Mental health

Mental health support series with Dr Zoe Burgess: Cognitive Behavioural Therapy (CBT)

Dr Zoe BurgessNext up in the mental health support series with Dr Zoe Burgess, Zoe explores another type of talking therapy: Cognitive Behavioural Therapy (CBT).

Following my last blog on medication management and group therapy, I’m going to discuss and summarise Cognitive Behavioural Therapy (CBT).

CBT is a type of talking therapy which is most commonly used to treat anxiety and depression. It can also be useful for other mental and physical health challenges.

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT)

This is a time-limited structured talking therapy which is based on the idea that your thoughts, feelings, physical sensations and actions are interconnected; and that – essentially – negative thoughts and feelings can trap us in a vicious cycle.

Individuals are shown how to change these cycles to improve the way they feel. This therapy very much deals with the ‘here and now’; and the changes we can make daily rather than focusing on issues from the past.

In order for this therapy to be successful, it is important that individuals are prepared to carry out home tasks between sessions. Change is unlikely to happen unless we apply the CBT strategies.

Skills/strategies will vary from person to person as CBT should be individually tailored. CBT sessions typically occur weekly and last 50-60 minutes.

The number of sessions will vary depending on the type of mental health difficulty and the level of need.

Specialist CBT interventions

Specialist CBT interventions

An example of this is trauma-focused CBT. While it uses many CBT principles, it is a more specialist intervention that uses a range of psychological techniques. These techniques help individuals come to terms with the traumatic event that they have experienced.

For example, the therapist may ask the person to face their traumatic memories by describing aspects of the experience in detail. During this process, the therapist helps the person to cope with any distress they feel while identifying any unhelpful beliefs they have about the experience.

The therapist can help that person gain control of their fear and distress by reviewing any conclusions that they have drawn about the experience (e.g. feeling to blame for what happened).

People are also encouraged to gradually restart any activities they have avoided since the experience. Sessions will typically last 60-90 minutes and the number of sessions varies.

“Third wave” cognitive behavioural therapies (CBT)

“Third wave” cognitive behavioural therapies

This refers to a group of emerging approaches that represent an evolution and extension of traditional CBT approaches. The focus is often on health and well-being rather than purely on the reduction or elimination of symptoms.

Concepts such as metacognition, acceptance, mindfulness, personal values, and spirituality are frequently incorporated.

Rather than looking solely at the content of a person’s thoughts and internal experiences, the third wave approach instead looks at the context, processes and functions of how a person relates to their internal experiences; such as thoughts, urges and sensations.

Some of the most commonly used third-wave interventions in my experience are: Acceptance and Commitment Therapy (ACT); Compassion Focused Therapy (CFT) and Metacognitive Therapy.
Sessions will again typically last 50-60 minutes and the number of sessions varies.

 

If you would like more information on CBT, you can visit the NHS website or the National Institute of Health & Care Excellence (NICE) who can provide more detail including the pros and cons, as well as how to find a CBT therapist.

Stay tuned for my next blog, which will be discussing psychotherapy and Eye Movement Desensitisation and Reprocessing (EMDR).

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Mental health

Mental health support series with Dr Zoe Burgess: medication and group therapy

Dr Zoe BurgessWe are extremely fortunate to have a varied team of experts on our Advisory Board. Clinical psychologist Dr Zoe Burgess is part of the team who has vast experience in the role mental health plays in life. In this mental health support series, Zoe summarises some commonly-used mediations for those who may be struggling with their mental health and wellbeing.

The field of psychology is ever evolving. This means that our understanding of mental ill health and the associated interventions is always improving. When it comes to addressing our mental health, I hope that you will not be surprised to hear that there is no such thing as a ‘one size fits all’ approach.

There are many different factors to consider when it comes to finding the right fit. This includes (but is not limited to): the specific difficulties that individual is currently facing (or what some would refer to as ‘diagnosis’), the factors that are maintaining current difficulties, that individual’s ability to carry out tasks between sessions (or not) and personal preference.

If you are looking for an in-depth description of all different interventions out there, then I would suggest having a look on the NHS website and also referring to the National Institute of Health & Care Excellence (NICE) guidelines. These will tell you all you need to know about specific mental health difficulties and the evidence-based interventions for these.

There are many different interventions when it comes to mental health. In this series, I will highlight what I understand as the most commonly used in clinical practice. This is based on my experience of working across different NHS settings and within the third sector.

Medication

Psychopharmacology (medication management)

This refers to the use of medication in treating mental health conditions. Medication can play a role in improving most mental health conditions. Some people are treated with medication on its own; others are treated with both medication and talking therapy.

Generally speaking, the most effective treatments for mental health difficulties involves a combination of medication and talking therapy. For children and young people under 18, a Child and Adolescent Mental Health Services (CAMHS) Consultant Psychiatrist should be prescribing this. For adults over 18, a GP can do this.

Medication will always require monitoring. In my experience (and perhaps as a slightly biased psychologist), medication is not the recommended first-line treatment – talking therapy is. However, it can be useful in reducing the intensity of someone’s symptoms. This then allows them to benefit more from the talking therapy.

Different people will be suited to different medications. Different people will also be prescribed different doses since it is important to find what we call the ‘therapeutic dose’.

 

There are many types of talking therapy, but all involve working with trained therapists. This may be one-to-one, in a group, online, over the phone, with family, or with a partner.

The therapist helps people to find answers to the problems they are having. For some problems and conditions, one type of talking therapy may be better than another. Different talking therapies also suit different people.

Group therapy

Group therapy

This will vary depending on the type of difficulties that someone is experiencing and on the therapeutic model that it is based on.

In my experience, group therapy is most often psychoeducational and skills-based. This means that the group is aimed at helping people to understand their symptoms better and learn day-to-day coping strategies for these.

Group therapy is sometimes used alone, but it is also commonly integrated into a comprehensive treatment plan that also includes individual therapy. Again, in my experience groups are mainly closed groups and meet once a week for anything between 60-120 minutes and the number of group sessions is variable.

 

I hope these brief summaries in medication management and group therapy have been useful to you. If you’d like to investigate these in further detail, visit the NHS website.

The next blog in this series will be exploring another type of talking therapy.

 

 

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Henry Ives after he had completed his 50km challenge

50km ultra-marathon raises more than £3,600

The Charlie Watkins Foundation is extremely fortunate to have many supporters who give up their free time to raise funds for our cause – we call them Charlie’s Champions! One such Champion is Henry Ives, who ran a 50km ultra-marathon across Dartmoor and has to date, raised more than £3,600.

Read more on Charity Today

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