In-Conference Workshops
Thursday 13th - Friday 14th September

FREE WORKSHOPS
Delegates attending the BABCP Conference will be able to attend one or more of the in-conference workshops (3 hours approx.). Although there is no charge for these this year it is necessary to book in advance since places will be limited and some may have been fully subscribed in advance. You can check out the details at the In-congress desk in Bramber House on Wednesday or in the Meeting Room on Thursday and Friday. 

Thursday 1.30 - 5.00pm

Workshop 1

Treating Eating Disorders in the Age of Size Zero: Working with Ambivalence, Values and Personality
Lucy Serpell, Dept of Clinical Health Psychology, Central and NWLondon NHS Trust/St Mary’s Hospital, London

Workshop 2

Using Free Online Computerised CBT Packages for Depression and Anxiety
Chris Williams and Paul Farrand, University of Glasgow

Workshop 3

Stepped-care Services for the Common Mental Health Problems: Going Beyond the Tip of the Iceberg
Jim White, Greater Glasgow and Clyde NHS Trust, Scotland

 

Friday 9.00 - 12.00am

Workshop 4

CBT for the Treatment of Substance Abuse with Comorbid Mental Health Disorders
Renuka Arjundas and Patrick Roycroft, Northumberland, Tyne and Wear NHS Trust

Workshop 5

Bringing Interpersonal Process into Mainstream CBT: A New Conceptual Model for Understanding Ruptures/stuckness in CBT
Vivien Twaddle and Peter Armstrong, Newcastle Cognitive and Behavioural Therapies Centre and University of
Newcastle upon Tyne

 


Workshop 1

Treating eating disorders in the age of “Size Zero”:Working with ambivalence, values and personality.

Lucy Serpell, Dept of Clinical Health Psychology, CNWL/St Mary's Hospital.

Eating disorders remain some of the most challenging psychological disorders to treat. Many people with eating disorders fail to engage in treatment, drop out early or fail to improve. One of the main reasons for such treatment failures is ambivalence about recovery. This can be frustrating and frightening for clinicians and families.

Recent developments in the treatment of eating disorders have offered a well-specified and comprehensive cognitive behavioural model which aims to apply to all eating disorders (Fairburn, Cooper & Shafran, 2003).

There is a growing evidence base for the use of such an approach. However, this workshop aims to explore some of the issues which may prevent some individuals from benefiting from such approaches.

Firstly, reasons for treatment ambivalence will be explored. Research into pro-eating disorder beliefs suggests that cultural, interpersonal and intrapersonal issues may be implicated (Serpell et al, 1999; 2004) and that each may need to be addressed as part of any cognitive behavioural treatment (Schmidt & Treasure, 2006, Lavender
& Schmidt, 2006).

A further issue which may impede recovery is personality in eating disorders this tends to involve either impulsive or rigid and perseverative traits (Serpell et al, 2006, Serpell et al, submitted). Methods for addressing these traits will also be explored.

Key Learning Objectives

  1. To understand cognitive behavioural approaches to common eating disorders.
  2. To develop additional skills to address complex issues in eating disorders including ambivalence and working with values.
  3. To understand how personality features may impede treatment and to develop ways of harnessing such features to improve therapy outcomes.

Lucy Serpell is a Clinical Psychologist who has worked with eating disordered individuals since 1995. She has conducted extensive research in the field and was awarded her PhD entitled '"Anorexic Thinking": Cognitive Processes in Anorexia Nervosa' in 2000. Her specific interests in the field include treatment resistance, motivation and personality. She also runs edr.org.uk, an eating disorders website providing information to mental
health professionals and people struggling with eating problems. She currently works in a clinical/research post with individuals with HIV, many of whom struggle with eating and body image issues. She also works with eating disorders in private practice.

Key References
FLavender, A., & Schmidt, U. (2006). Cognitive-Behavioural Case Formulation in Complex Eating Disorders. In N. Tarrier (Ed.), Case formulation in Cognitive Behaviour Therapy (pp. 238-262): Routledge.

Schmidt, U., & Treasure, J. (2006). Anorexia nervosa: valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice. Br J Clin Psychol, 45(Pt 3), 343-366.

Serpell, L., Teasdale, J., Troop, N., & Treasure, J. (2004). The development of the P CAN: a scale to operationalise the pros and cons of anorexia nervosa. International Journal of Eating Disorders, 36, 416-433.

Serpell, L., Livingstone, A., Neiderman, M., & Lask, B. (2002). Anorexia nervosa: Obsessive compulsive disorder, obsessive compulsive personality or neither. Clinical Psychology Review, 22, 647-669.

Workshop 2

Using free online computerised CBT packages for depression and anxiety.

Chris Williams, University of Glasgow and Paul Farrand, Univ Plymouth.

The NICE computerised CBT (CCBT) review recommends Beating the Blues and Fearfighter as treatments for depression and anxiety respectively. A recent review for the Care Services Improvement Partnership (CSIP) produced by BABCP has identified that free online sites like Mood Gym and Livinglifetothefull.com offer promise
as effective treatments available at no cost.

Key Learning Objectives
This mini-workshop will:
  • Review the current evidence base for Mood Gym and Living Life to the Full.
  • Based on CSIP recommendations consider how free resources can be included in the options available to mental health services.
  • Review practical ways of delivering such resources in primary, community and specialist mental health settings.


Dr Chris Williams is a senior lecturer in psychiatry at the University of Glasgow and manages the self-help treatment access resource team (START) in Glasgow.
Dr Paul Farrand is senior lecturer at the University of Plymouth and leads the South West Book Prescription scheme.

Key References
1. Gellatly J, Bower P, Hennessy S, Richards D, Gilbody S & Lovell K. What makes self help interventions effective in the management of depressive symptoms? Meta analysis and meta regression. Psychological Medicine: In press.

2. National Institute for Clinical Excellence. Technology appraisal 51. Computerised cognitive behaviour therapy for depression and anxiety. London: National Institute for Clinical Excellence 2000.

Workshop 3

Stepped-care Services for the Common Mental Health Problems: Going Beyond the Tip of the Iceberg.

Jim White, Greater Glasgow and Clyde NHS.

While CBT approaches are strongly recommended for the treatment of common mental health problems, the reality is that these services are scarce, relatively low volume, typically involve high drop-out and significantly poorer outcomes at the routine clinic level than at the research centre level. Long waiting lists are the rule in theNHS. Services, even at the primary care level, tend to focus on well-entrenched problems and little preventative or early intervention work is carried out. While the Layard proposals appear to be gathering influence, they are only one approach to the needs of primary care. There is a need to look at altering the way we provide services.

This workshop will look at the problems found at the primary care level and discuss a range of pragmatic solutions within a CBT framework. We will focus on the work of the Glasgow NHS STEPS primary care mental health team. This service, a Scottish Executive Exemplar project, offers stepped-care intervention at six levels: individual, group, single contact, non-face-to-face, working with others and population level work. We have developed a high volume multi-level/multi-purpose service that attempts to tackle the above problems. At the clinic level, we offer individual therapy and Rapid Access Services (RAS) that offer a real alternative to prescribing and allow user choice. Currently, these RAS include Stress Control large group (100+) evening classes, Advice Clinics and Advice Lines, Mental health sections in public libraries, book prescribing schemes, support groups run by an expert patient, self-help book series, website (www.glasgowsteps.com), podcasts, exercise and wellbeing options. At the community level, we are working with, and training, others, e.g. Muslim faith leaders, going into schools and developing awareness raising approaches (Good Mood Week, DVD, StressMaster days, etc).

Key Learning Objectives

  • To look at the range of needs found at the primary care and community level.
  • To explore ways to move from a traditional individual therapy-based service to a multi-level/multi-purpose stepped-care service.
  • To look at ways to improve both efficiency and effectiveness.

Jim White is a consultant clinical psychologist and STEPS team leader. He has worked for many years in primary care, developing services to better fit the needs of this heterogeneous population. He has presented numerous workshops and papers at national and international conferences.

Key References
White, J. (2000) Treating anxiety and stress. Wiley (Chapters 1 and 3).

Bower, P. and Gilbody, S. (2005). Stepped care in psychological therapies: access, effectiveness and efficiency. British Journal of Psychiatry, 186, 11-17.

Workshop 4

Cognitive Behavioural Therapy for the Treatment of Substance Abuse with Comorbid Mental Health Disorders.

Renuka Arjundas and Patrick Roycroft Northumberland, Tyne and Wear NHS Trust.

Substance use disorders commonly coexist with mental health disorders such as Depression, Anxiety disorders, Schizophrenia and Mania. The relationship between substance abuse and mental health disorders can be complex and substance abuse can affect the treatment outcome and prognosis of these disorders.

The effectiveness of Cognitive Behavioural Therapy (CBT) in various mental health problems is well established. CBT has also been widely studied and shown to be effective in the treatment of substance use disorders, such as the abuse of tobacco, alcohol and cocaine.

This workshop aims to help the participants understand the interrelationship between substance abuse and mental health disorders and to use this understanding to develop formulations informed by theoretical disorderspecific CBT models. Another aim is to demonstrate the application of appropriate cognitive behavioural interventions derived from the formulation. The emphasis of the workshop will be on evidence-based approaches for substance use disorders such as Motivational Enhancement Therapy (MET) and CBT. The use of Transtheoretical stage of change model to assess readiness to change and inform interventions for co occurring disorders will be demonstrated. Newer treatment approaches such as Mindfulness Meditation for relapse prevention of substance abuse will also be briefly discussed.

The department of health recommends that mental health practitioners develop skills in assessing and treating substance use disorders. This workshop is relevant to generic mental health practitioners and to specialist practitioners in the field of addiction who wish to enhance their skills for the treatment of substance abuse with comorbidity. Specific training in the field of addictions is not required but it is assumed that participants have knowledge and experience of application of CBT in generic mental health problems.

Key Learning Objectives
At the end of this workshop participants would be able to:

  1. Assess substance use disorders and their interaction with comorbid mental health disorders.
  2. Understand models of therapy that underpin common cognitive behavioural interventions for substance use disorders.
  3. Develop a idiosyncratic case formulation of substance abuse and comorbidity.
  4. Understand the application of evidence based approaches such as MET and CBT.

Dr Renuka Arjundas is a Consultant Psychiatrist in CBT. She has worked in the field of addictions, written and presented on CBT for substance use disorders in young people and supervises specialist practitioners in addictions on the use of CBT in comorbid disorders.
Dr Patrick Roycroft is a Consultant Clinical Psychologist who has over 10 years’ experience working with substance abuse and mental health problems. He is involved in
the training and supervision of Psychological Therapists, Counselling and Clinical Psychologists.

Key References
Beck, A.T., Wright, F.D., Newman, C.F and Liese, B.S (1993). Cognitive Therapy of Substance Abuse. New York: Guilford Press.

Marlatt, G.A. and Gordon, J.R. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviours. New York: Guilford Press.

Miller, W.R. and Rollnick, S. (2002). Motivational Interviewing: Preparing people for change. New York: Guilford Press.

Workshop 5

Bringing Interpersonal Process into Mainstream CBT: a new conceptual model for understanding ruptures/stuckness in CBT.

Vivien Twaddle and Peter Armstrong, Newcastle Cognitive and Behavioural Therapies Centre and University of Newcastle upon Tyne.

This workshop is aimed at people with experience treating complex emotional disorders (in adults) with CBT.

Although mainstream cognitive therapy recognises the importance of interpersonal process (IPP), the level of specification has generally been lower than in some other psychological models. Our collective experience of IPP is that much of the understanding remains implicit, there is a pull towards pathologising some aspects of these processes and that we often rely on concepts from other therapeutic traditions that have a high resonance, but a low level of specification. In Newcastle we have been developing a framework and concepts that are more consistent with the cognitive behavioural approach – in that they are explicit, normalising and more highly specified.

Learning objectives:
Participants will

  1. learn about the conceptual framework and how it has been developed;
  2. learn how to identify and work with relevant process markers using a new therapist and patient measure;
  3. learn about some general guiding therapeutic principles when working with IPP within CBT.

Vivien Twaddle (Consultant Clinical Psychologist/cognitive behavioural therapist) and Peter Armstrong (Clinical Nurse Specialist/cognitive behavioural therapist) work in the Newcastle Cognitive and Behavioural Therapies Centre – a regional specialist NHS centre for CBT in the North East of England. They are both highly experienced therapists who work with broad-ranging and complex emotional disorders and have substantial experience of training and supervising others in CBT. They have a particular interest in how to work explicitly with interpersonal processes to overcome ruptures/stuckness in CBT. More specifically. Over the last three years, they have been working with colleagues throughout the United Kingdom to develop this IPP framework for CBT.