Workshops
BABCP Pre-Congress Workshops

BRISTOL 1999

14th July

9.00 - 5.00


Workshop One

Cognitive Therapy from Action to Insight (and Back Again)

Steven D Hollon, Vanderbilt University, USA

Cognitive behaviour therapy has shown rapid growth and considerable maturation over the past 20 years. In particular, new techniques have been developed and theory has been extended to deal better with long-standing personality disorders that often put patients at risk for depression. These newer techniques can also facilitate the course of treatment with patients with less complex Axis 1 disorders, but care must be taken lest they crowd out the more basic strategies Targeted at producing change in specific situations. This workshop will focus on integrating the specific behavioural and cognitive change strategies that have traditionally formed the core of the approach with these more recent developments in theory and technique.


Workshop Two

Cognitive Behaviour Therapy for Agoraphobia and Panic

Michelle Craske, University of California, at Los Angeles, USA

This workshop will cover recent developments in the cognitive-behavioural conceptualisation and treatment approach for panic disorder and agoraphobia. Treatment efficacy data will be presented as well. The well-established therapeutic strategies of psychoeducation, cognitive restructuring, interoceptive exposure and in vivo exposure will be covered in detail, with the aid of video demonstrations. In addition, the following issues will be addressed; impact of panic-control upon agoraphobia (i.e., is control of panic attacks sufficient for the control of agoraphobia); conceptualisation and treatment approach for nocturnal panic; management of comorbid diagnoses (e.g., should adjunct intervention strategies by used for co-morbid diagnoses); the effects of adding pharmacological treatment to cognitive-behavioural therapy for panic disorder and agoraphobia; therapeutic mechanisms and tailoring for group treatment formats and treatment in the primary care setting.


Workshop Three

Cognitive-Behaviour Therapy for Worry and Rumination in GAD and Related Disorders'.

Mark H. Freeston, Centre de recherche Fernand-Seguin and Université de Montréal, Montréal, Québec, Canada

Worry and rumination may be conceptualised as complex chains of thoughts and images about possible events, elaboration of the consequences of these thoughts, ineffective problem solving, and attempts to control these chains of cognitive events or the associated distress. Based on developing an alternative understanding of worry and rumination, people can learn to break these self-perpetuating chains during therapy. This workshop will provide participants with 1) a framework for identifying the key components in chains of worry, 2) an understanding of the often contradictory assumptions that maintain the ineffective processing, 3) criteria for distinguishing between thoughts about situations that require instrumental action and those where no instrumental action is possible, 4) a structured approach to reduce the ineffective control strategies, and 5) strategies for consolidating treatment gains. The workshop will use formal presentation of the treatment model, case examples, step-by-step guidelines for key interventions, and material that may be used with clients.


Workshop Four

Shame: Understanding and Working with Shame

Paul Gilbert, University of Derby

There is increasing evidence that shame plays a prominent role in the origins and maintenance of various psychiatric disorders. This workshop will look at various ways of conceptualising shame and how shame can be linked to a variety of behaviours emotions and personal characteristics (such as body shape and textures). Participants will:

1. Learn how to formulate shame problems within various disorders

2. Recognise the difference between shame and humiliation

3. Recognise defensive avoidance of shame issues

4. Consider the implications of shame for the therapeutic relationships

5. Work with various behavioural and cognitive interventions of de- shaming.


Workshop Five

Health Anxiety and Hypochondriasis

Paul Salkovskis, University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford

The cognitive-behavioural approach developed by Paul Salkovskis and colleagues is described in this workshop. Hypochondriasis is conceptualised as an anxiety disorder, in which the person misinterprets bodily sensations and variations as well as medical information as indicating that they may be seriously ill. Such misinterpretations often arise from general assumptions about illness, health and the medical profession made by vulnerable individuals. Anxiety related to threat beliefs is maintained by a combination of physiological, affective, cognitive and behavioural responses. This theory has led to the development of a highly effective treatment now validated in several controlled trials. This workshop emphasises the way in which specific cognitive and behavioural techniques are interwoven with the use of therapeutic empathy in order to help the patient feel understood. The importance of strategies which foster engagement and guided discovery in reaching a shared understanding is emphasised and ways of understanding these processes detailed. The workshop will use a mixture of teaching, video demonstration and role-play.


Workshop Six

A General Cognitive Behavioural Model for Understanding and Treating Somatisation

Trudie Chalder, Kings College School of Medicine and Dentistry and The Institute of Psychiatry, London

Physical symptoms without identifiable organic pathology have been referred to by a variety of labels such as medically unexplained symptoms, hypochondriasis, somatisation and psychosomatic. Everyone experiences physical symptoms, unrelated to specific aetiology from time to time. However, when the symptoms become the focus of an individuals attention the severity of the symptom often increases and varying degrees of disability results. The aim of this workshop is to present a coherent model of understanding somatisation. Whilst enabling clinicians to overcome specific barriers encountered in dealing with this group of patients, the importance of adopting a flexible therapeutic style will be emphasised. Difficulties regarding engagement will be focused upon. Participants will be expected to participate in role-play.


Workshop Seven

Cognitive Therapy for Psychosis: Addressing the Meaning of Psychosis

David Fowler, University of East Anglia

Making sense of psychosis by sharing the cognitive formulation may be the key ingredient of cognitive behaviour therapy for psychosis. This workshop will provide an overview of evidence from trials which support this perspective. It will focus on promoting a clear understanding of the cognitive model of psychosis and its implications for therapy. The workshop will also highlight practical issues and difficulties in the process of cognitive therapy for psychosis.


Workshop Eight

You Can't Have Your Cake and Eat it Too:

A Cognitive Behavioural Treatment for Eating Disorders

Melanie A. Katzman, Cornell Medical Centre, USA and Institute of Psychiatry, London

This workshop will combine didactic presentation with experiential learning to enable participants to deliver an eight-week manualised programme for bulimia nervosa either individually or in group. Specific techniques to improve psychological as well as nutritional functioning will be reviewed and recent efficacy data will be presented. The use of this model in no specialist units and with minimally trained therapists will be explored. There will be opportunities to engage in a number of the exercises as well as to discuss current case examples.


Workshop Nine

Maximising Training Effectiveness in Cognitive Therapy

Melanie Fennell, Warneford Hospital, Oxford

Research suggests that, to ensure clinical effectiveness, adherence to the cognitive therapy protocol is essential. This requires therapists to possess not only sound theoretical knowledge of cognitive models of emotional disorder, but also a broad, flexible and well-practised repertoire of cognitive-behavioural procedures. Even for experienced therapists, training others in these complex performance skills is no easy task. Yet the high volume of potential patients requires that knowledge and skill should be widely and effectively disseminated.

The workshop draws on its leader's experience as Director of the Oxford Diploma in Cognitive Therapy. It uses ideas from management development and from education as a basis for considering what the content of cognitive therapy training should be, and how trainers may develop an active learning environment which mirrors the collaborative style of cognitive therapy. By the end of the workshop, participants will:

a) understand the content of cognitive therapy training in terms of a 3-dimensional model of meetings derived from management development training;

b) have identified how the theory and practice of cognitive therapy inform training and supervision, creating a learning culture that reflects the qualities of the therapy itself;

c) understand how use of Kolb's learning circle encourages learning and retention;

d) Have designed a forthcoming training event, using ideas and methods from the workshop.

The workshop is intended for experienced cognitive therapists now supervising and training others in cognitive therapy. Participants will be expected to relate what they learn to their own experience as trainers, and to participate actively in practical exercises.


Workshop Ten

Dialectical Behaviour Therapy for Borderline Personality Disorder

Heidi Heard, University of North Wales, Bangor

This workshop aims to introduce primary Dialectical Behaviour Therapy (DBT) strategies and demonstrate some of the DBT skills, including mindfulness. The workshop will provide an overview of DBT for borderline personality disorder (BPD) and will review the diagnostic criteria of BPD. The empirically demonstrated efficacy of DBT will also be reviewed and the biosocial theory and dialectical philosophy described. Treatment tasks with their respective modes and the treatment target hierarchy will also be outlined.


Workshop Eleven

Behavioural Interventions with the Families of Children with Severely Disruptive Behaviours

Judy Hutching, University of Wales, Bangor

Behavioural Interventions with families are the only effective methods of helping children with behavioural difficulties but these strategies are only successful with half of all treated children. Helping those children and families where the prognosis is poorer requires much greater attention to the assessment process. This workshop describes the intensive treatment programme developed in North Wales in which the emphasis is on setting up a range of situations to assess both child problem behaviours and parenting skills and strategies. The workshop will describe how families are recruited to the programme, the baseline information gathering procedures and how this information is made use of in the intervention phase.


Workshop Twelve

Pain, Anger and Beliefs: Rational Emotive Behaviour Therapy and the Treatment of Chronic Pain

John Blackburn, Behavioural Psychotherapist and Andrea Johnson, Anaesthetist, Sheffield.

This workshop will focus on the psychological aspects of treatment of people with a wide range of chronic painful conditions. It will focus on the role of dysfunctional anger in the chronic pain experience, both in the development and maintenance of the chronic pain condition.

The workshop will introduce the Rational Emotive Behaviour Therapy concept of dysfunctional anger and will describe several techniques to deal with it. It will include work on how to overcome the practical difficulties associated with psychological treatment of physical problems. The workshop is based on research currently being carried out in the Chronic Pain Clinic at the Northern General Hospital in Sheffield.