Psychological therapy and assessment for adults

Our thoughts, feelings and behaviours and physical feelings are all connected – when we change one of these, we can influence the others. Cognitive Behavioural Therapy (CBT) is a collaborative structured therapy that helps you to identify the patterns that influence your mood, including automatic cycles of thinking and behaving that may have become problematic for you. CBT usually focuses on making changes in the here and now, but can also include a focus on the beliefs you have learnt from the past, that influence the way you cope. The aim of CBT therapy is to help you to identify unhelpful patterns, and to learn skills – such as to challenge your thinking, and to develop more helpful ways of responding to enable you to better manage your difficulties in the present.

CBT tends to be a short-term therapy that focuses on specific problems and takes quite a structured approach where you set goals and work on developing skills to manage your difficulties. It often includes practicing skills and undertaking work in between sessions, such as keeping a diary, challenging your thoughts, or testing out new ways of behaving. The number of sessions that you may find helpful will be dependent on the type of problem you are experiencing and what your goals for change are.

What can CBT help with?

CBT is evidence-based and recommended by NICE (National Institute of Clinical Excellence) as it is effective in treating a wide range of mental health conditions including anxiety (including social anxiety, panic, phobias and OCD) and depression. It can also help with other conditions such as sleep problems, pain and long-term health conditions which can impact upon our mental health.

CBT further links:

• ‘What is CBT?’ – BABCP article

• ‘Cognitive behavioural therapy (CBT)’ - Mental Health Foundation article

• ‘What is CBT? | Making Sense of Cognitive Behavioural Therapy’ - MIND video

What is EMDR?

Eye Movement Desensitisation and Reprocessing (EMDR) is an evidence-based therapy that helps people recover from symptoms and emotional distress that are the result of disturbing or overwhelming life experiences. Like the body, the mind has a natural ability to heal - but sometimes that process gets stuck. EMDR helps unblock it.

EMDR is well-researched and recognised as a treatment for Post-Traumatic Stress Disorder by the National Institute for Health and Care Excellence (NICE) and the World Health Organization. Studies show that for many people, EMDR can bring lasting relief - sometimes in just a few sessions.

What can EMDR help with?

EMDR was originally developed for trauma and PTSD, but in addition to this, it’s now used for a wide range of issues, where life experiences can continue to hold an impact on how you feel in the present. It can be helpful for issues such as:

• Anxiety and panic

• Phobias or specific fears

• Low self-worth or shame

• Depression

• Relationship challenges

• Grief and loss

• Childhood emotional neglect or abuse

• Addictive behaviours or urges

It can also help people who experience pain and other physical health difficulties to process the impact of their symptoms and how these are held in the body.

If there’s something that causes a strong emotional or physical reaction - even when it seems irrational - it could be a sign your system is holding on to something unprocessed from the past. That’s where EMDR may be able to help.

How does it work?

Most of the time the mind can heal itself naturally similar to how the body recovers from physical trauma. However, when something distressing or overwhelming happens, our natural coping mechanisms can become overloaded, which can result in disturbing experiences being unprocessed and remaining ‘stuck’ in the emotional processing part of our brain. When this happens the emotional intensity, thoughts, feelings and bodily sensations linked to the memory of the event can resurface repeatedly, even though the event is in the past. EMDR can help to unblock or reprocess memories from the past, so that they are stored and remembered more adaptively. The aim is not to get rid of the memory, but to reduce the distress and the ongoing impact of it in the present.

EMDR uses ‘bilateral stimulation’ - typically back and forth eye movements (or sometimes tapping or gentle sounds) - to help the brain reprocess these stuck memories. Similar to how the brain naturally processes information during rapid eye movement (REM) sleep, these rhythmic left-right stimulations help the brain to process distressing experiences, reduces disturbance and leads to feelings of relief. As a result usually more adaptive, helpful thoughts and feelings begin to emerge. You’ll still remember what happened - but it will no longer be disturbing.

Is EMDR right for me?

You might come to therapy already thinking that EMDR would be helpful for you, or we may decide to integrate some sessions of EMDR later on within a treatment plan that includes other approaches.

Some people need relatively few sessions of EMDR to address the impact of a traumatic incident, whereas others may need many more sessions, particularly when there is complex or developmental trauma from childhood. All EMDR therapy should include some time for preparation and learning skills to be able to regulate your feelings before processing past traumas, and some people need more time for this phase of the treatment process. Most people experience EMDR as a very natural and empowering therapy that can lead to significant and lasting change.

EMDR further links:

• ‘Discover EMDR’ - EMDR UK Association article

• ‘EMDR: the basics’ - EMDR UK Association article

• ’EMDR Therapy for Clients’ - EMDR Europe article

• ‘How EMDR works’ - VEN EMDR video

Cognitive Analytic Therapy (CAT) is a time limited therapy (usually either 16 or 24 sessions) that integrates principles from both cognitive behavioural therapy and psychoanalytic therapy. It is based on the idea that our early experiences influence the way we relate to other people and how we treat ourselves, and that we have often developed coping strategies in childhood that may have become unhelpful to us in adulthood.

CAT therapy is highly collaborative and individually tailored. In therapy we work actively together to identify and make sense of your difficulties, and where they have originated from in your past. Therapy tools such as letters and visual maps are used to connect with your feelings, and to map out and name problematic patterns in how you relate to yourself and others. The therapy aims to foster a greater sense of self-awareness and understanding whereby you learn to recognize ongoing patterns as they occur and how they continue to affect you. Through increased self-awareness, the goal in CAT is to help you develop healthier ways of relating to yourself and others, and finding alternative ‘exits’ to the old patterns to enable you to create meaningful change.

What can CAT help with?

CAT can help with a wide range of difficulties including relationship difficulties, anxiety, low self-esteem, depression, and for whom there are patterns of self-defeating or self-destructive coping patterns originating from the past.

CAT further links:

• ’What is Cognitive Analytic Therapy?’ - ACAT article

• ’What is Cognitive Analytic Therapy?’ - ACAT info sheet

Acceptance and Commitment Therapy (ACT) is a type of cognitive behavioural therapy that aims to improve psychological flexibility, and helps you to deal with difficult feelings and thoughts whilst still moving forwards in life. It incorporates principles and skills of mindfulness and acceptance. It differs from traditional CBT in that instead of challenging distressing thoughts, it teaches ways of having a different relationship with our mind and our thoughts through acceptance and willingness to feel. It is based on the idea that generally trying to control or get rid of psychological pain and distress only seems to increase it, thereby locking us into a struggle within our minds and leading to avoidance behaviours which take us further away from the life we would like to lead.

ACT focuses on developing skills to relate differently to our thoughts and feelings, through mindfulness, defusing from our thoughts, and embracing a willingness to feel our feelings. It also has a focus on identifying our personal values and what matters to us -  freeing up our energy to set goals in a direction that is meaningful for us.

What can ACT help with?

ACT can be beneficial for people experiencing a wide range of mental and physical health conditions including: anxiety, depression, chronic pain, eating problems, sleep difficulties, OCD, substance abuse, relationship difficulties and managing long term health conditions.

ACT further links:

• ‘An introduction to ACT: Acceptance and Commitment Therapy’ - Getselfhelp.co.uk article

• ’What is ACT and Mindfulness?’ - ACT Mindfully article

• ’ACT for the Public’ - Association for Contextual Behavioral Science article

• ’Rich Blonna, Ph.D.: A Brief Introduction to ACT’ - Association for Contextual Behavioral Science video

• ’The Struggle Switch - By Dr. Russ Harris’ - Dr. Russ Harris - Acceptance Commitment Therapy video

Compassion Focused Therapy (CFT) is a therapeutic approach designed to help people develop compassion for themselves and others. It integrates principles from various therapy approaches including CBT, along with an understanding of neuroscience, attachment theory and mindfulness practice.

The goals of CFT are to reduce psychological distress by fostering a compassionate mindset, to develop skills to soothe emotions and to increase self-acceptance which can lead to improved self-esteem and resilience for coping. CFT has a focus on teaching greater self-understanding and self-compassion through the use of guided exercises and skills including mindfulness, breathing, visualization, compassionate imagery, and letter writing.

What can CFT help with?

CFT can be particularly helpful for people struggling with shame, self-criticism and emotional regulation issues stemming from trauma or neglect. It has been shown to be helpful for people with a wide range of issues including depression, anxiety and trauma related difficulties.

CFT further links:

• ’What is Compassion Focused Therapy?’ - The Compassionate Mind Foundation article

• ’What Is Compassion Focused Therapy?’ - Balanced Minds article