‘The way forward’ Beacon Business Healthcare are pleased to offer a diverse range of specialist therapeutic services to individual clients and organisations. All therapies are delivered by experienced, insured, professional clinicians educated to Masters degree or equivalent and regulated by the BACP and UKCP. They are available at short notice nationwide, using our extensive team.
CONTENTS Behavioural Therapies Cognitive Behavioural Therapy for Addiction (CBT) EMDR Exposure Therapy Post Traumatic Stress Disorder
2 3 4 4
Solution Focused Therapies Executive Mentoring and Coaching Neuro Linguistic Programming (NLP)
5-6 6
Specialist Therapeutic Services Family Therapy Clinical Supervision Psychosexual Therapy Psychological Assessments Psychotherapy Rehabilitation Programmes and Medical Detoxification
7 7 8 8 9 9
Therapeutic Approaches for Organisations Employee Assistance Programmes (EAP)
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Brief Term Therapy Counselling Brief Psychodynamic Psychotherapy Couples Therapy Group Therapy Managing Critical Incidents
11 11 12 12 12
Behavioural Therapies Cognitive Behavioural Therapy for Addiction (CBT) Recognise, Avoid and Cope Cognitive Behavioural Therapy is mostly used to treat depression, anxiety disorders, phobias, and other mental disorders, but it has also been shown to be valuable in treating alcoholism and drug addiction, especially as part of an overall program of recovery. Cognitive-behavioural coping skills treatment is a short-term, focused therapeutic approach to helping drug-dependent people become abstinent by using the same learning processes the person used to develop alcohol and drug dependence initially.
What Is Cognitive Behavioural Therapy? Cognitive behavioural therapy is based on the idea that feelings and behaviours are caused by a person's thoughts, not on outside stimuli like people, situations and events. People may not be able to change their circumstances, but they can change how they think about them and therefore change how they feel and behave, according to cognitive-behaviour therapists. In the treatment for alcohol and drug dependence, the goal of cognitive behavioural therapy is to teach the person to recognise situations in which they are most likely to drink or use drugs, avoid these circumstances if possible, and cope with other problems and behaviours which may lead to their substance abuse.
What Are Other Approaches to Cognitive Behavioural Therapy? According to the National Association of Cognitive-Behavioural Therapists, there are several approaches to cognitive-behavioural therapy, or CBT as it is called, including
Dialectic Behavioural Therapy. What Are the Components of Cognitive Behavioural Therapy? In its use to treat alcohol and drug-dependence individuals, cognitive behaviour therapy has two main components: functional analysis and skills training. Functional Analysis: Working together, the therapist and the patient try to identify the thoughts, feelings and circumstances of the patient before and after they drank or used drugs. This helps the patient determine the risks that are likely to lead to a relapse. Functional analysis can also give the person insight into why they drink or use drugs in the first place and identify situations in which the person has coping difficulties. Skills Training: If someone is at the point where they need professional treatment for their alcohol or drug dependence, chances are they are using alcohol or drugs as their main means of coping with their problems. The goal of cognitive behaviour therapy is to get the person to learn or relearn better coping skills. The therapist tries to help the individual unlearn old habits and learn to develop healthier skills and habits. The main goal of cognitive behavioural therapy is to educate the alcohol or drug-dependent person to change the way they think about their substance abuse and to learn new ways to cope with the situations and circumstances that led to their drinking or drugging episodes in the past.
How Long Does Cognitive Behavioural Therapy Take? Because cognitive behavioural therapy is a structured, goal-oriented educational process focused on the immediate problems of the alcohol or drug-dependent patient, the process is usually short-term. Although other forms of therapy and psychoanalysis can take years, cognitive behaviour therapy is usually completed in 12 to 16 sessions with the therapist.
How Effective Is Cognitive Behavioural Therapy? According to the National Institute on Drug Abuse, more than 24 randomised controlled trials have been conducted among users of tobacco, alcohol, cocaine, marijuana, opiates, and other types of substances, making cognitive-behavioural treatments one of the most frequently evaluated psychosocial approaches to treat substance use disorders. In these studies, cognitive behavioural therapy has been shown most effective when compared with having no other treatment at all. When compared with other treatment approaches, studies have had mixed results -- some show cognitive behavioural therapy more effective while others show it to be of equal, but not greater, effectiveness than other treatments. As with other treatments for alcoholism and drug abuse, including pharmaceutical treatments, cognitive behavioural therapy works best when combined with other recovery efforts, such as participation in support groups. In summary, cognitive behavioural therapy works well for some, but not for everyone, as is the case with all alcoholism and drug treatment approaches. All therapy and care services are offered nationwide by Beacon with fast turnaround times.
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Behavioural Therapies EMDR Eye Movement Desensitization and Reprocessing (EMDR) is a comprehensive, integrative psychotherapy approach. It contains elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioural, interpersonal, experiential, and body-centered therapies. EMDR is an information processing therapy and uses an eight phase approach to address the experiential contributors of a wide range of pathologies. It attends to the past experiences that have set the groundwork for pathology, the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviours and mental health. During treatment various procedures and protocols are used to address the entire clinical picture. One of the procedural elements is "dual stimulation" using either bilateral eye movements, tones or taps. During the reprocessing phases the client attends momentarily to past memories, present triggers, or anticipated future experiences while simultaneously focusing on a set of external stimulus. During that time, clients generally experience the emergence of insight, changes in memories, or new associations. The clinician assists the client to focus on appropriate material before initiation of each subsequent set. Eight Phases of Treatment The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviours that will be needed by the client in future situations. During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilisation is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete. In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Although eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice what ever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced. In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two. The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system. After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioural and personal change, which are further enhanced with standard EMDR procedures.
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Behavioural Therapies Exposure Therapy What is exposure therapy? In exposure therapy your goal is to have less fear about your memories. It is based on the idea that people learn to fear thoughts, feelings, and situations that remind them of a past traumatic event. By talking about your trauma repeatedly with a therapist, you'll learn to get control of your thoughts and feelings about the trauma. You'll learn that you do not have to be afraid of your memories. This may be hard at first. It might seem strange to think about stressful things on purpose. But you'll feel less overwhelmed over time. With the help of your therapist, you can change how you react to the stressful memories. Talking in a place where you feel secure makes this easier. You may focus on memories that are less upsetting before talking about worse ones. This is called "desensitisation," and it allows you to deal with bad memories a little bit at a time. The therapist also may ask you to remember a lot of bad memories at once. This is called "flooding," and it helps you learn not to feel overwhelmed. You also may practice different ways to relax when you're having a stressful memory. Breathing exercises are sometimes used for this.
Post Traumatic Stress Disorder Treatment of PTSD Today, there are effective treatments available for PTSD. When you have PTSD dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But talking with a therapist can help you get better. Cognitive-behavioural therapy (CBT) is one type of counselling. It appears to be the most effective type of counselling for PTSD. There are different types of cognitive behavioural therapies such as cognitive therapy and exposure therapy. There is also a similar kind of therapy called eye movement desensitisation and reprocessing (EMDR) that is used for PTSD. Medications have also been shown to be effective. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.
How long does treatment last? For some people, treatment for PTSD can last 3 to 6 months. If you have other mental health problems as well as PTSD, treatment for PTSD may last for 1 to 2 years or longer.
What if someone has PTSD and another disorder? Is the treatment different? It is very common to have PTSD at that same time as another mental health problem. Depression, alcohol or substance abuse problems, panic disorder, and other anxiety disorders often occur along with PTSD. In many cases, the PTSD treatments described above will also help with the other disorders. The best treatment results occur when both PTSD and the other problems are treated together rather than one after the other.
What will we work on in therapy? When you begin therapy, you and your therapist should decide together what goals you hope to reach in therapy. Not every person with PTSD will have the same treatment goals. For instance, not all people with PTSD are focused on reducing their symptoms. Some people want to learn the best way to live with their symptoms and how to cope with other problems associated with PTSD. Perhaps you want to feel less guilt and sadness? Perhaps you would like to work on improving your relationships at work, or communication issues with your friends and family. Your therapist should help you decide which of these goals seems most important to you, and he or she should discuss with you which goals might take a long time to achieve.
What can I expect from my therapist? Your therapist should give you a good explanation for the therapy. You should understand why your therapist is choosing a specific treatment for you, how long they expect the therapy to last, and how they see if it is working. The two of you should agree at the beginning that this plan makes sense for you and what you will do if it does not seem to be working. If you have any questions about the treatment your therapist should be able to answer them. You should feel comfortable with your therapist and feel you are working as a team to tackle your problems. It can be difficult to talk about painful situations in your life, or about traumatic experiences that you have had. Feelings that emerge during therapy can be scary and challenging. Talking with your therapist about the process of therapy, and about your hopes and fears in regards to therapy, will help make therapy successful. If you do not like your therapist or feel that the therapist is not helping you, it might be helpful to talk with another professional. In most cases, you should tell your therapist that you are seeking a second opinion.
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Solution Focused Therapies Executive Coaching/Mentoring Business coaching and mentoring Organisational development, changes brought about by mergers and acquisitions as well as the need to provide key employees with support through a change of role or career are often catalysts, which inspire companies to seek coaching or mentoring. At one time coaching and mentoring were reserved for senior managers and company directors, now it is available to all as a professional or personal development tool. Coaching and mentoring are also closely linked with organisational change initiatives in order to help staff to accept and adapt to changes in a manner consistent with their personal values and goals. Coaching and mentoring, both of which focus on the individual, can enhance morale, motivation and productivity and reduce staff turnover as individuals feel valued and connected with both small and large organisational changes. This role may be provided by internal coaches or mentors and, increasingly, by professional coaching agencies. Coaching and mentoring programmes generally prove to be popular amongst employees as coaching achieves a balance between fulfilling organisational goals and objectives whilst taking into account the personal development needs of individual employees. It is a two-way relationship with both the organisation and the employee gaining significant benefits. There is also an increasing trend for individuals to take greater responsibility for their personal and professional development and even those who are employed in large organisations are no longer relying on employers to provide them with all or their career development needs. There has been an increase in the number of individuals contracting coaches and mentors on a private basis. Some are looking for a career change, but many are also seeking to maximise their potential with an existing employer or achieve greater balance with their work and home lives.
Executive Coaching and Mentoring There is a great deal of overlap between business and executive coaching or mentoring. Many people will offer either service, but there is a growing body of professionals in the UK who are calling themselves executive coaches and mentors and are differentiating themselves in the marketplace. The key differences between business and executive coaching and mentoring are that executive coaches and mentors typically… • • • • • •
Have a track record in professional and executive roles Work exclusively with the ‘high-flyers’ or with those who have potential to be a high flyer Work at board or CEO level within high profile or ‘blue-chip’ organisations Offer total confidentiality Work with potential 'captains of industry' and high profile business leaders Performance coaching and mentoring
Many coaching clients will seek coaching or mentoring for performance enhancement rather than the rectification of a performance issue. Coaching and mentoring have been shown to be highly successful intervention in these cases. When an organisation is paying premium rates for development services, performance is usually the key pay-back they are looking for. Even if an executive or manager receives support in balancing work and home life, it will be with the aim of increasing their effectiveness and productivity at work and not for more altruistic reasons. Performance coaching derives its theoretical underpinnings and models from business and sports psychology as well as general management approaches.
Skills coaching and mentoring Skills coaching has some commonalities with one-to-one training. Skills coaches & mentors combine a holistic approach to personal development with the ability to focus on the core skills an employee needs to perform in their role. Skills coaches & mentors should be highly experienced and competent in performing the skills they teach. Job roles are changing at an ever increasing rate. Traditional training programmes are often too inflexible or generic to deal with these fast moving requirements. In these instances one-to-one skills coaching allows a flexible, adaptive ‘just-in-time’ approach to skills development. It is also possible to apply skills coaching in ‘live’ environments rather than taking people away from the job into a ‘classroom’ where it is less easy to simulate the job environment. Skills coaching programmes are tailored specifically to the individual, their knowledge, experience, maturity and ambitions and is generally focused on achieving a number of objectives for both the individual and the company. These objectives often include the individual being able to perform specific, well-defined tasks whilst taking in to account the personal and career development needs of the individual. One-to-one skills training is not the same as the ‘sitting next to Nelly’ approach to ‘on the job training’. What differentiates it is that like any good personal or professional development intervention it is based on an assessment of need in relation to the job-role, delivered in a structured (but highly flexible) manner, and generates measurable learning and performance outcomes. This form of skills training is likely to focus purely on the skills required to perform the job function even though it may adopt a facilitative coaching approach instead of a 'telling' or directive style.
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Solution Focused Therapies Executive Coaching/Mentoring (continued) Personal coaching and mentoring Personal or ‘life coaching’ is growing significantly in the UK, Europe and Australia. Personal coaches may work face-to-face but email and telephone based relationships are also very common. These coaches and mentors operate in highly supportive roles to those who wish to make some form of significant change happen within their lives. Coaches offer their clients a supportive and motivating environment to explore what they want in life and how they might achieve their aspirations and fulfil their needs. By assisting the client in committing to action and by being a sounding-board to their experiences, coaching allows the individual the personal space and support they need to grow and develop. The coach's key role is often is assisting the client to maintain the motivation and commitment needed to achieve their goals. In many cases personal coaching is differentiated from business coaching purely by the context and the focus of the programme. Business coaching is always conducted within the constraints placed on the individual or group by the organisational context. Personal coaching on the other hand is taken entirely from the individual's perspective.
Neuro Linguistic Programming (NLP) NLP has been described as a software manual for the brain. It is a proven model for accelerating human change and is used as a means to improve the way we think, feel and behave. Ultimately, NLP is a model of communication that focuses on identifying and using patterns of language and thought to influence a person's behaviour. It offers a definition of how the brain works (neuro), about how language interacts with the brain (linguistic) and how we use this interaction to get the results we want for ourselves and others (programming). NLP was initially created by linguist Dr John Grinder and computer scientist and Gestalt therapist Dr Richard Bandler. Together they produced a linguistic model that identified the language patterns of a few exceptionally gifted individuals such as hypnotherapist Milton Erickson, Fritz Perls of Gestalt therapy and anthropologist Gregory Bateson. The collection of their findings, a blend of cognitive and behavioural science, resulted in the technology known as Neuro Linguistic Programming. In the 25+ years since it was first developed, NLP has grown, changed and expanded, and it continues to do so today.
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Specialist Therapeutic Services Family Therapy Family therapy is a type of psychotherapy. Through family therapy, families or individuals within a family learn better ways to interact with each other and resolve conflicts. If your family is feeling torn apart, family therapy may help you heal. Family therapy is usually provided by clinical social workers or licensed therapists known as marriage and family therapists. These therapists have graduate or postgraduate degrees - and many choose to become accredited through the BACP. Family therapy is often short term. Family therapy may include all family members or just those most able to participate. The specific treatment plan will depend on your family's situation.
Clinical Supervision Supervision is used in counselling, psychotherapy, and other mental health disciplines as well as many other professions engaged in working with people. It consists of the practitioner meeting regularly with another professional, not necessarily more senior, but normally with training in the skills of supervision, to discuss casework and other professional issues in a structured way. This is often known as clinical or counselling supervision or consultation. The purpose is to assist the practitioner to learn from his or her experience and progress in expertise, as well as to ensure good service to the client or patient. Clinical supervision is used in many disciplines in the NHS across the UK. Registered Allied Health Professionals such as occupational therapists, physiotherapists, dieticians, speech and language therapists and art, music and drama therapy. Drama therapists are now expected to have regular clinical supervision. C. Waskett (2006) has written on the application of solution focused supervision skills to either counselling or clinical supervision work. Some practitioners (e.g. art, music and drama therapists, chaplains, psychologists, and mental health occupational therapists) have used this practice for many years. In other disciplines the practice may be a new concept. For NHS nurses, the use of clinical supervision is expected as part of good practice. Practising members of the British Association for Counselling and Psychotherapy are bound to have supervision for at least 1.5 hours a month. Students and trainees must have it at a rate of one hour for every eight hours of client contact. The concept is also well used in psychology, social work, the probation service and other workplaces.
Models or approaches to supervision There are many different ways of developing supervision skills which can be helpful to the clinician or practitioner in their work. Specific models or approaches to both counselling supervision and clinical supervision come from different historical strands of thinking and beliefs about relationships between people. A few examples from a very wide range of approaches are given below. Two psychotherapists, P. Hawkins and R. Shohet (2003), developed a humanistic process model which springs from “ourselves as wounded helpers� (p7). S.Page and V. Wosket describe a cyclical structure. F. Inskipp and B. Proctor (1993, 1995) developed an approach based on the normative, formative and restorative elements of the relationship between supervisor and supervisee. The Brief Therapy practice teaches a solution focused approach based on the work of Steve de Shazer and Insoo Kim Berg which uses the concepts of respectful curiosity, the preferred future, recognition of strengths and resources, and the use of scaling to assist the practitioner to progress. Counselling or clinical supervisors will be experienced in their discipline and normally then have further training in any of the above-mentioned approaches, or others.
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Specialist Therapeutic Services Psychosexual Therapy Psychosexual Therapy, known as PST, is treatment by a qualified practitioner which addresses a sexual dysfunction or emotional block within a relationship. PST has a proven success rate and takes referrals from GPs and counsellors to look at physiological and psychological problems which are causing distress. Any physical cause such as medication, alcohol, stress or illness will also be considered. PST is a behavioural programme which openly explores and discusses the sexual problem and looks at emotional blocks for the couple.
The main dysfunctions for men: • • •
Erectile failure: the inability to maintain an erection sufficiently to allow penetration. Premature ejaculation: this is the inability to control the timing so ejaculation occurs too soon. Retarded ejaculation: an inability to ejaculate at all or intercourse taking too long before ejaculation takes place.
The main dysfunctions for women: • • •
Vaginismus: involuntary spasm of the muscles around the vagina, which make sexual intercourse impossible. Dyspareunia: penetration is painful. Orgasmic dysfunction: an inability to experience an orgasm.
There are 5 distinctive stages of arousal which are a combination of the emotional and physical communication between the couple. The timing and the meaning can be quite different for each partner. For example where anger and resentment are major issues within a relationship the excitement phase may be problem-free but the resolution stage may be disappointing. Such a couple may rely on pornography or arousing jealousy in the other. • • • • •
Desire Excitement Plateau Orgasm Resolution
Intensive therapy, using a behavioural approach, should only be attempted by a suitably qualified therapist. Inappropriate sex therapy can reinforce problems in a relationship rather than help the situation. Dealing with physiological or emotional difficulties must be sensitively and skilfully managed.
Psychological Assessments Often, such assessments are the only means of understanding and explaining behaviour. Before any treatment or remediation can begin, it's important to understand the nature of the problem or difficulty. A psychological assessment is the necessary first step in determining the strengths and weaknesses in an individual's functioning when that functioning has been called into question, either by displaying actions that are unexpected or by not displaying actions that are expected, in a given circumstance or environment. Psychological assessments involve the observation, measurement and evaluation of an individual's or organization's adaptive functioning in the modern world. Assessments are used to assess the developmental, behavioural, academic, psychological, neuropsychological and personality functioning of infants, children, adolescents and adults in a wide variety of circumstances ranging from career counselling to marriage compatibility, school performance to job performance, normative to criminal behaviour, and competence to guardianship to detect potential drug and alcohol misuse problems. There are literally thousands of psychological assessments available and all such assessments must be done by experienced, licensed and accredited professionals to ensure that such assessments are not accidentally or deliberately misused to provide false or misleading information.
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Specialist Therapeutic Services Psychotherapy Psychotherapy has a long history and resolving issues through counsel and reassurance date back thousands of years, but the therapy known today can be traced back to the late 19th century when Sigmund Freud used 'psychoanalysis' to help patients suffering with hysteria and other mental dis orders. Freud's treatment involved association, analysis of dreams and transference to treat a patient. The patient could then express the repressed conflict that was causing them mental harm and slowly learn to overcome it. From Freud's pioneering work, physicians and scientists in the early 20th century developed the theories further. Psychodynamic systems and behaviour modification therapy treated problems like phobias and became a strand of psychotherapy that was less focused on the internal struggles Freud was treating, concentrating more on external influences on the human condition. A third strand that involved a humanistic branch of psychotherapy was developed in the 1950s by Carl Rogers and centred on an approach of understanding the patient as an individual with unique needs. Psychotherapy is carried out with an individual or as a group and involves talking through a particular problem to find a cure. A psychotherapist will develop a rapport with the patient so they can explore emotions and experiences that are the cause of feelings such as anxiety and depression or serious mental disorder. A psychotherapist will work with people, usually over a long period, to overcome psychological, behavioural and emotional problems. By understanding a patient's thoughts, beliefs and personal or childhood experiences, the psychotherapist will help the patient make changes to their way of thinking and behaviour. Within psychotherapy there are different styles and different techniques. Cognitive behaviour therapy will involve work for the patient away from the face-to-face session. Psychodynamic therapy involves looking at past experiences while other techniques concentrate predominantly on the future. When visiting a psychotherapist (or indeed any therapist / practitioner) it is sensible to check they are a registered and accredited member of a professional association. The British Association for Counselling and Psychotherapy (BACP), and the UK Council for Psychotherapy (UKCP) and the British Psychoanalytic Council (BPC) are the largest psychotherapy organisations in the UK. Members are expected to have high standards of training and abide by codes of ethics and practice. Psychotherapy is available on the NHS and will need a referral from your GP. It is subject to long waiting times and many people choose to find private practitioners. Your session will be confidential and usually take place in a quiet environment. Some therapists conduct sessions over the internet or via telephone but it is generally done face-to-face. The psychotherapist will begin by trying to define your problem, asking questions about how long it's been going on and what steps you have previously made to prevent it. The therapist will try and learn more about you, any personal relationships you have and your work or interests. Be prepared to answer questions about your mental health and any previous problems or family history. You will be given a treatment plan that lays out the direction of your therapy and what you are expected to do during your treatment. It is important to be honest and open-minded about your psychotherapy as forming a trusting relationship with your therapist is fundamental to your progress. Should they be needed, your therapist may recommend medication or referral to another specialist. They will discuss this with you at your first appointment and throughout your therapy. Although confidential, there are certain legal exceptions that your therapist will discuss with you and you may also be required to sign an agreement for conducting your sessions.
Rehabilitation Programmes and Medical Detoxification: Beacon Business Healthcare offers clients specialist, bespoke rehabilitation care programmes, incorporating intensive therapeutic care packages ranging from 6 months to 2 years duration. We have robust, well established links with a number of leading rehabilitation clinics throughout the UK and abroad, offering fast access to medical detoxification within 24 hours of initial referral. Typically, issues to be tackled include psychological breakdown and associated disorders, depression, bereavement, eating disorders, gambling and sex addiction. A comprehensive range of rehabilitation options are available for the immediate implementation of treatment of drug and alcohol addiction and dependency programmes.
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Therapeutic Approaches for Organisations Employee Assistance Programmes (EAP) What is an EAP? An EAP, or employee assistance programme, is a confidential, short term, counselling service for employees with personal problems that affect their work performance. EAPs grew out of industrial alcoholism programs of the 1940s. EAPs should be part of a larger company plan to promote wellness that involves written policies, superviser and employee training, and, where appropriate, an approved drug testing programme.
What is the purpose of an EAP? The EAP offers help with the resolution of problems that are affecting work. These problems, however, do not have to be caused by workplace issues. Employee Assistance Programmes are designed to help people understand or overcome their personal problems. Whilst most EAPs offer a wide range of services, they often refer to other professionals or agencies who can offer more or extended care in particular areas.
What types of services does an EAP offer? The range of areas typically managed by an EAP provider include: • • • • •
Personal issues Job stress Relationship issues Eldercare, childcare, parenting issues Harassment
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Substance abuse Separation and loss Balancing work and family Financial or legal Family violence
Who can use an EAP? EAPs are open to all employees and members of their immediate family.
What happens when I call an EAP? In most cases, an EAP phone number is posted or otherwise distributed to staff members. This number is often to what is known as a referral agent. A referral agent could be a someone from within the organisation such as a health professional in the medical department, a union counsellor or an employee who has received EAP training. If there is no internal referral agent, the employee could be referred to an external EAP resource. Referral agents must be familiar with available community resources which could include social, financial and mental health services, professional counsellors, or ministers. A referral agent defines the specific nature of the problem and refers the person to the appropriate resource for assistance. The actual referral depends on the type of problem, the preference of the person, and the ability of the person to pay for the service (if costs are not other wise covered by the EAP or insurance programme). When an employee voluntarily contacts an EAP provider, a confidential record is opened. The EAP provider will collect any necessary information and, depending on the severity of the problem and the capabilities of the EAP personnel, will decide if the problem can be handled by the provider or if a referral is needed to an outside resource (such as a particular substance abuse programme). Interviews are typically offered to the employee within a set period of time (e.g. interviews will be conducted within 24 or 48 hours) unless the situation is judged to be an emergency.
What happens with an EAP referral and who knows about it? In an EAP, there are three types of referrals: • •
Self-referral where the employee seeks help on their own The informal referral where a supervisor, friend or co-worker recommends the EAP.
No record of these two types of referral appears in the employee's personnel file. A formal referral is based on job performance and the supervisor recommends the EAP. This recommendation may or may not appear in the individual's personnel file depending on the situation. Often, no notation is made unless there is a need for formal disciplinary action. What is discussed during the sessions, however, is not reported to the employer in either case. What makes an EAP successful? Several factors make an EAP successful: • • • • • • • •
Strict confidentiality Open to employees and their immediate families Recognition and commitment by management, employees and union (if there is one) that an EAP is needed Policies and procedures supported by top management, employees and the union Establishment of both formal and informal referral procedures Promotion of the EAP and encouragement to use the service Managers and employees educated in the workings of the EAP Periodic evaluation of the EAP to be sure the needs of both the employee and the employer are being met
In addition, the EAP must be monitored and evaluated to ensure continued quality of the referral/assistance and to correct potential trouble situations. An appropriate assessment, referral and follow-up of progress are important for continued success of the EAP.
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Brief Term Therapy Counselling The BACP definition of counselling Counselling takes place when a counsellor sees a client in a private and confidential setting to explore a difficulty the client is having, distress they may be experiencing or perhaps their dissatisfaction with life, or loss of a sense of direction and purpose. It is always at the request of the client as no one can properly be 'sent' for counselling. By listening attentively and patiently the counsellor can begin to perceive the difficulties from the client's point of view and can help them to see things more clearly, possibly from a different perspective. Counselling is a way of enabling choice or change or of reducing confusion. It does not involve giving advice or directing a client to take a particular course of action. Counsellors do not judge or exploit their clients in any way. In the counselling sessions the client can explore various aspects of their life and feelings, talking about them freely and openly in a way that is rarely possible with friends or family. Bottled up feelings such as anger, anxiety, grief and embarrassment can become very intense and counselling offers an opportunity to explore them, with the possibility of making them easier to understand. The counsellor will encourage the expression of feelings and as a result of their training will be able to accept and reflect the client's problems without becoming burdened by them. Acceptance and respect for the client are essentials for a counsellor and, as the relationship develops, so too does trust between the counsellor and client, enabling the client to look at many aspects of their life, their relationships and themselves which they may not have considered or been able to face before. The counsellor may help the client to examine in detail the behaviour or situations which are proving troublesome and to find an area where it would be possible to initiate some change as a start. The counsellor may help the client to look at the options open to them and help them to decide the best for them.
Models of counselling Although there is considerable consensus about the core content of a counselling course, there are nevertheless distinct methods of counselling. Most courses start from a theoretical base - typically humanistic, psychodynamic, cognitive or behavioural. Before enrolling on a course it is advisable to be aware of its theoretical emphasis and what that means in terms of the learning experience offered and the skills acquired. All therapy and care services are offered nationwide by Beacon with fast turnaround times. Prices are available upon request.
Brief Psychodynamic Psychotherapy In this type of therapy, you learn ways of dealing with emotional conflicts caused by trauma. This therapy helps you understand how your past affects the way you feel now. Your therapist can help you: • • • •
Identify what triggers your stressful memories and other symptoms. Find ways to cope with intense feelings about the past. Become more aware of your thoughts and feelings, so you can change your reactions to them. Raise your self-esteem.
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Brief Term Therapy Couples Therapy Couples therapy is often seen as different from psychotherapy because a relationship is the focus of attention, instead of one individual diagnosed with a specific psychological problem. This difference only arises if you consider psychological problems to be similar to medical illnesses, and therefore confined to a "sick" individual who needs treatment. That medical model of psychological diagnosis and treatment is common, but is really inadequate to describe and resolve psychological problems. All psychological problems, and all psychological changes, involve both individual symptoms (behaviour, emotions, conflicts, thought processes) and changes in interpersonal relationships. Couples therapy focuses on the problems existing in the relationship between two people. But, these relationship problems always involve individual symptoms and problems, as well as the relationship conflicts. For example, if you are constantly arguing with your spouse, you will probably also be chronically anxious, angry or depressed (or all three). Or, if you have difficulty controlling your temper, you will have more arguments with your partner. In couples therapy, the psychotherapist will help you and your partner identify the conflict issues within your relationship, and will help you decide what changes are needed, in the relationship and in the behaviour of each partner, for both of you to feel satisfied with the relationship. These changes may be different ways of interacting within the relationship, or they may be individual changes related to personal psychological problems. Couples therapy involves learning how to communicate more effectively, and how to listen more closely. Couples must learn how to avoid competing with each other, and need to identify common life goals and how to share responsibilities within their relationship. Sometimes the process is very similar to individual psychotherapy, sometimes it is more like mediation, and sometimes it is educational. The combination of the these 3 components is what makes it effective.
Group Therapy Many people want to talk about their trauma with others who have had similar experiences. In group therapy, you talk with a group of people who also have been through a trauma and who have PTSD. Sharing your story with others may help you feel more comfortable talking about your trauma. This can help you cope with your symptoms, memories, and other parts of your life. Group therapy helps you build relationships with others who understand what you've been through. You learn to deal with emotions such as shame, guilt, anger, rage, and fear. Sharing with the group also can help you build self-confidence and trust. You'll learn to focus on your present life, rather than feeling overwhelmed by the past.
Managing Critical Incidents In the current environment, there is a need for employers to be aware of the threats and risks that employees face in the workplace. There are two reasons for this: • •
To enable the organisation (and its employees) to function as normal following an incident Fulfilling the legal duty of care employers have towards their employees
Critical incidents are defined as any situation involving one or more people experiencing a threat to life or physical safety or the death or injury of another. It can be because of an accident, suicide or criminal behaviour. Our critical incident team have extensive experience in dealing with the effects of critical incidents in the workplace. They use a range of interventions to provide support and assistance in the planning for, and management of, such events. These include: • • • • •
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Critical incident review and consultation Critical incident management support Training and advice for managers On-site support to defuse the situation Individual and/or group trauma counselling
T: +44 (0)800 012 2417
E: info@beaconhealthcareltd.com
www.beaconhealthcareltd.com
T: +44 (0)800 012 2417
E: info@beaconhealthcareltd.com
www.beaconhealthcareltd.com
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Beacon Business Healthcare Ltd The Old Post Office, High Street, West Meon, Hampshire, GU32 1LJ T: +44 (0)800 012 2417 E: info@beaconhealthcareltd.com www.beaconhealthcareltd.com
Acknowledgement: Image source (not all images) www.freedigitalphotos.net, Suat Eman and Danilo Rizzuti
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