In-Conference Workshops
Thursday 20th - Friday 21st July

Paid for In-conference Workshops
Delegates attending the BABCP Congress will be able to attend one or more of the paid for in-conference workshops (2.5 hours approx.). There is a small extra charge of £22 for each of these workshops. You can make a booking in advance by using the booking form available on the BABCP website (www.babcp.com). Alternatively you can register on site when you arrive at the University. Places will be limited for each workshop and will be allocated on a first come first served basis.

Complimentary In-conference Workshops
In addition the Scientific Committee have this year included within the conference programme, and therefore conference registration, 6 complimentary in-conference workshops (2.5 hours approx.). These workshops will operate on a first come first served basis and will take a maximum of 35 attendees each. Please note that it is only possible to register for one complimentary in-programme in-conference workshop per person. If you wish to attend a complimentary in-conference workshop then you will need to register and collect a ticket on site at the University where there will be a desk in the registration area of the Rootes Building. Please note that we cannot guarantee that you will be able to register for the workshop of your choice. Admission to these complimentary in-conference workshops will be strictly by ticket only.

Paid for In-conference Workshops

Thursday 1.15 - 3.30pm

Workshop 1

Using CBT techniques to supervise CBT therapy
Maggie Gray, Cullen Centre, Royal Edinburgh Hospital and Forbes Craig, Insight Associates in Training

 

Workshop 2

When telling stories is helpful, and when it is not
Gillian Butler, Oxford Cognitive Therapy Centre, and Oxfordshire Mental Health Care NHS Trust

 

Workshop 3

Contemporary Rational Emotive Behaviour Therapy. Theoretical And Clinical Advancements
John Blackburn, Specialist Psychotherapy Services, Sheffield Care Trust

 

Workshop 4

Schema-Focused Therapy for Borderline Personality Disorder
Arnoud Arntz, Maastricht University and Marjon Nadort, the VU Medical Center/GGZ Buitenamstel at Amsterdam

 

 

Friday 9.00 - 11.20am

Workshop 5

Working with flashbacks linked to type I and Type II trauma
Helen Kennerley and Deborah Lee, Oxford Cognitive Therapy Centre

 

Workshop 6

Is the mind/body really able to heal itself
Irene Tubbs, Accredited BABCP member & Chair AREBT

 

Workshop 7

Working with Dissociation and Dissociative Idenity Disorder
Vivia Cowdrill, Hampshire Partnership NHS Trust, Fiona Kennedy and Janine Day, Isle of Wight Healthcare NHS Trust

 

 

Friday 1.15pm - 3.30pm

Workshop 8

Using computer and web-based treatments for bulimia
Christopher Williams, University of Glasgow and Ulrike Schmidt, Institute of Psychiatry and South London and Maudsley NHS Trust.

 

Workshop 9

What's a Nice Therapist like You doing in a Place like This? The Challenge of Delivering CBT Focused Return to Work Programmes Within a Political/Economic Agenda
Simon Darnley, Prisma Health Ltd

 

Workshop 10

Cognitive-behavioural strategies for working with difficult and resistant clients
Wayne Froggatt, New Zealand Centre for Cognitive Behaviour Therapy

 

Workshop 11

 

Therapeutic Factors in CBT with Personality Disorders and Complex Trauma
Claudia Herbert, The Oxford Development Centre Ltd

 

 

Complimentary In-conference Workshops

Thursday 1.15 - 3.30pm

Workshop 12

Beyond Simple Techniques in the Treatment of Medically Unexplained Symptoms
Trudie Chalder, Institute of Psychiatry, London

 

Workshop 13

Enhancing Exposure Efficacy: Strategies for Improving Anxiety Interventions
Michael Otto, Center for Anxiety and Related Disorders at Boston University, USA

 

Friday 9.00 - 11.20am

Workshop 14

Anger Assessment and Treatment
Raymond Novaco, University of California, Irvine, USA

 

Workshop 15

Focusing on What Works with Mindfulness and Metacognition: An Introduction to the Method of Levels
Tim Carey, Fife Primary Care Trust, NHS

 

 

Friday 1.15pm - 3.30pm

Workshop 16

CBT for OCD in Children and Adolescents
Polly Waite and Catherine Gallop University of Reading

 

Workshop 17

The Power of Affect: Principles of Emotion-focused Therapy
Diana Wais, AEDP Institute

 

 

 

Workshop 1

Using CBT techniques to supervise CBT therapy

Maggie Gray, Cullen Centre, Royal Edinburgh Hospital and
Forbes Craig, Insight Associates in Training

Relevant Background: It is generally accepted by therapists using various models of therapy (Driver 2002, Padesky 1996) that supervision, particularly of beginning therapists, should model the type of therapy being delivered. Perhaps this is particularly so in CBT when the model itself favors behavioural techniques and learning theory. However, as supervisors we often find it difficult to find ways of staying within the model without resorting to didactic teaching. This workshop aims to explore ways of doing this and to expand the repertoire of each of us by sharing the techniques we use. In order to organise our thinking we use an adapted Hawkins and Shohet 7 eyed model.

Key Learning Objectives: 1. To propose a CBT model of supervision using Hawkins and Shohet's 7 eyed model. 4. To question the limits of CBT techniques - are there times when other techniques are more helpful? 2.To expand the knowledge of CBT supervision techniques. 3. To experience using these techniques both as supervisor and supervisee.

Training Modalities: This workshop aims to be experiential with time to discuss and expand the experience. There will be a short didactic input to explain the Hawkins and Shohet model and how it can be adapted for use by CBT therapists.

Key References: 1. Improving Supervision Skills: A Cognitive Perspective, Gillian Butler workshop 2001

2. Developing Cognitive Therapist Competancy: Teaching and Supervision Models. Padesky C.A in Frontiers of Cognitive Therapy, ed Salkovskis P. (1996) Guildford Press New York

3.Internal States in the Supervisory Relationship, Driver C. in Supervising Psychotherapy: Psychanalytic and Psychodynamic Perspectives. ed Driver C. and Martin E. Sage(2002)

4. Supervision in the Helping Professions. Hawkins P. and Shohet R. OU Press (2000).

Workshop Presenters: Maggie Gray is a Nurse Psychotherapist who is registered with BABCP and supervises and teaches CBT to diploma level on the South of Scotland CBT Course. She has run several workshops for beginning supervisors in CBT and is involved in developing and running a generic training for supervisors with Insight Associated in Training. Forbes Craig is a registered trainer with a background in nursing and is the owner of Insight Associates in Training. She has developed and presented several training courses around the issues of supervision and is interested in seeing training delivered effectively to enhance it's content.

 

 

Workshop 2

When telling stories is helpful, and when it is not

Gillian Butler, Oxford Cognitive Therapy Centre, and Oxfordshire Mental Health Care NHS Trust

Relevant background: There are a number of pressures on therapists to stray from the recommended methods of CBT. One of these concerns story-telling, and it affects both patients and therapists. Patients often want to tell their stories. Sometimes it is not possible to stop them doing so, and sometimes they say that once they have 'told all' they will be able to 'move on'. From the other angle, therapists are aware of the value of re-living following circumscribed or single-incident traumas; and they may also know about the theories that underpin Narrative Therapy, and about the work that documents the value of writing about traumatic events described by Pennebaker. The two pressures combine to encourage story-telling during therapy. However, my work with a case series of about 40 people who have experienced traumatic childhoods, and who have a dysfunctional sense of identity, has raised many questions. Those addressed in this workshop concern how and when telling the story is likely to lead to helpful results, and the value, or necessity, of telling the story following a traumatic childhood.

Key Learning Objectives: The overall objective is to clarify how story-telling can be used effectively. This will be achieved by: Identifying examples of when story-telling was useful, or not useful, Distinguishing different aspects of meaning, and the various methods that can be used to change meaning, Identifying principles that would help to determine how and when to encourage someone to tell their story.

Training Modalities: The workshop will make use of a variety of interactive methods, including discussion between participants, small group exercises and role-play.

Key references: Butler, G. 2004. Clinical difficulties to revisit. In J. Yiend (Ed.), Cognition, Emotion and Psychopathology. Cambridge University Press.

Richert, A.J. 2002. The self in narrative therapy: thoughts from a humanistic/existential perspective. Journal of Psychotherapy Integration, 12, 77-104.

Ylvisaker, M. & Feeney, T. 2000. Reconstruction of identity after brain injury. Brain Impairment, 1, 12-28.

Workshop Leader: Gillian Butler works for the NHS and for Oxford Cognitive Therapy Centre. She has a special interest in the use of CBT during recovery from traumatic experiences in childhood and runs training workshops on a wide variety of topics relevant to practitioners of CBT, in this country and overseas. She is particularly interested in making the products of research available to the general public and is author of Overcoming Social Anxiety and Shyness; co-author of Manage Your Mind: The Mental Fitness Guide, and Psychology: A Very Short Introduction, and co-editor of The Oxford Guide to Behavioural Experiments in Cognitive Therapy.

 

Workshop 3

Contemporary Rational Emotive Behaviour Therapy. Theoretical And Clinical Advancements

John Blackburn, Specialist Psychotherapy Services, Sheffield Care Trust

Background: Rational Emotive Behaviour Therapy has been gaining ground in the UK over the past few years, though not as established as Cognitive Therapy, it is becoming more and more popular with clinicians in an increasingly wide variety of settings.

Key Learning objectives: Understanding of the theory of REBT Appreciation of the current trends in REBT theory and practice, Gain an understanding of the clinical applications of REBT to a wide range of psychological problems.

Training modalities: Role-play, video demonstrations, didactic presentations, and small group work.

References: Dryden, W. (ed) RATIONAL EMOTIVE BEHAVIOUR THERAPY Theoretical Developments. Brunner Routledge 2003 Ellis, A. Reason and Emotion in Psychotherapy. Citadel Press 1962.

Workshop Leader: John Blackburn is a Rational Emotive Behaviour Therapist working in a NHS CBT out-patient clinic. He has been practising REBT since training with Windy Dryden in the mid eighties. His main area of interest in the application of REBT to anger problems and working with people with chronic pain problems.

 

Workshop 4

Schema-Focused Therapy for Borderline Personality Disorder

Arnoud Arntz, Maastricht University and Marjon Nadort, the VU Medical Center/GGZ Buitenamstel at Amsterdam

Relevant Background: Borderline Personality Disorder (BPD) has for a long time been known as an untreatable mental disorder, which could best be approached by providing low-frequency and emotionally distant contacts, aiming at stabilizing but not treating the disorder. Recent developments have challenged this therapeutic nihilism, and our recent multicenter trial has quite convincingly demonstrated that prolonged schema-focused therapy (SFT) has a good response and recovery rate, superior to those of a psychodynamic alternative.

Key Learning Objectives: To get a first impression of the essential ideas and treatment techniques of SFT for BPD. Note that proper training in SFT for BPD requires an intensive training of several days and supervision. Nevertheless, the present workshop intends to give participants a balanced overview of how in SFT BPD problems are viewed, how the therapeutic relationship is used, and what the major experiential, cognitive and behavioral techniques are. Training Modalities: Verbal presentations and DVD examples of major ingredients of the treatment.

Key References: Arntz, A.; Weertman, A. (1999). Treatment of childhood memories; theory and practice. Behaviour Research and Therapy, 37, 8, 715-740.

Arntz, A. (2004). Borderline Personality Disorder. In: A.T. Beck & A.Freeman (Eds.), Cognitive Therapy of Personality Disorders, 2nd Edition. New York:

Guilford. Arntz A. (2004). The abandoned child. Wellcome news supplement 8, 24-25.

Genderen, H. van & Arntz, A, (2005). Schema-gerichte cognitieve therapie bij borderline persoonlijkheidsstoornis. Amsterdam: Uitgeverij Nieuwezijds. Giesen-Bloo, J., van Dyck, R., Spinhoven, P., van Tilburg, W., Dirksen, C., van Asselt, T., Nadort, M., Arntz, A. (in press).

Outpatient Psychotherapy for Borderline Personality Disorder: A randomized clinical trial of Schema focused therapy versus Transference focused psychotherapy. Archives of General Psychiatry (June 2006).

Nadort, M. DVD's of SFT for BPD, www.schematherapie.nl Young, J.E., Klosko, J., & Weishaar, M.E. (2003). Schema Therapy: A Practitioner's Guide. New York: Guilford.

Workshop Leaders: Arnoud Arntz is a full professor in Clinical Psychology and Experimental Psychopathology at Maastricht University. One of his major research interests is the psychological understanding and treatment of Borderline Personality Disorder. He was project leader of the Dutch multicenter trial comparing SFT and TFP as treatments of BPD. Marjon Nadort, MSc, is SFT therapists, trainer and supervisor at the VU Medical Center/GGZ Buitenamstel at Amsterdam. She developed an extended training program and DVD series to train mental health professionals in the Netherlands and abroad. She is presently investigating implementing SFT for BPD in regular mental health institutes. An important part of her implementation program is her training and supervision of therapists, supported by the DVD series she developed to demonstrate the most important ingredients of SFT.

 

Workshop 5

Working with flashbacks linked to type I and Type II trauma

Helen Kennerley and Deborah Lee, Oxford Cognitive Therapy Centre

Relevant Background: Traumatic flashbacks are vivid intrusions, which give rise to feelings of current distress, threat, disgust or shame, for example, even though the traumatic event might have occurred some time in the past. Flashbacks can reflect recent or distant experiences or can result from acute or chronic trauma. Historically, these have been distinguished as 'Type I and 'Type II' related flashbacks, but there has been little systematic exporation of the phenomenology associated with these types of experiences and consequently little exploration of the different treatment approaches necessary to work with these distinctive presentations.

Key Learning Objectives: To appreciate the underlying mechanisms of type I trauma related flashbacks (TORFS) and type II trauma related flashbacks (TTRFs). To consider the similarities and differences between them. To formulate their origin and maintenance.

Training modalities: Didactic presentation, case presentation, opportunities for discussion.

Key References: Terr LC (1991). Childhood traumas: An outline and overview Am J PSychiatryy 148:1 10-20. Brewin, Dalgeish & Joseph (1996)

A Dual Representation Theory of Post Traumatic Stress Disorder. Psychological Review, 103, 670-686.

Workshop Leaders: Helen Kennerley is a consultant clinical psychologist and founder member of the Oxford Cognitive Therapy Centre. She is an experienced Clinician who has specialised in working with survivors of childhood trauma, Dissociative disorders and self-injurious behaviours. Amongst other publications she is the author of overcoming childhood trauma. Deborah Lee is a Consultant Clinical Psychologist, who has specialist in working with traumatised people for 12 years. She works at UCL and the Oxford Cognitive Therapy Centre. She has extensive experience in this field as a clinician and has contributed to the dissemination of her clinical knowledge through her writing and workshops. Her interests lie in working with complex cases, shame and developing compassion in cognitive therapy.

 

Workshop 6

Is the mind/body really able to heal itself

Irene Tubbs, Accredited BABCP member & Chair AREBT

Background: Given a humans essential pre-occupation with survival, there are constant scientific research programs, which review and demonstrate the benefits of health programs to the general public. Even so there is a large percentage of the general public who are not using such knowledge to counterbalance unhealthy habits, ultimately lowering their immunity to disease. Reasons for this decline are manifold, but the underlying psychological factor, which constantly fuels a tendency towards relapse, is the lack of a person's 'belief' in their ability to improve their health.

Key Learning objectives: Using research evidence, the placebo effect and client case studies I will be exploring how such lack of self determination can be enhanced by using the power of the mind to maintain such changes. Giving clear examples of health inhibiting thoughts, beliefs and practices alongside health enhancing thoughts, beliefs and practices, all key elements within Rational Emotive & Cognitive Behavioural Therapies.

Training modalities: The timing of this half day course will by necessity require a didactic approach, but I will be encouraging group participation/interaction through experiential practice.

Workshop Leader: Irene Tubbs has been an Educationalist since l976, initially as a Physical Education Specialist and then a Senior Lecturer in Adult Education, initiating developing and delivering a wide spectrum of educational courses to suit all ages. In l977 she was a founder-contributor of a rehabilitation programme set up to assist patients recovering from any condition that affects the heart, a programme which she still offers. Her new book 'Heart Recovery' Sheldon Press is out in March 2006. Her specialist areas have included coronary rehabilitation, relaxation, stress management, diet/nutrition, exercise, health coaching, fertility and generic counselling, appraisal and management skills. She has previously written books on relaxation, coronary rehabilitation and fertility, plus many pamphlets, and self-help guidelines for combating stress. As a Counsellor Irene has extensive experience of working with clients covering Post Traumatic Stress Disorder, Bereavement, Anorexia, Bulimia, Depression, Panic Attacks, Obsessive Behavioural traits, Physical and sexual abuse, miscarriage/ still-birth, recovery after illness, psychosexual issues, relationship issues with partner, family, friends, colleagues and general self- damming processes, lack of confidence etc. As a Life and Health Coach, she has extensive experience of working with clients to learn educative formats for self development and health orientated programs. She is currently training others related to health coaching and is shortly to have a book published on this aspect of health. She is BACP (Accred) AND BABCP (Accred); BICA; ISMA; REBT; MIHPE; FMCA; UKCP AND UKRC REGISTERED.

 

Workshop 7

Working with Dissociation and Dissociative Idenity Disorder

Vivia Cowdrill, Hampshire Partnership NHS Trust, Fiona Kennedy and Janine Day, Isle of Wight Healthcare NHS Trust

Relevant Background: Having successfully offered this workshop at the EABCT Conference in Greece in 2005 the aim is to introduce a new CBT model for dissociation. This model allows the formulation of complex dissociative phenomena, including pseudo-hallucinations, flashbacks, conversion symptoms, borderline personality 'state-switching' and construction of the self in dissociative identity disorder. Authors are aware that the DID construct is controversial and will discuss ways of conceptualizing cases. A new scale for measuring three 'levels' of dissociation will be mad available to participants. Two cases of DID will be presented briefly, with time for discussion and questions. These will illustrate the usefulness of the scale in aiding formulation and deciding treatment targets. The treatment approaches used, integrate techniques from other approaches, including management development team-building approaches and Dialectical Behaviour Therapy, while formulating using CBT principles and theory from cognitive psychology. Ideas for working with dissociation in less severe presenations will also be discussed. There will also be an opportunity for discussion, consultation and sharing of ideas with other theorists and therapists interested in working in this challenging field.

Key Learning Objectives: Participants will : - 1. be able to formulate dissociative phenonmena using CBT concepts. 2. be able to conceptulaize complex cases involving dissociative presentations 3. learn target-setting, case management and treatment strategies.

Training Modalities: Didactic and experiential modalities will be used, including role-play as appropriate.

Key references: Kennedy, F.C., Clarke, S., Stopa, L., Bell, L., Rouse, H., Ainsworth, C., Fearon, P., & Waller, G. (2004) Towards a cognitive model and measure of dissociation. Journal of Behavior Therapy and Experimential Psychiatry, 35, 25-48.

Waller, G., Hamiliton, K., Elliott, P., Lewendon, J.,Stopa, L., Waters, A., Kennedy, F.C., Lee, G., Pearson, D., Kennerley, H., Hargreaves, I., Bashford, V., & Chalkley, J. (2000) Somatoform dissociation, psychological dissociation and specific forms of trauma. Journal of Trauma & Dissociation. 1 (4), 81-98.

Kennerley, H. (1996) Cognitive therapy of dissociative symptoms associated with trauma. British Journal of Clinical Psychology, 35, 325-340.

Workshop Leaders: The workshop leaders are clinicians working with clients with dissociative disorders in adult mental health settings. Drs. Vivia Cowdrill and Fiona Kennedy are clinical psychologists who have developed and published the new model and scale, along with a wider network of researchers and clinicians in the UK and Europe. Janine Day is a community psychiatric nurse who has extensive practical experience of working with dissociative clients in the community.

 

Workshop 8

Using computer and web-based treatments for bulimia

Christopher Williams, University of Glasgow and
Ulrike Schmidt, Institute of Psychiatry and South London and Maudsley NHS Trust.

Relevant Background: Computer-based treatments offer many advantages in eating disorder settings. They provide rapid access to treatment and help patients work on problems in a stepped care way. Such packages are ideal for those who face lengthy waiting lists. Our research has shown that such approaches are very well received by patients with bulimia, but also play an important role in engaging people in treatment as a crucial first step to discovering key information and skills in self-management. Finally, they also appear to be an effective treatment for many.

Key Learning objectives: The session will focus on the practical aspects of using the web in its broadest sense to provide support and treatment. This includes: Using Google to find information, How to judge the quality of information on the web, Using email support of patients, Bulletin Board support systems- how they can help your service, Eating Disorder Association online support resources, A brief overview of online CBT treatment packages for bulimia, A discussion of the research data and practical learning points we have gathered from researching the Overcoming bulimia online package and CD Rom. Attendees will have the chance to see some computer-based materials in action and consider how the wide range of web-based supports may be used in your own services.

Training Modalities: Workshop style presentation, and an interactive format. Large and small group discussion will allow participants to stop, think and reflect about how what they are learning could be used clinically.

Key references: 1). Kathryn Murray, Maria Guadelupe Pombo-Carril, Nuria Bara-Carril, Miriam Grover, Yael Reid, Helen Birchall, Chris Williams, Janet Treasure, Ulrike Schmidt. (2003). Factors determining uptake of a CD-ROM based CBT self-help treatment for bulimia: patient characteristics and subjective appraisals of self-help treatment. European Eating Disorders Review, 11, 243-260

2). Williams, C. New technologies in self-help: another effective way to get better? (Editorial). European Eating Disorders Review (2003), 11, 170-182.

3). Bara-Carril, N., Pombo-Carril, MG., Reid, Y., Murray, K., Aubin, S., Harkin, PJR., Treasure, J., Schmidt, U. Williams, CJ. (2004) A Preliminary Investigation into the Feasibility and Efficacy of a CD-ROM Based Cognitive-Behavioural Self-Help Intervention for Bulimia Nervosa. International Journal of Eating Disorders, 35: 538-548.

Workshop Leaders: Dr Chris Williams has developed and evaluated a number of self-help packages including one on bulimia. He is based at the University of Glasgow and is a Director of Glasgow Institute of Psychosocial Interventions. Dr Ulrike Schmidt is a Reader at the Institute of Psychiatry and has done extensive work in the areas of eating disorders ad self-harm. She is leading a Medical Research Centre (MRC) funded study of the Overcoming Bulimia CD Rom in adolescents, and also a separate RCT in adults. A further web-based package aimed at supporting parents of children with anorexia is also being developed.

 

Workshop 9

What's a Nice Therapist like You doing in a Place like This? The Challenge of Delivering CBT Focused Return to Work Programmes Within a Political/Economic Agenda

Simon Darnley, Prisma Health Ltd

Relevant Background: The Green Paper on Welfare Reform (January 2006) describes changes in the benefit system aimed at helping people off Incapacity Benefit and into work. There are approximately 2.7 million people receiving Incapacity Benefit and the DWP estimate that approximately 1 million could be assisted back to work with appropriate help. There is an increasing focus on Return to Work with the success of programmes such as the government-funded Pathways to Work Programme and the privately funded Prisma Programme. Increasing numbers of CBT therapists are involved through these programmes in helping people back to work. There are important training implications - Lord Layard estimated that approximately 10,000 extra therapists would be needed to provide 10 sessions of CBT to one million people each year. CBT is traditionally seen as focusing on the clinical aspects of mental and physical health problems. However, with clients who are currently not working, clinical progress may be limited because therapists have insufficient influence on the non-clinical maintaining factors (e.g. financial and employment issues). We will discuss the additional case management skills needed to work effectively with these clients. Despite the success of Return to Work programmes, the proposed reforms have met with opposition from some disability rights groups and Labour Party backbenchers. In presenting an effective model for Return to Work we will explore the therapeutic implications of working within a politically generated environment, asking 'What happens when you mix politics with therapy?', 'Can CBT and Incapacity Benefit Reforms be comfortable bedfellows?', 'What if the individual is ambivalent about engaging?', 'How ethical is it to use motivational techniques when the result is cessation of benefit?'. In short, 'What's a nice therapist like you doing in a place like this?

Key Learning Objectives: At the end of the workshop participants will be able to: Describe the economic and therapeutic benefits of return to work, Outline the main points of the Green Paper on Welfare Reform (due end Jan 2006), Identify the clinical and non clinical barriers to return to work, Discuss the application of CBT to return to work programmes, Describe methods of dealing with beneficiaries' anxieties, apprehensions or ambivalence about return to work in order to increase readiness for change, Describe the concept of 'rights and responsibilities' within a therapeutic framework , Discuss the extended role of the Case Manager/CBT therapist working in this field.

Training Modalities: The workshop will include various training modalities, e.g. didactic presentation, small group discussion and role play.

Key References: Layard R (2004) Mental Health: Britain's Biggest Social Problem? Paper presented at Downing Street Strategy Unit Seminar, January 2005.
Department of Work and Pensions (2006). A new deal for welfare: Empowering people to work

Workshop Leaders: Dr Verina Wilde (General Manager Prisma Health Ltd) has extensive experience of return to work focused Cognitive Behavioural Psychotherapy, Supervision and Case Management within the insurance industry. She advises and liaises with the Department of Work and Pensions and Vocational Rehabilitation organizations on the development of return to work programmes and related staff training programmes. Simon Darnley (General Manager Prisma Health Ltd) has specific responsibility for overseeing and supervising the Prisma assessment and treatment programmes for all clients referred by Insurance Companies. He has extensive experience of Cognitive Behavioural Psychotherapy, Case Management and Supervision.

 

Workshop 10

Cognitive-behavioural strategies for working with difficult and resistant clients

Wayne Froggatt, New Zealand Centre for Cognitive Behaviour Therapy

Relevant background: Cognitive Behaviour Therapy does not always succeed. This is not necessarily because the method is unsuited to the client - more often than not it is due either to factors within the client that block progress, or to the way treatment is delivered by the therapist. Cognitive-behaviour therapy contains within itself a range of strategies and techniques that can be used to overcome these blockages. The overall objective of this workshop is to enable participants to identify the blocks to therapeutic progress and selectively apply appropriate strategies and techniques to move the therapy forward.

Key Learning Objectives: At the end of this workshop, participant's will:
1. Understand the most common blocks to progress for example clients' practical difficulties, problems with the therapeutic relationship, anxiety about therapy, fear of getting better, and secondary gain/payoffs.
2. Be aware of strategies to overcome these blocks, including helping clients move from intellectual to 'action' insight and working with client or therapist core beliefs that block progress.
3. Know specific techniques to facilitate these strategies, such as the benefits calculation, imagery, modelling, paradoxical interventions, pragmatic disputation and anti-sabotage counters.
4. Know how to apply these strategies and techniques to specific problems, eg: Involuntary clients, Clients who believe that change is impossible, Clients who explicitly resist, Clients who comply but insufficiently, Poor compliance with homework, Clients who drop out, Clients who cooperate but whose improvement is poor.

Training Modalities: Teaching methods for this workshop will include some didactic presentation of information combined with small group discussion and input from participants' own clinical experiences; with the emphasis on demonstrations and experiential practice work. Participants will also be provided with a comprehensive handout on the workshop content.

Key references: to be referred to are: Ellis, A. (1995). 'Rational-Emotive Therapy approaches to overcoming resistance', in: Dryden, W. (Ed.) Rational Emotive Behaviour Therapy: A reader. London: Sage Publications. Rorer, L. (1999).

Dealing with the intellectual-insight problem in Cognitive and Rational Emotive Behaviour Therapy. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 17(4), 217-236. Safran, J.D. & Segal, Z.V. (1990).

Interpersonal Process in Cognitive Therapy. New York. Basic Books. Seligman, Martin E.P. (1994). What You Can Change and What You Can't: The complete guide to successful self-improvement. Sydney: Random House.. Turkat, I.D. & Mayer, V. (1982).

The behavior-analytic approach. In Wachtel, P.L. (Ed.) Resistance: Pychodynamic and behavioral approaches. New York: Plenum.

Workshop Leader: The workshop will be presented by Wayne Froggatt, Dip.Soc.Wk, C.Q.S.W., MANZASW, Cert. Adult Teaching; Associate Fellow, Albert Ellis Institute for Rational Emotive Behaviour Therapy; Certified REBT Supervisor; Lecturer in CBT and Clinical Supervision, Eastern Institute of Technology; Executive Director, Centre for Cognitive Behaviour Therapy (NZ) and New Zealand Centre for Rational Emotive Behaviour Therapy; Consultant Director, UK Centre for REBT; author of Choose to be Happy, Taking Control (in print 2006), FearLess, Relaxation for the Real World, The Rational Treatment of Anxiety, Learning to use Rational Emotive Behaviour Therapy, and Learning to use Cognitive-Behaviour Therapy.

 

Workshop 11

Therapeutic Factors in CBT with Personality Disorders and Complex Trauma

Claudia Herbert, The Oxford Development Centre Ltd

Background: In recent years, the field of trauma therapy has hugely expanded with new research emerging all the time. As a result, it is becoming increasingly apparent that in order to be effective with clients in this field, we have to widen our understanding to consider findings from a variety of different disciplines, such as for example, cognitive science, neuroscience, developmental psychology, and information-processing theories, rather than confining ourselves to the more narrowly defined approaches of the past. Excitingly, with this expansion in knowledge, a number of therapeutic factors are emerging, which seem important to be considered in the context of CBT-based work with complex trauma and personality disorders. 

Key Learning Objectives: This workshop will consider the following therapeutic factors, within the context of current trauma theory: a '3-Systems Approach' (Herbert, in print) of integrating cognition-, affect- and body-based techniques; the ability to use 'top-down', as well as, 'bottom-up' processing; the concept of safety and the distinction between Type I, IIA and Type B Traumas; the nature of the therapeutic relationship; therapist qualities; Therapeutic Spectrum of Trauma Work; Importance of appropriate Timing; Inner States work as a Method for integrating dissociated parts of Self. The implications of the above call for an Integrative CBT Model for Trauma Work, which will be introduced. · To understand the theoretical relevance of specific therapeutic factors, especially in relation to personality disorder and complex trauma. To find out about some ways in which these factors may be applied in clinical practice. To explore and self-evaluate your own therapist qualities. To understand the service implications for mental health care providers for complex trauma. 

Training Modalities: Training will be mainly didactic, with some experiential exploration. Active audience participation will be encouraged and there is some scope for exploration of the proposed therapeutic factors in terms of participants' own experiences with this client group and the clinical setting, in which they work. 

Key References: 1. Herbert, C. (in print) - Healing from Complex Trauma An Integrated 3-System's Approach. Invited Chapter in J. Corrigal, H. Payne, H. Wilkinson, (Eds): About a Body. Taylor & Francis Publishers: London 

2. Collard, P. (2003) Interview with Dr Claudia Herbert, Counselling Psychology Quarterly, 16, No. 3, 187-193 

3. Herbert, C. (2002) A CBT-based therapeutic alternative to working with complex client problems. European Journal of Psychotherapy, Counselling & Health, 5, No. 2, 135-144. 

Workshop Leaders: Dr Claudia Herbert, BSc(Hons), MSc, DClin Psy, AFBPsS is a Chartered Clinical Psychologist, UKCP Registered Cognitive Behavioural Psychotherapist, EMDR Consultant and an Associate Member of the British Psychological Society (BPS). She is the Founder Director of The Oxford Development Centre Ltd, which incorporates Oxfordshire's Independent Psychology Service and The Oxford Stress and Trauma Centre. She is a specialist in trauma psychology and has presented at conferences worldwide. She has published several academic articles; three books on trauma, which are translated worldwide; is Series Editor of the CBT-based 'Getting-through-it' series for young people and BABCP's representative on the UKCP Registration Board

 

Workshop 12

Beyond Simple Techniques in the Treatment of Medically Unexplained Symptoms

Trudie Chalder, Institute of Psychiatry, London

The essential features of medically unexplained symptoms are physical symptoms for which no demonstrable organic findings can be found. The symptoms are not feigned or intentionally produced. Work, social and private functioning are usually impaired and the extent of the disability is usually determined by the degree of belief in the physical nature of the symptoms and/or fearful cognitions about the consequences of them. Health professionals including physicians and psychologists find these patients particularly difficult to treat. This workshop will provide clinical insight into how these patients can be engaged in the therapeutic process. We will discuss strategies that may be employed when meeting resistance in the patient and demoralization in the health professional.

 

Workshop 13

Enhancing Exposure Efficacy: Strategies for Improving Anxiety Interventions

Michael Otto, Center for Anxiety and Related Disorders at Boston University, USA

Relevant Background: Rather than being a weakening of a learned association, extinction of a fear response is best characterized as the active learning of an alternative response ("relative safety"). Inherent within this perspective is the idea that this new learning has to compete with previous learning, and that this competition may be resolved in terms of either the old learning (fear) or the new learning (relative safety). This workshop is designed to provide an accounting of the successes, and more importantly, the failures (non-response and relapse) of exposure-based treatment for the anxiety disorders, relative to current conceptualizations of the nature and limits of extinction learning. The presentation will include discussion of parameters of exposure learning for maximizing acute and longer-term treatment outcome, including distraction, safety behaviors, anti-phobic behaviors, post-exposure processing, the length and spacing of exposure trials, and the appropriate targets for extinction learning. Issue of exposure context will be used to summarize many of these topics, including a discussion of issues in combination treatment strategies.

Key Learning objectives: Your will learn: An integrated perspective on exposure and cognitive restructuring in the treatment of anxiety disorders, The role of distraction, attention, and context effects in modulating exposure efficacy and relapse, Strategies to enhance exposure effectiveness.

Training Modalities: Slide presentation and discussion, including discussion of cases presented by attendees.

Key references: Bouton, M. E. (2002). Context, ambiguity, and unlearning: sources of relapse after behavioral extinction. Biological Psychiatry, 52, 976-986. Otto, M. W., Safren, S. A., and Pollack, M. H. (2004).

Internal cue exposure and the treatment of substance use disorders: Lessons from the treatment of panic disorder. Journal of Anxiety Disorders, 18, 69-87. Otto, M. W., Smits, J. A. J., Reese, H. E. (2005).

Combined psychotherapy and pharmacotherapy for mood and anxiety disorders in adults: Review and analysis. Clinical Psychology: Science and Practice, 12, 72-86. Powers, M.B., Smits, J.A., & Telch, M.J. (2004).

Disentangling the effects of safety-behavior utilization and safety-behavior availability during exposure-based treatment: a placebo-controlled trial. Journal of Consulting and Clinical Psychology, 72(3), 448-454.

Workshop Leader: Dr. Otto specializes in the cognitive-behavioral treatment of anxiety, mood, and substance use disorders. An enduring theme across these disorders is the role of exposure-based emotional tolerance/acceptance strategies in improving mental health. Dr. Otto's research has tended to focus on difficult-to-treat populations, including the application of cognitive-behavioral strategies to anxiety patients who have failed to respond to previous interventions, as well as developing novel strategies for bipolar disorder, patients with substance use disorders, and non-English speaking populations (e.g., Cambodian refugees with posttraumatic stress disorder). Current research at the Center for Anxiety and Related Disorders also includes investigations of potential moderators of CBT efficacy, including several translational-research agendas ranging from studies of de novo fear conditioning to the application of memory enhancers (i.e., d-cycloserine) to enhance exposure-based treatments. Dr. Otto has published over 200 articles, book chapters, and books spanning his research interests. Dr. Otto is currently President of the Association for Behavior and Cognitive Therapies (formerly AABT), a fellow of the American Psychological Association, and a member of the Scientific Advisory Board for the Anxiety Disorders Association of America. He also serves as on the editorial boards of Anxiety, Behavior Research and Therapy, Clinical Psychology: Science and Practice, Cognitive and Behavioral Practice, Journal of Anxiety Disorders, Journal Watch in Psychiatry, and Psychotherapy and Psychosomatics. Dr. Otto is a regular provider of continuing education and continuing medical education workshops across the United States.

 

Workshop 14

Anger Assessment and Treatment

Raymond Novaco, University of California, Irvine, USA

Workshop Background: Anger dysregulation is commonly observed in various personality, psychosomatic, and conduct disorders, in schizophrenia, in bipolar mood disorders, in organic brain disorders, in impulse control dysfunctions, and in a variety of conditions resulting from trauma. Anger is a common precursor of aggressive behaviour, and it can be unsettling for mental health professionals as a treatment focus. Clients with recurrent anger problems are often not eager to engage in treatment. As treatment should be grounded in assessment of anger control deficits, various psychometric, staff-rated, and interview methods will be overviewed. CBT anger treatment will be presented, focusing in this brief workshop on cognitive restructuring techniques and 'stress inoculation' provocation hierarchy procedure. Both individual-based and group-based treatment will be addressed. Anger assessment is not straightforward, because of reactivity to the testing situation and the multi-dimensionality of anger. Targeting anger treatment and ascertaining therapeutic gains, hinges on assessment proficiency. Issues of validity will be delineated, and recommendations for clinical service will be given. Anger psychometrics, including use of an imaginal provocation test, will be presented. Getting treatment engagement with chronically anger people presents multiple challenges, especially if they are seriously disordered and historically assaultive. Cognitive-behavioural anger treatment has demonstrated efficacy with patients in secure hospitals, patients with developmental disabilities, and a variety of community outpatients, including clients having severe posttraumatic stress disorder. Core themes arising in the treatment process and ways of obtaining leverage for change through a 'preparatory phase' will be discussed. Achieving therapeutic change by addressing symbolic structures associated with anger and aggression will be illustrated. Case examples will be provided for practice. The format for the workshop will be didactic and experiential with structured exercises.

Key learning objectives: 1. Introduction to key anger assessment tools 2. Cognitive structuring techniques for anger engendering cognitions 3. Procedures for developing anger provocation hierarchies 4. Procedures for stress inoculation exposure therapy for anger control 5. Individual and group-based applications.

Training Modalities: didactic with small group experiential practice.

Key references: Novaco, R. W. The Novaco Anger Scale and Provocation Inventory (NAS-PI). Los Angeles: Western Psychological Services, 2003. Novaco, R. W., Ramm, M., & Black, L. (2000).

Anger treatment with offenders. In C. R. Hollin (Ed.), Handbook of offender assessment and treatment (pp. 281-296). Chichester: John Wiley. Novaco, R. W. & Taylor (2004).

Assessment of anger and aggression in offenders with developmental disabilities, Psychological Assessment, 2004, 16, 42-50. Taylor, J. L., & Novaco, R. W. Anger treatment for people with developmental disabilities: A theory, evidence, and manual based approach. London: John Wiley & Sons, 2005.

Workshop Leader: Raymond W. Novaco, Ph.D., is Professor of Psychology and Social Behavior at the University of California, Irvine, USA. He pioneered CBT anger treatment and coined the term "anger management". He has worked extensively on the subjects of anger and violence, including clinical research conducted in the UK, which remains on going

 

Workshop 15

Focusing on What Works with Mindfulness and Metacognition: An Introduction to the Method of Levels

Tim Carey, Fife Primary Care Trust, NHS

Relevant Background: Increasing and improving a client's awareness of their problem is often an implicit factor in the success of many traditional cognitive behavioural techniques. The redirection and focussing of awareness, therefore, can be considered a basic therapeutic process in cognitive therapy. Through completion of activities such as thought diaries and activity schedules clients may become more aware of the extent of their problems, important areas to target, and also their rate of improvement. Later developments such as schema focussed work, guided discovery, and mindfulness approaches also utilise the mobility of awareness to access different aspects of a client's consciousness. The method of levels (MOL) is a cognitive technique that explicitly harnesses a client's awareness to direct thei! r attention to higher and deeper cognitive levels. MOL helps the client focus on the process by which their difficulties manifest rather than the specific content of any particular difficulty. In this way the client is enabled to become more aware of the nature of their difficulties. From this point of view a problem solving perspective is pursued and the client is assisted in generating solutions to their troubles. As a way of helping clients focus on process rather than content, MOL can be used to enhance the effectiveness of treatments for specific problems and disorders and also to address issues in the delivery of treatment such as lack of engagement, poor motivation, and resistance.

Key Learning Objectives: By the end of the workshop the participants will have had opportunities to:
1. Understand the role of awareness in symptom reduction.
2. Identify the role of awareness in their current practices.
3. Explore the implications of incorporating more awareness activities in their current practices.
4. Participate in awareness focussing activities.
5. Experience shifting awareness of others through role-play.

Training Modalities: 1. Didactic 2. Group Discussion 3. Role play 4. Experiential.

Key References: Carey, T. A. (2005). Can patients specify treatment parameters? A preliminary investigation. Clinical Psychology and Psychotherapy: An international journal of theory and practice, 12(4), 326-335.

Carey, T. A. (due for publication January 2006). The Method of Levels: How to do psychotherapy without getting in the way. Hayward, CA: Living Control Systems.

Workshop Leaders: Timothy A. Carey PhD is a Chartered Clinical Psychologist and cognitive therapist. He works in the Fife Primary Care Trust and has been developing MOL in clinical settings in Australia and Scotland over the last eight years. Recently he has been researching the effectiveness of MOL in primary care settings. He has presented at conferences in Australia, New Zealand, Singapore, the USA, and Canada. In July 2005 he conducted a positively evaluated three-day MOL workshop in Canada. He uses MOL in his clinical practice, supervises cognitive behavioural psychotherapists in the use of MOL, and conducts an MOL discussion group.

 

Workshop 16


CBT for OCD in Children and Adolescents

Polly Waite and Catherine Gallop University of Reading

Relevant Background: This workshop will describe an approach to the treatment of OCD with children and adolescents, which is being used in a treatment trial run by the University of Reading and the Institute of Psychiatry, London.

Key Learning Objectives: The aims of the workshop are that attendees will have a conceptual overview of the assessment and treatment of OCD using CBT, be familiar with tools and techniques and understand when they can be used and to also consider how therapy can be adapted to meet the developmental needs of the young person and their family.

Training Modalities: The workshop will be interactive throughout and as well as power point presentation, will involve role-plays, videotaped demonstrations of key interventions and extensive use of illustrative clinical material.

Key References: Williams, T.I., Salkovskis, P.M., Forrester, E.A. & Allsopp, M.A. (2002) Changes in symptoms of OCD and appraisal of responsibility during cognitive behavioural treatment: A pilot study. Behavioural and Cognitive Psychotherapy, 30, 69-78.

Salkovskis, P.M. et al (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research & Therapy, 38, 347-372. Freeston, M.H. (2001).

Cognitive behavioural treatment of a 14-year old teenager with obsessive compulsive disorder. Behavioural and Cognitive Psychotherapy, 29, 71-84.

Workshop Leaders: Dr Polly Waite and Dr Catherine Gallop are Clinical Psychologists and Senior Research Fellows at the University of Reading and are working on a CBT treatment trial for young people with OCD, jointly run with the Institute of Psychiatry.

 

Workshop 17

The Power of Affect: Principles of Emotion-focused Therapy

Diana Wais, AEDP Institute

Relevant Background: Emotion-focused therapies provide an empirically based, active, structured approach for treating chronic and complex emotional problems. The model draws on recent advances in neuroscience, attachment research, emotion theory, trauma studies and psychotherapy process research. The main focus is to help patients feel their feelings during sessions and learn new ways of working with them, rather than avoid or control them. With the moment by moment active help of the therapist, the patient learns to access, tolerate, regulate, transform and resolve previously feared and difficult feelings. This often leads to rapid symptom reduction. Knowing why one feels something, or wishing the feeling was not there, is not always enough to make the feeling go away. This is because some emotional processes occur in the limbic structures of the brain, outside of conscious control. Emotion-focused techniques attempt to activate those structures during treatment and process and transform such feelings. These in-session corrective emotional experiences in turn provide new procedural knowledge of adaptive emotion regulation for the patient.

Key Learning Objectives:
1. The Map: Understand the links between early attachment experiences, emotion regulation problems and psychopathology. Learn to recognize emotion regulation problems in your clients.
2. Distinctions: Learn to distinguish different types of affect, ie. primary, secondary, adaptive, maladaptive, healing, etc.
3. Techniques: Learn techniques for working with and regulating emotions in session; ie. techniques to access feelings that are "stuck", techniques to regulate and soothe feelings that feel overwhelming, etc.

Training Modalities: 1. Video Demonstration: see video presentations of actual clinical sessions with real patients 2. Didactic: an explanation of key principles, distinctions and techniques.

Key References: Greenberg, L. (2002). Emotion-Focused Therapy: Coaching Clients to Work Through Feelings. Washington, DC: American Psychological Association Press. (www.emotionfocusedtherapy.org)

McCullough L, Kuhn N, Andrews S, Kaplan A, Wolf J, Hurley C. Treating Affect Phobia: a Manual for Short-Term Dynamic Psychotherapy, Guilford Press, 2003. (www.affectphobia.org)

Fosha, D. (2000). The Transforming Power of Affect: A Model for Accelerated Change. New York: Basic Books (www.aedpinstitute.com).

Workshop Leader: Diana Wais, Ph.D. obtained her doctorate in clinical psychology from the State University of New York at Stony Brook, where she first trained in CBT. Her research on attachment and emotional processes led her to study for many years with the developers of emotion-focused therapies, such as Dr. Leslie Greenberg, Dr. Leigh McCullough and Dr. Diana Fosha. Three years ago, Dr. Wais moved to the UK and started working for the NHS. Currently, Dr. Wais is on the faculty of the AEDP Institute (www.aedpinstitute.com), and its representative in London, where she is in private practice, teaches and supervises.