreatment with its call to pay more attention to emotional abuse.

So much fascinating and helpful information here. Remember you can always search these and earlier studies using keywords on James’s Scoop.it pages.

You can read James’ blog at www.goodmedicine.org.uk, find his Scoop.it page at www.scoop.it/u/DrJamesHawkins and follow him on Twitter @DrJamesHawkins

ORDER ONLINE

Public information leaflets

BABCP has produced a series of information leaflets aimed at the general public, explaining how CBT works in the treatment of various emotional and physical conditions.

These leaflets are available to buy now, and are ideal for use in surgeries for members of the public to obtain basic information on the benefits of CBT. Choose from the following:

CBT for agoraphobia • CBT for anxiety • CBT for bipolar disorder • CBT for depression CBT for eating disorders • CBT for fear of flying • CBT for OCD • CBT for PTSD • CBT for social anxiety CBT - therapy worth talking about They are available in packs of 25 and can be ordered by downloading and completing the order form at www.babcp.com/store

Widely Recognised Accreditation | High Quality CPD | CBT Register UK

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Compassion SIG

East Midlands Branch

presents

presents www.babcp.com

Building Resilience in Therapists with Dr Mary Welford

Friday 24 June 2016 Wakefield

www.babcp.com

CBT for the Elderly with Professor Ken Laidlaw

As therapists we are really unusual. We choose to spend our time, day in day out, engaging with the emotional suffering of others with the aim of alleviating their distress. This has an impact on us. If we look after our wellbeing, and feel we have skills that will be of assistance, we can feel very privileged to do the job we do. Our wellbeing is good.

Unfortunately busy lives and work pressures often mean that we do not look after ourselves to the extent that we should. In addition, sometimes we feel we just do not have the skills or approach to assist the people we see. Our wellbeing suffers.

This workshop will aim to enhance psychological resilience in delegates by building a compassionate relationship with themselves and addressing shame and self-criticism. Individuals will have direct experience of applying Compassion Focused methods to their own lives and a secondary outcome will be a greater understanding of how they may use it within their teams and with their clients.

27 & 28 April 2016 Derby

Treating GAD using the Dugas and Robichaud model with Dr Helen Moya

Friday 10 June 2016 Nottingham

Registration fees BABCP members: £85, Non-members: £95

To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com South East Branch

Southern Branch

presents

presents www.babcp.com

www.babcp.com

ABC of OCD with Joy McGuire Tuesday 21 June 2016 Southampton

CBT for Couples with Marion Cuddy and Dan Kolubinski

Monday 9 & Tuesday 10 May 2016 Sevenoaks This workshop will provide an introduction to the theory and application of cognitive behavioural couple therapy. The theoretical underpinnings of the model will be described, along with the main intervention techniques. Materials will cover assessment, formulation and outcome measurement. The challenges of working with distressed couples will be discussed.

The workshop will be interactive and role-play exercises - as well as group discussions - will be used to practice clinical skills throughout the day. The evidence supporting couple therapy will be presented and participants will have plenty of opportunities to ask questions.

OCD can often be a complex and perplexing condition for both sufferer and therapist alike. Clients present, frequently, with a variety of confusing behaviours making therapy challenging – to say the least!

This workshop aims to help clinicians understand more about the nature of OCD. Through participation in role play and other experiential methods we will explore ways of engaging and treating this client group using evidence-based interventions.

Registration fees Early Bird: payments received up to 22 April BABCP Member: £75, Non-member: £85, Student/Trainee: £65*

Registration fees

Full Registration Fee from 23 April BABCP Member: £90, Non-member: £100, Student/Trainee: £70*

BABCP members: £100, Non-members: £120

*Evidence must be provided with application

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“Living with the Enemy” - ACT for Physical Health Problems“ Dr Ray Owen

Monday 10th & Tuesday 11th October, 2016 Resource for London, 356 Holloway Rd, London N7 6PA Serious physical health problems can take over a person’s existence; the daily struggle with the physical and psychological effects can take so much time and energy that it can feel as if the rest of life is ‘on hold’.

Sometimes, they feel they’re just existing, not really living.

This intermediate training will help you recognise, understand and respond effectively to these and other difficulties, giving you new tools and approaches for helping your clients and their carers to have a meaningful existence in the presence of their health problem - to ‘Live with the Enemy’.

Learn how to: • Apply your existing knowledge of the 6 core processes of ACT to the problems of physical ill health • Flexibly adapt your interventions to different physical health contexts (eg illness trajectory, family systems, healthcare providers) • Skillfully approach difficult issues such as ‘denial’, altered sense of self and hopelessness • Learn practical skills to be ‘doing ACT’ rather than simply ‘talking a bout ACT’ • Use ACT with carers and other family members

About the Presenter Ray Owen is a Consultant Clinical Psychologist and Health Psychologist with over 20 years experience of working in Physical Health settings within the NHS. He is a Fellow of the Higher Education Academy, and an accredited facilitator in the national Advanced Communication Skills Programme for senior cancer practitioners.

He has taught extensively on ACT in physical health contexts, and is the author of two successful self-help books published by Routledge - ‘Facing the Storm (2011)’ and ‘Living with the Enemy (2014)’, both of which were shortlisted for the BMA Popular Medicine Book of the Year Award.

Rates • Early bird - £220 (ends 12th September) • Special “Bring a Friend” 30% discount - book 2 places: £154 per person (£308 total) - ends 12th September • Standard rate £240 (up 9th October)

Check out our other upcoming 2016 Workshops!

Professor Steve Hayes - ACT Clinical Skills Workshop - 2-3rd Sept, London ACT for Coaches & Organisational Psychologists (Nov - date to be confirmed

For more information on how to register, go to: www.contextualconsulting.co.uk

CBT Today | April 2016 21

Devon & Cornwall Branch

Chester Wirral & North East Wales Branch

presents

presents www.babcp.com

www.babcp.com

Working with Tics and Tourette’s

Brief Introduction to CFT

with Dr Tara Murphy

This workshop will introduce delegates to the theory and practice of Compassion Focussed Therapy (CFT) and provide some practical ideas that can be used straight away (both personally and professionally). It is suitable for those who are new to CFT, or anyone who wants a refresher.

Thursday 12 May 2016

29 April 2016

Acceptance and Commitment Therapy: Experiential Introduction with Skills Training with Martin Wilks and Henry Whitfield

12-13 May & 21-22 July 2016 - 4 Day workshop

Trauma Focused Cognitive Therapy for PTSD Presented by Dr Nick Grey

3 June 2016

CFT in Practice Workshop Friday 13 & Saturday 14 May 2016 Formulation, the training of attention, mindfulness, guided imagery and letter writing are just some of the skills associated with the practice of CFT. This workshop focuses on the practice and development of such skills and, most importantly, the therapist’s confidence. It is suitable for those who are familiar with the CFT model and wish to develop or practice their skills in a warm and supportive environment.

Ellesmere Port with Dr Mary Welford

Working with Chronic Pain

Registration fees

Presented by Helen Macdonald

23 September 2016

Workshop One (12 May) BABCP Member: £100, Non-member: £120

All workshops are held in Buckfast

Both Workshops BABCP Member: £275, Non-member: £335

Workshop Two (13 & 14 May) BABCP member: £200, Non-member: £240

To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com North West Wales Branch

Manchester Branch

presents

presents www.babcp.com

www.babcp.com

Cognitive Therapy for Social Anxiety Disorder (SAD) and Panic Disorder with Dr Nick Grey

29 April 2016 Bangor This workshop will highlight the core skills such as the use of discussion techniques, behavioural experiments and imagery. It will clarify the differences in diagnosis, formulation and treatment methods. There will be a greater focus on the clinical approaches needed to address SAD, including the use of video, and the role of attentional processes.

The workshop will include reflecting on tapes of actual sessions, experiential exercises, and the opportunity to consider one’s one cases.

Registration fees BABCP members: £80, Non-members: £90

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Best Practices: CBT for Depression & Suicide with Dr Christine Padesky

10 & 11 June 2016 Manchester Registration fees Early Bird rate for payment received by 31 March BABCP Members: £170, Non-members: £185 Full rate for payment received from 1 April BABCP members: £185, Non-members: £200

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