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DURHAM 1998

PRE CONFERENCE WORKSHOPS

Wednesday 8th July 1998

A programme of 12 one-day Workshops will be held on Wednesday 8th July before the Conference begins. The workshops begin at 9.30 am and finish at 5.00 pm. Many of these workshops, led by internationally acclaimed experts in the areas covered, offer participants an opportunity to develop practical skills in the assessment and treatment of a range of problems and populations. A brief description of each workshop follows and an application form is available from the Conference Secretariat. The number of places on each workshop is limited so early application is advised to avoid disappointment. Admission to the workshops is by ticket only.


1. Cognitive Therapy for Social Phobia
David M. Clark, University of Oxford

2. Anger Treatment with Assaultive and Resistant Patients
Raymond W Novaco, School of Social Ecology, University of California, Irvine, USA

3. 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

4. Imagery
Ann Hackmann, University of Oxford and Mary Anne Layden, University of Pennsylvania, USA

5. Cognitive Behavioural Treatment of Generalised Anxiety Disorder and Worry: Applied Relaxation, Self-Control Desensitization, and Cognitive Therapy with Special Reference to Interpersonal Factors
Tom D Borkovec, Pennsylvania State University, USA

6. Autism and Aspergers Syndrome
Patricia Howlin, St George’s Hospital Medical School, London

7. Single-Case Methodology: From Clinical Practice to Practitioner Research
Graham Turpin, University of Sheffield

8. Cognitive Behaviour Therapy for Psychotic Symptoms
Doug Turkington, University of Newcastle

9. Cognitive Therapy for Chronic Depression: Instilling Hope and Optimism in Treating Chronic Affective Disorder
Anne Garland, Dept of Psychiatry, University of Newcastle

10. Research for Beginners: A Practical Approach
Chris Williams, University of Leeds and Dave Richards, Leeds Community and Mental Health Trust and the University of Leeds

11. Developing Self-Acceptance: A Brief Small Group Approach
Windy Dryden, Goldsmiths College and John Blackburn, Community Health Sheffield

12. Cognitive Behavioural Treatments for Addictive Behaviours
Paul E Davis and Jane Benanti, Pathfinders Addiction Services and D Colin Drummond, St George’s Medical School, London

13. Case Formulation: Thinking about the Relationship Between Theory and Practice in Cognitive Therapy
Gillian Butler, Warneford Hospital, Oxford.


1. Cognitive Therapy for Social Phobia
David M. Clark, University of Oxford

Social phobia is a common and disabling problem. Existing cognitive-behavioural treatments are only moderately effective. To improve treatment outcomes, a new cognitive model (Clark are Wells, 1995) focusing on the processes that maintain social phobia has been proposed and a new form of cognitive therapy which attempts to reverse the maintaining factors developed. Data suggests the treatment may be particularly effective The workshop will describe the model and then gives a step by step outline of the new treatment, using case illustrations, role-play video and comprehensive handouts.The workshop will be of great interest to anyone involved in the treatment of anxiety disorders.


2. Anger Treatment with Assaultive and Resistant Patients
Raymond W Novaco, School of Social Ecology, University of California, Irvine, USA

Engaging seriously disordered and historically assaultive patients in treatment for their anger dyscontrol presents multiple challenges. Some patients are typically avoided by clinicians because of their treatment resistant characteristics and the risks faced by the clinician. Advances in cognitive-behavioural anger treatment with such patients will be presented with regard to facilitating and maintaining therapeutic engagement. Issues arising in the recruitment, referral, assessment, and preparation of such patients for treatment will be discussed. Core themes arising in the treatment process and ways of obtaining leverage for change will be presented. The key ingredients of the approach to severe anger problems are overviewed, and a description given of an ongoing work with psychiatric patients at a maximum security hospital. Some new methods of assessment will also be presented.


3. 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 program 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 non 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.


4. Imagery
Ann Hackmann, University of Oxford and Mary Anne Layden, University of Pennsylvania, USA

Cognitions (including memories) can be assessed as words or sensory images. Such images are frequent in many psychological disorders, and may be recurrent, intrusive and laden with meaning. They often reflect important meanings for the client, so that they are a powerful aid in conceptualisation. In this workshop ways of assessing and changing imaginal material will be described, with reference to negative automatic thoughts, schemas, dysfunctional assumptions and traumatic memories. Participants will have the chance to utilise images to enhance their work in these areas, and to utilise imagery to support new and more functional underlying assumptions. The workshop will include experiential work, role-plays and video material


5. Cognitive Behavioural Treatment of Generalised Anxiety Disorder and Worry: Applied Relaxation, Self-Control Desensitization, and Cognitive Therapy with Special Reference to Interpersonal Factors
Tom D Borkovec, Pennsylvania State University, USA

This workshop covers cognitive behavioural techniques for GAD, including (a) learning to detect early anxiety cues; (b) flexible use of multiple relaxation methods; (c) rehearsal of coping responses using self-control desensitization; and (d) cognitive techniques designed to facilitate more flexible ways of perceiving and more complete processing of present-moment experience. The role of interpersonal factors in GAD and its treatment will also be discussed


6. Autism and Aspergers Syndrome
Patricia Howlin, St George’s Hospital Medical School, London

This workshop will cover recent research on autism and aspergers syndrome. The introduction will focus on research covering diagnosis and causation, and the implications of findings in these areas for intervention.
The following sections will cover changes in approaches to the treatment of autism over the last 3 decades. The transition from more traditional behavioural interventions to strategies that concentrate on the fundamental deficits associated with autism will be discussed. Particular attention will be paid to interventions that focus on communication skills, deficits in theory of mind, and problems of social understanding. Approaches to dealing with psychiatric problems in adults will also be addressed, as will strategies to enhance wider social functioning, i.e. via supported employment schemes and social skills groups.


7. Single-Case Methodology: From Clinical Practice to Practitioner Research
Graham Turpin, University of Sheffield

This workshop will examine the use of experimental single case studies in relation to clinical practice and as a basis for conducting clinical research. It will review the rationale and application of single-case methodology to clinical practice in behavioural psychotherapy, examine practical difficulties in implementation, make sense of graphical and statistical forms of analysis and provide a forum for individuals to discuss their problems associated with single case designs. The workshop is suitable for professionals with an interest in evaluating their individual case-work or in conducting single case studies as a means of pursuing research. No specific knowledge of experimental design or statistics will be assumed


8. Cognitive Behaviour Therapy for Psychotic Symptoms
Doug Turkington, University of Newcastle

This workshop will focus on a cognitive behavioural approach to neuroleptic resistant psychotic symptoms: hallucinations, delusions, thought disorder and negative symptomatology. Formulation, techniques and non specific factors, detailed case presentations will be illustrated by the use of videos of therapy sessions. discussions will then lead to clarification of the most pertinent techniques and their sequence of application. Role plays will help to further demonstrate key issues in the process of therapy. Schema level work will be covered, particularly in relation to very resistant delusional systems. Important, non- specific therapist variables related to good outcomes are explored


9. Cognitive Therapy for Chronic Depression: Instilling Hope and Optimism in Treating Chronic Affective Disorder
Anne Garland, Dept of Psychiatry, University of Newcastle

This workshop will look at clients mental models of depression and the implications for engagement in treatment. It will examine the role of affect regulation and the importance of identifying and modifying dysfunctional assumptions. Difficulties that arise in making an active, focused intervention with the client group and ways of combating therapist hopelessness and pessimism will be addressed. The workshop is based on data from the MRC funded Cambridge-Newcastle study investigating the efficacy of cognitive therapy in treating residual depressive chronicity. The workshop is aimed at an intermediate level and will utilise data and case vignettes and include skills development


10. Research for Beginners: A Practical Approach
Chris Williams, University of Leeds and Dave Richards, Leeds Community and Mental Health Trust and the University of Leeds

This workshop will incorporate a mixture of lecture-style teaching and small group work. It will cover: Why do research?; Facing up to the ‘R’ word; Making research interesting; overcoming ambivalence; starting to do research; writing a protocol; maintaining momentum!. There will be practical sessions on ‘What is the question?’ - Developing your ideas; developing a protocol within a group setting and addressing practical issues of how to develop the idea further and put it into practice; and feedback and future research plans.


11. Developing Self-Acceptance: A Brief Small Group Approach
Windy Dryden, Goldsmiths College and John Blackburn, Community Health Sheffield

This workshop will focus on the theoretical and practical applications of one of the key concepts that I peculiar to Rational Emotive Behaviour Therapy. It will highlight the theoretical and philosophical differences between REBT and Cognitive Behaviour Therapy when it comes to the concept of self-acceptance and self-esteem and show ho these differences influence what occurs during therapy. The workshop introduces the concepts and models of REBT and Group Therapy in the context of psychological disorders of the self. `It will cover the practical aspects of running such groups giving detailed session by session account of the process involved. It will show how the well -established concept of self-esteem (and how to obtain it), is often counter-productive and how the REBT concept of Self-Acceptance can have a greater therapeutic impact.


12. Cognitive Behavioural Treatments for Addictive Behaviours
Paul E Davis and Jane Benanti, Pathfinders Addiction Services and D Colin Drummond, St George’s Medical School, London

Cognitive Behavioural Therapies are well established as effective approaches in the treatment of a wide range of addictive behaviours including alcohol, tobacco smoking and drug problems, non-chemical dependencies such as gambling, some patterns of offending behaviour and excessive shopping, as well as other appetitive problems such as eating disorders. This workshop is intended for non specialist staff who wish to understand CBT approaches as applied in their generic work with substance misusers, problem gamblers, etc.; and for specialist staff in addiction services new to CBT or to the speciality. It will combine didactic presentation, small group tasks and case vignettes. The topics will include Motivational Interviewing, Relapse Prevention Programmes, stimulus control and cue exposure, and other behavioural and cognitive management approaches.


13. Case Formulation: Thinking about the Relationship Between Theory and Practice in Cognitive Therapy
Gillian Butler, Warneford Hospital, Oxford.

Case formulation, or conceptualisation, is one of those sophisticated and difficult arts required of clinicians that in the past they were required to pick up as they went. Until recently little was written about it and the topic occupied little formal teaching time. This is not surprising, because the issues involved are complex, but it is a pity, as formulation is a central activity in clinical practice, and the more complex the case the more important it becomes to be able to do it well and to be flexible in applying the skills involved in formulation.
This workshop will provide opportunities to think about issues and questions relevant to understanding, developing and using formulations generally, regardless of the theoretical orientation of the therapist. Some of the questions to be discussed will include definitions of formulation, its purpose and functions, the part played by formulation in making clinicians accountable for their practice, and the differences between diagnoses, models and formulations. Ample opportunity for practical involvement of participants will be provided. The case material used to illustrate the material and the exercises selected will be drawn from my experience in the use of cognitive therapy.


14. Cognitive Behavioural Group Work with Children and Adolescents
Veira Bailey and the Day Unit Team Hounslow Department of Child and Adolescent Psychiatry

This workshop will present the theory and research underpinning the use of CBT in age stratified groups for school aged children, focusing on the treatment of school refusal and conduct disorder. There will be a description of strategies and techniques used with an opportunity for audience participation. The morning session will outline the Unit’s rapid return programme for school refusers, the afternoon session will include the theoretical background to the use of CBT in groups as part of the multi-modal treatment for conduct disordered children and will include a demonstration of the treatment interventions used in Day Unit groups.


15. Dialectical Behaviour Therapy for Borderline Personality Disorder: An Introduction
Heidi Heard, University of Wales, Bangor

The workshop will introduce participants to Dialectical Behaviour Therapy (DBT) , a cognitive behavioural treatment developed to treat the behaviours associated with borderline personality disorder (BPD). The first randomized controlled trial of the therapy suggested that BT was significantly more effective than "treatment-as-usual" with respect to reducing treatment drop-out, parasuicidal behaviour, psychiatric in-patient days and anger. Although this outcome was trial conducted in an out-patient setting the therapy has since been adapted for a wide variety of settings. The workshop will provide an overview of the theory, structure, strategies and skills of DBT, emphasizing the basic principles within each topic. The workshop will first describe the bio-social theory and the dialectical philosophy which provides the foundation upon which DBT case conceptualisation is based. In describing the structure of the therapy, the workshop will address both how to match the various tasks of treatment to available treatment modes and how to establish a treatment hierarchy of the behaviours to be targeted. Next, the workshop will introduce participants to the DBT strategies, including dialectical validating, problem solving, stylistic and case management strategies. Finally, the workshop will teach participants several of the DBT skills, which include mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness skills.