In-Conference Workshops.
Thursday 17th, Friday 18th and Saturday 19th July

Delegates attending the BABCP Annual Conference will be able to attend one or more of the half-day workshops (2-3 hours) scheduled in the programme. There is a small extra charge of £20 for each of these workshops and you can use the form at the back of this programme to make a booking in advance. Alternatively you can register when you arrive at the Workshop desk near to the conference registration in the Exhibition Centre. Places will be limited for each workshop and will be allocated on a first come first served basis.
 
Workshop 1 The Treatment of Childhood and Adolescent Trauma Caused by acts of Terrorism
Alastair Black, Child and Adolescent Therapy Service, Northern Ireland
Workshop 2 Treating Clients with Maladaptive Habits, Tics, Tourette’s Syndrome, and Stuttering Using the Habit Reversal and Regulated Breathing Treatment Program
R. Gregory Nunn, National University and San Diego City Schools
Workshop 3 An Introduction to Contemporary Rational Emotive Behaviour Therapy
Robert Willson, Priory Hospital North London and Goldsmith’s College, London, and John Blackburn, Community Health Sheffield (NHS Trust)
Workshop 4 Working with Complex Clients
Angus Forsyth Newcastle, North Tyneside and Northumberland Mental Health NHS Trust and Paul Cromarty Newcastle, North Tyneside and Northumberland Mental Health NHS Trust & St Martins College Carlisle.
Workshop 5 Using cognitive-behavioural strategies to reduce suicidal ideation.
Wayne Froggatt, New Zealand Centre for Rational Emotive Behaviour Therapy
Workshop 6 Cognitive Therapy for Chronic Insomnia
Allison G. Harvey and Melissa J. Ree, University of Oxford
Workshop 7 Half-day workshop on Cognitive Behaviour Therapy for children and adolescents with Obsessive Compulsive Disorder
Dr Tim Williams, Berkshire Healthcare NHS Trust and School of Psychology, University of Reading
Workshop 8 Using imagery work and processing techniques with clients suffering from complex trauma experiences, including childhood sexual abuse
Claudia Herbert, The Oxford Development Centre, Oxford
Workshop 9 Treatment of Adult ADHD: Combining Cognitive and Medical Approaches
J. Russell Ramsay, and Anthony L. Rostain, University of Pennsylvania, USA
Workshop 10 Exposure-based work with avoidant children and young people
David Trickey, Traumatic Stress Clinic, London
Workshop 11 Cognitive Therapy for Bulimia Nervosa
Myra Cooper, University of Oxford, and Gillian Todd, University of Cambridge.
Workshop 12 CBT for traumatized refugees and asylum seekers
Kerry Young, Traumatic Stress Clinic, Camden & Islington Mental Health & Social Care NHS Trust and University College London and
Nick Grey,
Centre for Anxiety Disorders and Trauma, Maudsley Hospital, and Institute of Psychiatry, London
Workshop 13 Applicable research methods for practitioners
Nancy Pistrang and Chris Barker, University College London
Workshop 14 The Cognitive-Behavioural Treatment of Trauma Victims – PTSD and Beyond
Michael J. Scott, University of Manchester
   
   

Workshop 1

The Treatment of Childhood and Adolescent Trauma Caused by acts of Terrorism

Alastair Black, Child and Adolescent Therapy Service, Northern Ireland

Aims and Rationale
This workshop will examine Terrorist trauma and its impact on children and adolescents and how this form of traumatic event differs from other trauma stressors. Terrorist Trauma will be initially defined and explored in terms of traumatic acts perpetrated by organised extremists or individuals. Therefore this workshop will be particularly relevant in the treatment of those who have experienced such acts either first hand or vicariously. As terrorism is an increasingly global issue the workshop will be relevant to the treatment of the children of refugee populations.

Various types of critical incidents will be examined along with associated PTSD symptoms. In addition the concept of secondary trauma will be explored and the impact of parental trauma psychopathology on children and the family unit. The workshop will also cover factors that complicate treatment and affect prognosis such as multiple incident terrorist trauma, ongoing terrorist threat and the lack of ability due to age in conceptualising terrorist attacks.

In addition to exploring psychopathology traditionally associated with trauma other connected childhood symptoms will be examined such as OCD, self-harm, eating disorders etc. and how this is incorporated into the treatment plan. The main treatment approach presented will be cognitive behavioural psychotherapy but other therapeutic tools such as EMDR, art and play therapy will be explored within the context of the CBT model.

Learning Objectives

Gain an overview of trauma due to acts of terrorism and how this differs from other traumatic stressors.
Examine how terrorist trauma impacts on children and young people’s mental health, behaviour, level of functioning and perception of the world.
Explore PTSD symptoms including vicarious traumatisation due to parental psychopathology.
Gain an understanding of how trauma in children and adolescents may be displayed in other symptoms such as OCD, deliberate self-harm and eating disorders.
Be able to formulate a treatment plan for children and adolescents affected by terrorism including being able to prioritise treatment targets and deal with additional complications such as ongoing terrorist threats and multiple incident terrorists acts

Teaching Methods
The workshop will involve a didactic element including the presentation of clinical case studies illustrating terrorist trauma and also an experiential element incorporating a group exercise and discussion focusing on formulating a CBT treatment plan for children of young people who have suffered trauma due to an act of terrorism.

Workshop Leader
This workshop will be led by Alastair Black who runs the Child and Adolescent Therapy Service for the Police Rehabilitation and Retraining Trust in Northern Ireland. This CBT service provides treatment for children and young people who have developed mental health problems due to experiencing terrorist attacks, an ongoing terrorist threat or as a result of the impact of their parent’s police service and psychopathology. Alastair also provides CBT clinics within child psychiatry and adolescent psychiatry services within Northern Ireland. He is a BABCP accredited Cognitive Behavioural Psychotherapist and an EMDR Europe Approved Consultant and is currently conducting research into the psychological health of police children in Northern Ireland.


Workshop 2

Treating Clients with Maladaptive Habits, Tics, Tourette’s Syndrome, and Stuttering Using the Habit Reversal and Regulated Breathing Treatment Program

R. Gregory Nunn, National University and San Diego City Schools

Aims and Rationale
Maladaptive and undesirable habits, tics, Tourette’s Syndrome (TS), and stuttering are extremely common problems which can seriously affect the personal relationships and self-esteem of individuals who suffer from them. Because these problems can cause acute psychological distress, many different types of treatments for them have been developed.

The earliest treatments were provided by French physicians who regarded tics as "by-products of a deranged nervous and mental condition" which were "incurable because of their hereditary and pathogenic nature." Gradually, the purely medical model was reassessed as physicians and psychologists studying child development collected data demonstrating the high incidence of so-called "nervous habits" and tic-like movements among all children.

Emphasis shifted from the deviate whose movements were plainly neurotic, to the early identification and study of movement mannerisms and habits displayed by normal, healthy children. Researchers hoped to differentiate between persons with tics and those with transient, childhood movements which, while habitual, did not justify or require treatment. The identification of early manifestations was important from the standpoint of prevention since results of treatment with older tiqueurs were extremely poor. As summarized by Yates, "If a tic, whatever its origin, becomes a strong habit, it will, like all strong habits, become extremely resistant to any form of modification." (P. 201). Unfortunately, classification and epidemiologic studies did not lead to prevention, and this, coupled with poor results using conventional therapies, led to a decline in interest among researchers and clinicians.

The past two decades, however, have brought a renewed interest in the treatment of these disorders. Learning-based approaches have provided practitioners with new perspectives and outcome data regarding treatment. The basic medical, psychodynamic, cognitive, and behavioural approaches have been combined and extended into effective treatments for individuals suffering from habit disorders, tics, and stuttering.

Habit Reversal is a behavioural treatment approach which has proven to be a highly effective, multicomponent, “General treatment” for habit disorders and tics including TS (Azrin & Nunn, 1973; Azrin & Nunn, 1977; Nunn, 1978; Azrin, Nunn & Frantz, 1980; Azrin & Peterson, 1988a; Finney, Rapoff, Hall, & Christopherson, 1983; Franco, 1981; Zikis, 1983; O’Connor et. al. 2001;Miltenberger, 2001).

In this Workshop we will discuss the identification, nature, and treatment of children, adolescents, and adults with these type of problems. Specifically we will cover the diagnosis and treatment of individuals using the Habit Reversal and Regulated Breathing Treatment Procedures of Azrin and Nunn as well as treatment variations that have evolved from their original work including behavioural-cognitive interventions, e.g. Kieron O’Connor’s treatment recommendations. Case studies are included where possible and workshop participants are strongly encouraged to provide input.

Learning Objectives

To identify and diagnose maladaptive habits, tics, TS, and stuttering with children and adults.
To understand the theoretical rationales that have spawned the many treatments for these types of problems.
The Habit Reversal and Regulated Breathing Treatment Procedures.
Common pitfalls of treatment and ways of overcoming them.

· Questions that will be answered

How are most habits diagnosed?
What are the components of the Habit Reversal Treatment Program?
How are the Habit Reversal and Regulated Breathing Procedures applied to various types of habits, tics, TS, and Stuttering?
What type of Competing Activity would you teach for nailbiting, eyeblinking, and a stuttering block?
Why are the Habit Reversal and Regulated Breathing Programs successful?

Who is the workshop aimed at
All practitioners, educators, and other professionals working with children, adolescents, or adults presenting with these types of problems.

Workshop Leader
Dr. Greg Nunn is a Licensed Clinical Psychologist specializing in applied behaviour analysis and school psychology. He is Board Certified as a Behaviour Analyst as well as in Forensic Medicine. In the early 1970's he, along with Dr. Nathan Azrin, co-designed a general psychological treatment model that has proven highly effective in treating a variety of maladaptive habits, tics, Tourette's Syndrome, and stuttering known as Habit Reversal and Regulated Breathing. Their work has been published in various national and international scientific journals, as invited chapters in books, as a book, Habit Control, and presented at national and international conventions. Their book, Habit Control, was previously selected as one of the Outstanding Books of the Year in the field of behaviour therapy by Psychology Today. Dr. Nunn's work in this field continues to grow in clinical use and popularity and Habit Reversal was selected as one of the Best in Behaviour Research and Therapy by the editors of The Journal of Behaviour Research and Therapy in 1997. Dr.’s Nunn and Azrin’s work has been independently replicated and the results published in many research articles by practitioners throughout the world.


Background Readings:
1. Azrin, N. H., & Nunn, R. G. (1973). Habit reversal: A method of eliminating nervous habits and tics. Behaviour Research and Therapy, 11, 619-628.
2. Azrin, N. H., & Nunn, R. G. (1977). Habit control in a day. New York: Simon & Schuster.
3. Azrin, N.H., Nunn, R.G. and Frantz, S.E. (1979). Comparison of Regulated Breathing Versus Abbreviated Desensitization on Reported Stuttering Episodes. Journal of Speech and Hearing Disorders. 44, 331-339.
4. Azrin, N. H., & Peterson, A. L. (1988). Behaviour therapy for Tourette's Syndrome and tic disorders. In D. J. Cohen, J. F. Leckman, and R. D. Bruun (Eds.), Tourette Syndrome and Tic Disorder& Clinical Understanding and Treatment. New York: John Wiley.
5. Miltenberger, R. G. (2001). Habit Reversal Procedures. In Miltenberger, R. G. Behaviour Modification Principles and Procedures, Second Edition. Belmont, CA. Wadsworth/Thomson Learning:
6. Nunn, R.G. (1978), Maladaptive Habits and Tics, in The Psychiatric Clinics of North America (Ed. Liberman). W.B. Saunders Co.
7. O’Connor, K. P., Brault, M., Robillard, S., Loiselle, J., Borgeat, F., and Stip, E. (2001), Evaluation of a Cognitive-Behavioural Program for the Management of Chronic Tic and Habit Disorders. Behaviour Research and Therapy, 39, 667-681


Workshop 3

An Introduction to Contemporary Rational Emotive Behaviour Therapy

Robert Willson, Priory Hospital North London and Goldsmith’s College, London, and John Blackburn, Community Health Sheffield (NHS Trust)

Aims and Rationale
Rational Emotive Behaviour Therapy (REBT) was originated by Ellis in 1955, one of the earliest cognitive behavioural approaches to counselling and psychotherapy. However it is striking that despite nearly 50 years of practice, research, and development, REBT is frequently poorly understood or misunderstood, even by therapists working within the cognitive behavioural tradition. REBT is sometimes misrepresented as overly didactic, as paying insufficient attention to the therapeutic relationship, and ignoring formulation.

Learning objectives: The purpose if this workshop is to present current theory and practice of REBT, and perhaps dispel a few misconceptions. Though considerable crossover between REBT and CT has made it harder to distinguish the two approaches, REBT retains some distinctive features. The workshop aims to highlight some of these features, for example REBT approaches to helping clients develop self-acceptance and high frustration tolerance.

Teaching methods
Didactic and discussion.

Workshop Leaders:
John Blackburn
MSc. Is a Rational Emotive Behaviour Therapist working for Community Health Sheffield (NHS Trust).
Rob Willson BSc. MSc., Rational Emotive Behaviour Therapist, works as CBT programme coordinator at the Priory Hospital North London and Visiting Tutor at Goldsmiths College, University of London.

Background Readings:
1. Dryden, W., Yankura, J. and Neenan, M. (1999). Counselling Individuals: A Rational Emotive Behaviour Handbook, 3rd edition. London: Whurr
2. Dryden, W. (ed) Idiosyncratic approaches to Rational Emotive Behaviour Therapy.


Workshop 4

Working with Complex Clients

Angus Forsyth Newcastle, North Tyneside and Northumberland Mental Health NHS Trust and Paul Cromarty Newcastle, North Tyneside and Northumberland Mental Health NHS Trust & St Martins College Carlisle.

Abstract
The workshop will provide a model of understanding complex clients and will be of particular benefit to those professionals either implementing cognitive therapy or involved in supervision and consultation to the secondary care team. The workshop will examine the attributional framework upon which intentions to help are based on and will then be related to the underlying assumptions that interfere with the development of effective therapeutic alliance with this client group. Working within this framework will enable professionals to become adept at formulating and the development of more flexible and adaptable assumptions which will begin to positively influence the therapeutic relationship and validate the clients experience.

Learning Objectives:-
By the end of the half-day workshop participants will be able to:

Develop a model of understanding of non-clinical formulation
Implement cognitive behavioural interventions to promote cognitive therapy conceptualisation to clinical presentations in acute in-patient settings
Develop the ward environment as therapeutic laboratory

Teaching methods
The workshop will comprise a range of learning strategies, which will involve didactic presentations; demonstrations, experiential exercises; group work and discussions.

Workshop Leaders
Angus Forsyth: Nurse Consultant in Adult Acute Inpatient Services: Experienced trainer and practitioner in cognitive behaviour therapy. A major component of his role involves implementing cognitive therapy in acute in-patient settings with clients who are difficult to engage and are often found to be unsuitable for standard psychological interventions. Angus is currently involved in research on the effect of diagnosis and therapy withdrawal on alliance processes in acute psychiatric settings.

Paul Cromarty: Clinical Nurse Specialist/Senior lecturer in CBT. Paul is an experienced CBT therapist and supervisor at the Newcastle Cognitive and Behavioural Therapies Centre. His role has included developing and leading a Staff Support Strategy for acute psychiatric services in his trust, ranging from organisational consultancy, supporting staff following untoward incidents and formulation workshops for in-patient teams. He has been involved as a supervisor and lecturer in CBT at Diploma, Degree and Masters level and is currently Course Director of the CBT (Hons) Degree in Carlisle.

Background Readings
1. McGuiness,P & Dagnan,D (2001) Cognitive Emotional Reactions of Care Staff to Difficult Child Behaviour. Behavioural & Cognitive Psychotherapy, Vol29, pp295-302.
2. Safran,JD (1996) Interpersonal Process in Cognitive Therapy. New Jersey. Jason Aronson.
3. Weiner,B (1995) Judgements of Responsibility: a foundation for a theory of social conduct. New York, Guilford Press.


Workshop 5

Using cognitive-behavioural strategies to reduce suicidal ideation.

Wayne Froggatt, New Zealand Centre for Rational Emotive Behaviour Therapy

Aims and Rationale
An increasing suicide rate has created concern in the helping professions and the public at large. Much recent training has been appropriately directed at assessment and safety issues. But what do you do when safety has been taken care of? This workshop will show how cognitive-behaviour therapy can be used to go beyond protecting the person to help them reduce their suicidal ideation.

Learning objectives
At the end of the workshop, participants will know:

the basics of assessing suicide risk, deciding between protection and treatment, and planning immediate management of risk;
in particular, how to use a variety of cognitive-behavioural techniques to reduce depressive and suicidal ideation, including time projection, benefits calculation, decatastrophising, double standard technique, replacement imagery, behaviour rehearsal, activity scheduling and coping plans.

Teaching methods
Teaching methods for this 3-hour 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 of the techniques followed by experiential practice work. Participants will also be provided with information on obtaining a detailed handout on the workshop content from the presenter’s internet website.

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, Eastern Institute of Technology; Executive Director, New Zealand Centre for Rational Emotive Behaviour Therapy; Consultant Director, UK Centre for REBT; author of Choose to be Happy, GoodStress, Relaxation for the Real World, The Rational Treatment of Anxiety, Learning to use Rational Emotive Behaviour Therapy, Learning to use Cognitive-Behaviour Therapy and FearLess (in print).

Background Readings
1. Froggatt, W. (2001). The Rational Management of Self-Harm Risk: A cognitive-behavioural/problem-solving approach. In: Froggatt, W: Learning to Use Cognitive-Behaviour Therapy: An integrated approach. Hastings: Rational Training Resources.
2. Ellis, T.T. & Newman, C.F. (1996). Choosing to Live. Oakland: New Harbinger Publications.
3. Freeman, Arthur & White, David. M. (1989). The Treatment of Suicidal Behavior. In: Freeman et al (Eds.) Comprehensive Handbook of Cognitive Therapy. New York: Plenum Press,.
4. Ministry of Health. (1993). Guidelines on the Management of Suicidal Patients. Wellington: Ministry of Health.
5. Williams, J.M.G. & Wells, J. (1989). Suicidal Patients. In: Scott, J., Williams, J.M.G. & Beck, A.T. (Eds.) Cognitive Therapy in Clinical Practice: An Illustrative Casebook. London: Routledge.


Workshop 6

Cognitive Therapy for Chronic Insomnia

Allison G. Harvey and Melissa J. Ree, University of Oxford

Rationale
Insomnia is a complex disorder of heterogeneous aetiology that can include physical disorders, substances, circadian rhythm disturbances, psychological factors, and poor sleep habits. It is the second most common psychological health problem and has serious consequences including functional impairment, work absenteeism and increased use of medical services. Further, longitudinal studies indicate that insomnia significantly heightens the risk of developing depression or an anxiety disorder (Breslau et al., 1996: Ford & Kamerow, 1989) and is a prodrome for relapse in dipolar disorder (Lam et al., 1999). Despite the impact of insomnia on the sufferer, this disorder has received relatively little attention in terms of treatment development. Further, few CBT training courses include a module on sleep disorders. This has resulted in many health professionals being unconfident in the treatment of insomnia.

Learning Objectives
The aim of this mini-workshop is to outline the treatment components that comprise cognitive therapy for chronic insomnia. Both primary insomnia and insomnia that is secondary to another medical or psychological disorder will be described.
During the workshop we will outline:

The function of sleep and nature of sleep disorders
The assessment of clients with insomnia
The behavioural treatment for insomnia and its evidence base
Cognitive case conceptualisation
The management of worry/rumination about poor sleep
Behavioural experiments to tackle unhelpful beliefs about insomnia, monitoring for sleep-related threats, the use of safety behaviours, and fear of poor sleep.

Who the workshop is aimed at
This workshop is aimed at clinicians who have experience in the use of CBT and are interested in learning new ways of conceptualising and managing primary and secondary insomnia (students and people hoping to pursue clinical training also welcome).

Teaching Methods
Teaching methods will include interactive presentation, video clips case studies, and discussion.

Workshop leaders
Allison Harvey and Melissa Ree are clinical psychologists based in the Department of Psychiatry, University of Oxford. They are both working as therapists on a study testing the efficacy of a new cognitive therapy treatment for chronic insomnia that is being conducted with the Oxford Centre for Insomnia Research and Treatment. Allison Harvey is also a University Lecturer in the Department of Experimental Psychology, University of Oxford.

Background Readings
1. Harvey, A.G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40, 869-893
2. Horne, J. (1988). Why we sleep: The functions of sleep in humans and other mammals. Oxford: Oxford University Press
3. Morin, C.M. (1993). Insomnia: Psychological assessment and management. New York: Guildford Press


Workshop 7

Half-day workshop on Cognitive Behaviour Therapy for children and adolescents with Obsessive Compulsive Disorder

Dr Tim Williams, Berkshire Healthcare NHS Trust and School of Psychology, University of Reading

Aims and Rationale
The workshop will describe techniques for working with children and adolescents with obsessive compulsive disorder. The techniques are based on those used in a recently completed small scale randomised controlled trial of CBT for young people with OCD. The model of OCD is that pioneered by Salkovskis and his colleagues, and concentrates on responsibility appraisals as a key feature of the maintenance of OCD.

Following an initial assessment the formulation is shared with the parent and the young person. The formulation is used to plan the work, which the young person will carry out at home (homework – well known to young people). The following ten or so sessions are used to refine the formulation, identify problems with carrying out the homework and joint problem solving. The learning process is explicitly cooperative, with the ultimate aim being to be able to experience the obsessive thoughts without needing to perform the compulsive rituals. The aim of the workshop is to enable participants to become more confident in the application of cognitive techniques to the management of obsessive compulsive disorder in young people.

Learning objectives

The use of questionnaires to elucidate cognitive distortions will be described.
Adaptations of the method for different types of comorbidity will also be discussed.
If possible participants will be expected to bring case material of their own for discussion. If such material is available a less didactic approach can be adopted.

 

Workshop Leader
Dr Tim Williams is a consultant clinical psychologist working in Berkshire. He has held an NHS Research grant to carry out a small randomised controlled trial of CBT for young people with OCD and has just been jointly awarded with colleagues from the Institute of Psychiatry a research grant from the PPP foundation to extend this work.

Background Readings
1. Salkovskis, P.M. and Kirk, J. (1997) Obsessive-compulsive disorder, in, Clark, D.M. and Fairburn, C.G. (Eds). The science and practice of cognitive-behaviour therapy, Oxford University Press: Oxford.
2. Salkovskis, P.M., Forrester, E. and Richards, H.C. (1998) The cognitive behavioural approach to understanding obsessional thinking. British Journal of Psychiatry, 173: 53-63.
3. Salkovskis, P.M. (1999) Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37: 29-52


Workshop 8

Using imagery work and processing techniques with clients suffering from complex trauma experiences, including childhood sexual abuse

Claudia Herbert, The Oxford Development Centre, Oxford

Aims and Rationale
Therapeutic work with complex trauma clients requires a different clinical framework and the use of additional skills and techniques (Herbert, in print), than work with clients suffering from Posttraumatic Stress Disorder (PTSD) caused by single-incident or Type I trauma (Herbert & Wetmore, 1999, 2001). For complex trauma clients there is no defined index trauma, but rather a series of traumatic experiences, usually originating in early childhood and infancy. Traumatic material is often fragmented or only very partially accessible and unravels in stages, often in the form of body memories (Rothschild, 2000) and complex trauma clients have little or no conscious access to a positive model for coping with life and may never have known or experienced feelings of safety, love or esteem in their life. Their current lives may be marred by feelings of underachievement and a stream of unhappy working or private relationships, physical or psychiatric problems, often accompanied by feelings of complete emptiness or severe pain inside. One area of particular concern for therapists working with complex trauma clients is often whether to help their clients process past traumatic experiences, and if so, when in the course of therapy it would be an appropriate choice of timing to do so. Another clinical dilemma centres around how to do the actual processing work with clients, who may be plagued by flashbacks and body memories, but have little direct cognitive access to their traumatic experiences. This in-conference workshop will explore some therapeutic solutions to the above outlined clinical dilemmas.

Learning Objectives

Introduction of a therapeutic framework on how to work with complex trauma clients
Learning of specific imagery and processing techniques that have been successfully used in clinical practise with this client group
Introduction to methods of working with trauma body memories and dissociative flashbacks (black-outs), using a 3-system approach (Herbert, in print)

Teaching methods
Training will be didactic with experiential work being offered to further embed learning. Active audience participation will be encouraged and there is some limited scope for bringing in questions regarding participants’ own client cases for brief supervisory advice. Some experience of working with complex trauma clients is desirable.

Workshop Leader
Dr Claudia Herbert, BSc, MSc, DClin Psy, AFBPsS is a Chartered Clinical Psychologist and UKCP registered Cognitive Behavioural Psychotherapist, and EMDR Consultant and an Associate Member of the British Psychological Society. She is 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 the field of post trauma reactions and presents at conferences worldwide. She has published several articles and two books on trauma. She is engaged in a number of professional organizations, sits on the editorial board of the Journal of Behavioural & Cognitive Psychotherapy and also works with organizations and business as a consultant.

Background Readings
1. Herbert, C. (in print) - A CBT-based therapeutic alternative to working with complex client problems. Invited response to Acting, Feeling and Thinking – Psychoanalytic Psychotherapy with Tracey. European Journal of Psychotherapy, Counseling and Health
2. Herbert, C. & Wetmore, A. (1999, 2001) – Overcoming Traumatic Stress. A self-help guide using cognitive-behavioral techniques. Robinson & Constable Publishing, London. American Version published by New York University Press (2001)
3. Rothschild, B. (2000) - The Body remembers –The Psychophysiology of Trauma and Trauma Treatment. W.W. Norton & Company, London.


Workshop 9

Treatment of Adult ADHD: Combining Cognitive and Medical Approaches

J. Russell Ramsay, and Anthony L. Rostain, University of Pennsylvania, USA

Aims and Rationale
Attention-Deficit/Hyperactivity Disorder (ADHD) is a complex neurobehavioral disorder with widespread effects on behaviour, learning, and cognition, and social-emotional functioning that will persist into adulthood for over 50% of child patients. Moreover, many patients develop significant co-morbid psychiatric disorders requiring treatment.

The purpose of this workshop is to discuss the diagnosis and treatment of ADHD in adulthood, with particular emphasis on a combined treatment model, integrating psychopharmacology and cognitive-behavioural therapy. Outcome data for a sample of adult patients treated at the presenters’ clinic will be shared, which indicate that this combined treatment improves the functional status of adult patients with ADHD.

Learning Objectives
This workshop is designed to help attendee:

recognize the symptoms of ADHD as they manifest themselves in adult patients and to differentially distinguish them from symptoms associated with other disorders.
summarize the current research and clinical literature regarding pharmacological treatments and psychotherapy for adult ADHD.
design a cognitive-behavioural treatment plan and case conceptualisation for adult patients with ADHD.

Teaching methods
This 3-hour workshop will use a combination of didactics and case presentations, including discussion of cases presented by audience members.

Workshop Leaders
J. Russell Ramsay, Ph.D. is Assistant Professor of Psychology in Psychiatry at the University of Pennsylvania School of Medicine. In addition to serving as Associate Director of the University of Pennsylvania Adult ADHD Treatment and Research Program, he is a senior staff psychologist at the Center for Cognitive Therapy.
Anthony L. Rostain, M.D. is Associate Professor of Psychiatry and Paediatrics at the University of Pennsylvania where he serves as Director of Education for the Department of Psychiatry. Dr. Rostain is Co-Director of The Children’s Hospital of Philadelphia’s Paediatric Neuropsychiatry Program and Director of the University of Pennsylvania Adult ADHD Treatment and Research Program.

Background Readings
1. McDermott, S. P. (2000) Cognitive therapy for adults with attention-deficit/hyperactivity disorder. In T. E. Brown (Ed.), Attention deficit disorders and comorbidities in children, adolescents, and adults (pp. 569-606). Washington, D.C.: American Psychiatric Press.
2. Ramsay, J. R., & Rostain, A. L. (in press). A cognitive therapy approach for adult attention-deficit/hyperactivity disorder. Journal of Cognitive Psychotherapy: An International Quarterly.
3. Weiss, M., Murray, C., & Weiss, G. (2002). Adults with attention-deficit/hyperactivity disorder: Current concepts. Journal of Psychiatric Practice, 8(2), 99-111.


Workshop 10

Exposure-based work with avoidant children and young people

David Trickey, Traumatic Stress Clinic, London

Aims and Rationale
Traumatised and phobic children and adolescents, by definition, are trying to avoid something. However, this avoidance appears to maintain the symptoms and the best evidence available is that exposure-based treatment is an important component of treatment for PTSD symptoms and phobias. Evidence-based practice therefore dictates that clients generally need to remember, before they can ‘forget’ in the case of PTSD, or find their fear before they can lose it in the case of phobias. Consequently, interventions involve encouraging clients to do the very thing that they don’t want to do. This has important implications for how we explain the treatment rationale to them, and subsequently gain their fully informed consent: “you want me to do what!?”. How do we respect their fears, without colluding with them.

When working with children and young people, this becomes even more complex, because however collaborative we try to be, there is often an inevitable power imbalance, simply because we are adults and they are not. How persuasive should we be, and when does persuasive become coercive or even abusive? What are the risks of “re-traumatising” a young person with exposure treatment, and how might we avoid this?

Learning Objectives
By the end of the workshop, participants should have:

A greater understanding of the role of avoidance in maintaining PTSD and phobia symptoms
An increased familiarity with the evidence base and rationale for exposure based treatments
An increased awareness of the dilemmas involved in gaining consent from children and young people for exposure based treatments
Developed some ideas of how to approach such dilemmas
More knowledge concerning “re-traumatising”, and how to avoid it

Teaching methods
Didactic teaching, including clinical examples
Group discussion of relevant clinical dilemmas

Workshop leader
David Trickey is a Chartered Clinical Psychologist. He worked in South Lincolnshire for 6 years before joining the Child and Family Team at the Traumatic Stress Clinic at the beginning of 2000. His NHS post and his private work involve a number of different aspects specialising in traumatised children and families. These include: assessment and intervention of complex or chronic cases, consultation, teaching, and research. He is often consulted at an early stage following trauma and asked to inform the crisis response, particularly in train accidents, abductions, and family homicide cases. He facilitates clinical seminars and lectures on Doctorate Clinical Psychology Training Courses. In addition to psychology, his training includes family therapy and EMDR (Eye movement desensitisation and reprocessing).

Background Reading
1. Ehlers, A. & Clark, D.M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research & Therapy, 38, 319-345.
2. Paul, M., Foreman, D.M., Kent, L (2000). Out-patient clinic attendance consent from children and young people: Ethical aspects and practical considerations. Clinical Child Psychology & Psychiatry. 5(2), 203-211.


Workshop 11

Cognitive Therapy for Bulimia Nervosa

Myra Cooper, University of Oxford, and Gillian Todd, University of Cambridge.

Aims and Rationale
Bulimia Nervosa is a distressing, common and disabling disorder that can be very difficult to treat successfully. This workshop will present new developments in cognitive therapy (and theory) for bulimia nervosa (see Cooper, Todd & Wells, 2000; cooper, Wells & Todd, in pres). It is designed for practitioners of all levels who want an introduction to recent advances in the treatment of the disorder. Primarily skills based, it will teach participants how to develop a detailed conceptualisation of binge eating – taking into account different types of automatic thought (e.g. permissive thoughts, thoughts of no control, positive and negative thoughts about eating), feelings and behaviour.

Techniques to identify and challenge these thoughts will then be explained. This will include behavioural experiments and specially designed thought records. The role of behaviours in maintaining the disorder will be covered, and how to tackle these will also be explained. Participants will also learn how to develop a detailed conceptualisation of factors that may be important in the development of the disorder. This will take into account underlying assumptions, core (negative self) beliefs, and early experience. This will include the application of “state of the art” core belief strategies such as historical tests of beliefs and cognitive continua to bulimia nervosa.

Learning objectives
Participants will learn how to conceptualise bulimia nervosa using new developments in theory. This will include both the maintenance and development of the disorder. Participants will also learn how to apply novel, “state of the art” techniques to work with the thoughts and beliefs identified in such a conceptualisation.

Teaching Methods
These will include opportunity for experiential learning. Video material and examples from the authors’ practice will also be presented.

Workshop leaders
Myra Cooper, DPhil, is Research Tutor on the Oxford Doctoral Course in Clinical Psychology at the University of Oxford. She is an experienced cognitive therapist and supervisor, with a special interest in eating disorders. She is also an experienced researcher.
Gillian Todd, BA, is a cognitive therapist at the University of Cambridge. She has many years experience of working with eating disorders. She is currently working towards a PhD in the field.

Background readings
1. Cooper, M.J. (2003). Bulimia Nervosa: A Cognitive Perspective. Oxford: Oxford University Press.
2. Cooper, M.J. (1997). Cognitive theory in anorexia nervosa and bulimia nervosa: a review. Behavioural and Cognitive Psychotherapy, 25: 113-145
3. Cooper, M.J., Todd, G. & Wells, A. (2000). Bulimia nervosa: a self help cognitive therapy programme for clients. London: Jessica Kingsley
4. Cooper, M.J., Wells, A. & Todd, G. (in press). A cognitive theory of bulimia nervosa. British Journal of Clinical Psychology.


Workshop 12

CBT for traumatized refugees and asylum seekers

Kerry Young, Traumatic Stress Clinic, Camden & Islington Mental Health & Social Care NHS Trust and University College London and Nick Grey, Centre for Anxiety Disorders and Trauma, Maudsley Hospital, and Institute of Psychiatry, London

Who the workshop is aimed at
It should be suitable to clinicians of all levels, but some experience of both treating PTSD and working with asylum seekers and refugees would be advantageous. Familiarity of the general cognitive model and basic clinical skills are assumed.

Aims and Rationale
Increasingly clinicians are working with asylum seekers and refugees who present with multiple psychological and social problems. Almost invariably these clients have faced one or, more usually, a number of traumatic events both in their country of origin and also the UK. There are relatively few guidelines as to how best to approach treatment and therapists sometimes have unhelpful beliefs of their own about the difficulty of working with such cases. This workshop will outline a possible treatment pathway for clinicians to follow. This includes the role of asylum status, housing, and developing / integrating into social networks. Specific cognitive behavioural strategies to address depressive and posttraumatic stress symptoms will be detailed, including discussion of when and how to best use reliving / exposure techniques. Direct comparisons will be made between using ‘testimony’ and cognitive-behaviour therapy. The workshop will also address the issue of working with interpreters / translators. The main message for clinicians to take away is that they have the basic skills to work with such cases and that with careful thought about the timing and particular application of interventions progress can be made.

Learning objectives
Participants should:

Have a greater understanding of psychological presentations, especially PTSD and Depression, within asylum seeker and refugee populations.
Be able to plan a coherent treatment approach in difficult cases, including how and when to use reliving / exposure techniques.
Feel more confident about working with such cases, including the use of interpreters.

Teaching Methods
Use will be made of clinical examples including video and audiotape. Participants are encouraged to bring their own case material for discussion.

Workshop Leaders
Kerry Young, Traumatic Stress Clinic, Camden & Islington NHS Trust, & University College London, and Nick Grey, Centre for Anxiety Disorders and Trauma, Maudsley Hospital, & Institute of Psychiatry. Both presenters have worked for many years in specialist outpatient trauma services for adults including working with asylum seekers and refugees, particularly survivors of torture.

Background readings
1. Basoglu, M. (Ed.) (1992). Torture and its Consequences: Current Treatment Approaches. Cambridge: Cambridge University Press.
2. Ehlers, A. & Clark, D.M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research & Therapy, 38, 319-345.
3. Van der Veer, G. (1998). Counselling and Therapy with Refugees and Victims of Trauma: Psychological Problems of Victims of War, Torture and Repression (2nd ed.). Chichester: Wiley.


Workshop 13

Applicable research methods for practitioners


Nancy Pistrang and Chris Barker, University College London

Aims and Rationale
Practitioners often feel daunted by the prospect of conducting research in a working service setting. The potential barriers are many: lack of funding, time pressures, the complexity of standard research methods, the perceived exclusivity of the academic research community, the current emphasis on randomised controlled trials, and so on. However, in the last ten years or so, some new approaches to research have appeared that may be more congenial for working clinicians. This workshop will examine the issues involved in conducting research in clinical settings, and present some of these new approaches, especially those that involve small sample sizes, such as qualitative approaches; systematic case studies; and quasi-experimental designs.

Who is the workshop aimed at
Clinicians who want to put research into practice; those who want to know about the latest research methods; or learn about accessible ways of doing research when you have little time or resources.

Learning objectives
The workshop aims to give participants a good sense of the currently available methods for doing research in service settings and hopefully more confidence about combining research with clinical practice.

Teaching methods
There will be a combination of didactic presentation with group discussion: the final balance between the two will be determined by participants’ preferences. Individual participants’ research ideas or frustrations may be used as a basis for illustrating common research issues and their solutions.

Workshop leaders
Chris Barker and Nancy Pistrang are both Senior Lecturers in Clinical Psychology at UCL (and Honorary Clinical Psychologists in Camden & Islington Mental Health Trust). They have a joint research program focussing on psychological helping processes in clinical and non-professional contexts. They are currently researching the process and outcome of mutual support for a variety of psychological problems. They have co-authored (with Robert Elliott) a widely used clinical research methods text, a second edition of which is due out this summer. They also have an interest in virtual reality applications to clinical psychology.

Background readings
1. Barker, C., Pistrang, N., & Elliott, R. (2002). Research methods in clinical psychology: An introduction for students and practitioners. (2nd ed.) Chichester: Wiley.
2. Kendall, P.C., Butcher, J.N., & Holmbeck, G.N. (Eds.) (1999). Handbook of research methods in clinical psychology (2nd ed.). New York: Wiley.
3. Robson, C. (1993). Real world research: A resource for social scientists and practitioner researchers. Oxford: Blackwell.


Workshop 14

The Cognitive-Behavioural Treatment of Trauma Victims – PTSD and Beyond

Michael J. Scott, University of Manchester

Rationale
This workshop addresses the specifics of engaging and treating trauma victims, with different ports of entry for different diagnoses.

Learning objectives
Trauma victim’s wish to avoid the traumatic memory but the focus in cognitive-behaviour therapy (CBT) is on the trauma, in this workshop participants will learn how to resolve the conflicting agendas.

The engagement of client’s in CBT depends on the presentation of a credible rationale, in this workshop participants will learn how to translate the psychobiology of post-traumatic stress disorder (PTSD) into clinically useful analogy and pictures.

Extreme trauma effects not only the victim but also their friends/relatives, and the latter in turn effect the resolution of the victim’s symptoms, in this workshop participants will learn how to address the neglected interpersonal aspects of PTSD.

By the end of this workshop participants will have learnt how to help the client challenge the meaning of the trauma and it’s effects.

Learning objectives
In this workshop participants will learn how to address the specific concerns raised by clients with a) a sub-syndromal level of PTSD b) PTSD and Associated Symptoms (Complex PTSD) and c) PTSD in the severely mentally ill

Teaching methods
The workshop will be both didactic and experiential, involving small group role-plays.

Workshop leader
Dr Mike Scott is the author of the best-selling ‘Counselling for Post-traumatic Stress Disorder’, 5 other books on Cognitive-Behaviour Therapy, several book chapters and numerous papers. He is an Honorary Research Associate in the Department of Psychology at the University of Manchester, Consultant to a number of large organisations and has a private practice in Liverpool.

Background Readings
1. Scott, M.J & Stradling, S.G (2001) Counselling for Post-Traumatic Stress Disorder 2nd Edition London: Sage Publications.
2. Scott, M.J & Stradling, S.G (2001) Determining the cognitive ports of entry amongst the post-traumatic states: treatment implications. Behavioural and Cognitive Psychotherapy, 29, 245-250.
3. Scott, M.J & Stradling, S.G (1994) Post-traumatic Stress Disorder without the trauma. British Journal of Clinical Psychology, 33,71-74.