CBT Newtownabbey

Q: WHAT OTHER TREATMENTS ARE AVAILABLE FOR EMOTIONAL DIFFICUlTIES?

A: There are a number of treatment options; some people use "over the counter" preparations which are available through your local chemist or supermarket. These can include herbal or homeopathic remedies. Sometimes people talk to a friend or a minister, priest etc, or some use support groups of which there are many. Also acupuncture and hypnosis have been used, and of course there are multiple types of talking therapy.

Another common treatment, accessed via your GP, is prescription medication. Government guidelines indicate that treatments by prescribed medications versus CBT are broadly equal in outcomes, but that optimal outcomes are achieved when a combination of these two approaches are used.

Q: I AM INTERESTED IN CBT BUT I AM WORRIED ABOUT WHO WILL GET ACCESS TO MY PERSONAL INFORMATION (EG EMPLOYERS, FAMILY, GP, ANYONE ELSE).

A: CONFIDENTIALITY IS THE ABSOLUTE CORNERSTONE OF OUR PRACTICE. Our service is run on an entirely private basis i.e. it is a commercial arrangement between yourself and us. It is completely separate from the NHS. The only people to get to know anything are the people you give us permission to inform. Your consent, verbal and written, is required for all disclosures, and you can indicate what you want and what you don't want disclosed.

There is ONE EXCEPTION to this; ie. if you tell us you intend to harm yourself or another person, we are bound by law to inform the relevant parties. This is done to ensure your safety and that of other people.

If you want, we can record sessions using a camcorder; this will only occur if you give your written permission. The therapist sometimes uses these recordings to discuss your case with an associate therapist (BABCP registered) - but again, only with your consent. Clients often wish to buy copies of these recordings; they allow you to re-view your sessions in the comfort of your own home, and this has obvious therapeutic benefits. Also, for many people it offers the opportunity to see (and hear) yourself as others see and hear you. It can be a truly enlightening experience. All recordings are kept by the therapist and stored securely to protect your privacy. Again, all information released to any party must be authorised by you in advance, and again in writing. Always remember, this is YOUR treatment and YOUR information; we will only ever make any disclosures with YOUR agreement.

Q: WHAT HAPPENS DURING A SESSION?

A: All sessions follow a standard format. Firstly the therapist will agree an agenda (an outline of what is going to happen) for the session. In the early sessions this will be guided by the therapist; as treatment progresses, you the client will begin to take ownership of the agenda. Each session will also incorporate a mood check and the use of standardised questionnaires the PHQ-9, GAD-7 (measures for low mood and anxiety respectively), and other condition-specific measures.

Sessions will last approximately 60 minutes unless otherwise negotiated. The primary aim of the initial consultation is assessment; it aims to define the exact nature of the problem to be addressed, and how it impacts on your everyday life. In collaboration with you, the therapist will define the problem or problems in a very specific way. This will include a trigger, a thought, an emotion, coping or avoidant behaviours’ and physical responses. He will then try to show how these behaviours develop into cycles.

All sessions will be inter-connected and will build upon each other establishing connections between the above five components. The overall aim is to help clients become aware of their cognitive processes (thoughts), how these influence emotions and how they both then impact upon a person’s behaviour. Of course these patterns replicate themselves in many areas of the clients lives and the inevitable consequence is that these cycles of thoughts / feelings / actions start to effect more and more parts of your life. Once these cycles have been clearly identified the therapist and client can then explore whether alternative strategies may be more helpful.

Remember the therapist has many years experience studying people’s behaviour patterns. He is in a good position to help you identify what alternative behaviour patterns may be useful.

Q: I HEAR A LOT ABOUT "HOMEWORKS"...... WHAT WILL THESE INVOLVE?

A: When we talk about homework it’s probably more accurate to say self-therapy. Problems do not occur overnight - they usually take a considerable time to develop; as such it is not reasonable to assume that one session per week in isolation can have a dramatic impact. Homework (or self-therapy) is essential as it ensures that treatment continues between sessions. Issues of difficulty with homework can be addressed in the following session. A major benefit of this is that clients can continue to make improvements once treatment has concluded.

When we cover certain topics/issues in session we set homeworks to reinforce the new learning. Also, homeworks allow you to try out or experiment with new behaviours to see if these have a helpful impact upon problems. Some homework’s will involve making notes about specific events or experiences. This helps us identify the key thoughts and emotions which often drive our cycles of behaviour. Once we know these, we can subsequently work on them.

WE CANNOT EMPHASISE ENOUGH THE IMPORTANCE OF COMPLETING THE HOMEWORKS THAT ARE AGREED; IT IS OUR EXPERIENCE, TIME AND AGAIN, THAT THOSE CLIENTS WHO DO THE HOMEWORKS ARE THE ONES WHO DO BEST.

Q: WILL IT WORK FOR ME ?

A: Actually, there is a very large percentage of clients who have had CBT, were initially very doubtful about its' potential to help them; they believed their own individual problems have never been encountered before. Ironically, these people do exceptionally well. Remember, the same cognitive processes work for everyone. It is simply a matter of identifying how each person makes use of their thinking processes to engage wih the world.

Like any medical intervention, there are absolutely no guarantees that this treatment will be sucessful. However, the vast majority of people will be aware of some changes even DURING the first session. After all, the whole idea of the treatment is that people get a good understanding of the model, to let them see how it will work for them personally.

All the treatments we offer are based upon the best possible research to date. All of the evidence is available to the public and is easy to access. It is the same research which informs best practice in the NHS, and can be viewed online (via the NICE website), or hard copies can be obtained via local libraries. You should know that the therapist providing this service has worked long term (and still works) for the NHS. He has 35+ years experience of dealing with similar problems for many other individuals; whereas you may believe the problem is specific to you, you may find in fact that it is acually quite common.

If you would like to find out which conditions respond best, check out the following site; www.nhs.uk/choices (and enter "cbt" in the search box).

As far as getting good results however, we would again reinforce that those clients who complete the self therapy homeworks are the ones who get the best results.

Q: MANY OF THE COMPANIES WHO PROVIDE THIS SERVICE CHARGE SUBSTANTIALLY MORE FOR TREATMENT; HOW CAN YOU OFFER THIS SERVICE AT SUCH GOOD RATES?

A: Charges for this type of service can vary from about £60 per session up to about £115 per session. There are 2 main reasons for this wide variation in prices.

Firstly, most other companies who do this therapy undertake work which involves legal issues (eg. litigation on behalf of clients, marital and familial matters, disputes about DHSS benefits etc). This can be extremely complex and time-consuming work, and adds substantially to costs.

Secondly, some companies provide this therapy operate on a much larger scale, with multiple therapists. As a result, they have high staffing and administrative costs which must be covered.

CBT Newtownabbey gets around this problem by offering two strands of service.
For private individuals, CBT Newtownabbey offers a "no-frills" purely clinical service. As a result we can charge substantially less for our service, whilst maintaining effective therapeutic outcomes.
For those clients who come to us via insurance companies or from private medical companies, the costs generated by the extra layers of administration are passed onto the companies involved.

Q: EVEN SO, IT'S STILL QUITE EXPENSIVE; WHY?

A: In the first instance it should be remembered that Cognitive Behaviour Therapy can be accessed free through your GP. As such we would encourage prospective clients to consult with their family doctor first. If however you wish to avoid the long waiting times / bureaucracy of the NHS and pursue the private route, then the issue of cost arises. Like any other business, we have running costs such as accommodation, utilities etc. In addition, the field of Cognitive Behavioural Psychotherapy is a continually evolving field. This therefore requires that therapists continually have to access additional training to keep abreast of new techniques, and also to ensure that already acquired skills stay sharp. There are also professional fees which must be paid, for membership and accreditation with professional bodies. This accreditation is your guarantee that the therapist practices at the highest level. In addition to this, outside of your sessions, your therapist will be working on your case devising treatment programmes specific to yourself, sometimes with the help of another therapist.

On the plus side, we make very sustantial reductions to our costs (as outlined above) and these savings are passed directly to individual clients.

Some community based organisations (eg Voluntary Groups) do offer CBT as part of their overall package of services, but these are often conducted on a GROUP basis to minimise costs. There are a couple of problems with this; firstly, not everyone can talk easily within a group, and secondly, a group setting restricts flexibility in terms of appointment times etc. Also, donations are often requested anyway, to help cover overheads.

All in all we believe that given the high background costs, our charge represents a fair price. We will always endeavour to acheive the maximum therapeutic result in as few sessions as possible. Also, in reality, the first appointment is actually a double session offered at a decent concession rate, so it allows you to see whether this service could be useful to you. Clients often have long term issues resolved for around £250. Note too that many of our referrals are generated via word-of-mouth, so it is in our interests as well to give good value.

However we would still encourage you to check all your treatment and therapist options, which includes checking prices. Remember the body which sets the competency standards for CBT is the British Association for Behavioural and Cognitive Psychotherapy (BABCP), and we would strongly recommend that, whoever you choose, they are registered with that body.

Q: HOW DO I KNOW YOU ARE PROPERLY QUALIFIED, LEGITIMATE PRACTITIONERS?

A: To begin with the therapist involved with your care is a fully Registered Mental Health Nurse (RMN); that means his name is held on the register of the United Kingdom’s Nursing and Midwifery Council (NMC), (and also in the Specialist Practitioner section). His nursing qualifications can be found at the NMC site : www.nmc-uk.org/register

Additionally his name is also recorded as an accredited practitioner with the lead organisation for CBT in the UK, the British Association for Behavioural and Cognitive Psychotherapy (BABCP). This can be viewed at: www.babcp.com/register . Although there are many counsellors and therapists from a variety of backgrounds in the UK, comparitively few are accredited by the BABCP. They have very high standards which must be attained before you can be accredited.

In addition the therapist also has numerous academic awards and will be happy to provide certificates upon request.

All work with clients is conducted with due regard for personal respect and dignity, and professional guidelines are adhered to at all times.

Q: COULD YOU GIVE SOME SOURCES FOR FURTHER INFORMATION?

Here are some web-sites that might be helpful.

www.getselfhelp.com

www.depressionalliance.org

www.beatingtheblues.com

www.mindingyourhead.info

www.anxietyuk.org.uk (and type in cbt)

For those who do not have ready access to the internet, there is information about CBT freely available in public libraries and many other community facilities. Alternatively, you can seek advice from your GP; all GPs get basic training on the princiles of CBT and they would be very familiar with local services.