Evidence Based Treatments

CBT is a well-established and researched therapeutic technique that emphasises the links between our thoughts, feelings and behaviours. It encourages us to identify “unhelpful” behaviours, thoughts or thinking patterns that can spiral us downwards into negative emotions, and instead offer ourselves alternative (more helpful) interpretations, thus resulting in more positive emotions and more functional behaviour.

CBT focuses on current problems, rather than looking at issues from the past. The aim is to make sense of overwhelming current problems by breaking them down into smaller parts, and then to identify practical strategies that can be used to improve daily state of mind.

Research indicates that CBT is particularly helpful in tackling problems such as anxiety, depression, post-traumatic stress disorder (PTSD), eating disorders and drug misuse. CBT can also be used to help people to cope with long-term health conditions. Treatment programs usually last between 6 weeks and 6 months, depending on the objectives and the difficulties being addressed.

DBT was developed by Psychologist Marsha Linehan to assist individuals struggling with emotional regulation difficulties (including Borderline Personality Disorder) and particularly those who experience suicidal ideation and/or self-harming in order to regulate their difficult emotions.

DBT combines standard cognitive-behavioural techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness, partly derived from the Buddhist practice of meditation. DBT has been found in research to be generally effective in treating Borderline Personality Disorder, resulting in reduced rates of suicidal gestures, psychiatric hospitalizations and treatment drop-out when compared to standard treatments.

ACT is a type of psychotherapy that sets out to maximise an individual’s flexibility in thinking and adapting. The aim of ACT is to experience the fullness and vitality of life, which includes a wide spectrum of human experience, including the pain that inevitably goes with it. Acceptance (rather than approval) of how things are, without evaluation or attempts to change it, is a skill that is developed through mindfulness exercises in and out of session.

ACT does not attempt to directly change or stop unwanted thoughts or feelings (as in cognitive behavioural therapy), but to develop a new mindful relationship with those experiences that can free a person up to be open to take action that is consistent with their chosen values. Thus, values clarification of one’s values is a key component to ACT. ACT can be summed up with the following three concepts: Accept your reactions and be present, choose a valued direction, take action.

Eye Movement Desensitisation and Reprocessing (EMDR) is a therapy designed to assist in alleviating the symptoms associated with traumatic memories and disturbing life experiences. It is a highly validated therapy and is now recognised as frontline treatment for symptoms of trauma, PTSD and CPTSD.

EMDR is an evidence based treatment not only for those experiencing symptoms of trauma but for many other presentations including (but not limited to):

• Phobias
• Obsessive Compulsive Disorder
• Panic Disorder
• Generalised Anxiety Disorder
• Borderline Personality Disorder
• Depression
• BiPolar Disorder

For further information related to our EMDR services please head here.

Mindfulness

Mindfulness helps individuals accept and tolerate powerful emotions felt when challenging their habits or exposing themselves to upsetting situations. The concept of mindfulness and the involved meditative exercises are derived from traditional Buddhist practice, though not necessarily with religious or metaphysical concepts. Mindfulness includes the capacity to pay attention non-judgmentally to the present moment, to live in the moment, to experience one’s emotions and senses fully, yet with perspective.

Motivational interviewing (MI)

Motivational interviewing (MI) evokes intrinsic motivation to change and commitment towards the desired goal by helping people to resolve any feelings of ambivalence. Psychologists using MI have an openness to collaboration with clients’ own expertise, proficiency in client-centred counselling, including accurate empathy, are attuned to recognising key aspects of client speech that guide the practice of MI, elicit and strengthen client change talk, roll with resistance, negotiate change plans, consolidate client commitment, and also switch flexibly between MI and other intervention styles.

Psychological therapies are proven to be very successful in treating both Tourette Syndrome and Tic Disorder and are the first line of treatment before we try medication intervention. The Gold Standard treatment is known as Comprehensive Behavioural Intervention for Tics (CBIT) and has proven to be effective in many cases in just 6-8 sessions. The therapy is a combination of behavioural and some cognitive strategies designed to give the person control over their tic behaviours. Clients report the treatment to be validating, collaborative and effective, with many describing it as a “miracle cure”. 

Successful application of CBIT requires the therapist to have participated in some form of training in this specialised treatment frame-work so it is very important that you make sure the therapist you are referred to is appropriately trained. If you are seeking support for your child I encourage you to ask specifically if the therapist has attended or is formally trained in CBIT and whether they have access to a Supervisor familiar with TS and Tic Disorder. With help people with TS or Tic Disorder can gain control of their bodies and feel like they can live normal lives.

Psychologists using a Narrative Therapy approach seek to help a client to separate themselves from the problem or presenting issue. Narrative Therapy was developed by Michael White and David Epston and is based on the belief that a person’s identity is formed by their experiences or narratives and that a problem or difficulty itself is not an identity. By helping the client to see the problem as a separate entity sensitive issues can be externalised and this reduces the emotional load of the problem.

Resistance and defences can be reduced though the objectification process and this allows individuals to then address difficulties in a more productive way. Clients are encouraged to rely on their own skills and internal resources to minimise difficulties that exist in their everyday lives. The process of externalising is applied to behaviours, values, beliefs, and ideals, and a the psychologist helps the client to gain new perspectives and to rewrite negative aspects of their narrative or identity.

Schema Therapy was developed by Dr. Jeffrey E. Young to help treat personality disorders and other chronic disorders. The term “schema” is used to describe a pattern of thoughts and/or behaviour, a framework for how individuals interpret and view information, and their relation to the world and other people around them. Schemas can be adaptive or maladaptive, and are formed early on in a person’s life. Schema Therapy has been described as integrating cognitive behavioural therapy, psychoanalytic object relations, attachment Theory, and Gestalt therapy. Schema therapy helps clients to identify and address early maladaptive schemas. These have been described by Dr. Young as, “self-defeating life patterns of perception, emotion, and physical sensation” and addressing these help clients to utilise successful coping styles and meet their basic emotional needs.

Solution focused brief therapy (SFBT) (or simply ‘solution focused therapy’) is a goal directed collaborative change oriented approach conducted by analysing direct observation of clients’ responses to constructed questions. SFBT is based upon social constructionist thinking and looks at what a client wants to achieve by examining the history and presenting problem in detail. This approach emphasises that present and future life experiences during which some aspect of a goal was occurring can be identified and used to co-construct effective solutions. Thus clients are enabled to create positive directions for change in their lives- constructing a concrete vision of their preferred future.