A Guide to Therapies We Practice
At Hampshire & Surrey Psychology we always welcome new clients to an initial assessment session. This session gives you time to explain what you would like to achieve from therapy, and gives us an opportunity to explain which therapy (or therapies) will be the most effective in helping you to achieve your goals. We will discuss with you what you can expect from us and what you will need to do to achieve the best results.
At all times confidentiality is paramount. Respect for your individual values and beliefs is of great importance to us.
At Hampshire & Surrey Psychology we offer a range of effective therapies: Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), Interpersonal Therapy, Mindfulness based therapies, Psychodynamic, Positive Psychology and Humanistic. The initial assessment will determine which therapy (or therapies) you are going to benefit from most.
We explain some of the approaches below:
- Cognitive Behavioural Therapy (CBT)
- Dialectical Behavioural Therapy (DBT)
- Psychodynamic
- Positive Psychology
- Humanistic (person centred)
Cognitive Behavioural Therapy
What is Cognitive Behavioural Therapy (CBT)?
CBT is a therapy concerned with the relationship between thoughts/beliefs (cognitions) and behaviour. It suggests that the way you think about an event is responsible for how you feel about that event. CBT also suggests that the way you feel is dependent on what you do (behaviour). We know that different people have different reactions to the same event, so it is your interpretation of that event that leads to your particular emotional reaction. Therefore if one thinks differently about an event, or acts differently in response, then one would feel differently.
The aim of therapy is to develop an understanding of the problem and what thoughts and behaviours trigger and maintain the problem; then to develop skills and techniques for dealing with the thoughts and behaviours in realistic, rational and helpful ways.
The goal is to help you to become your own therapist, gradually reducing the need for the therapist. To develop a toolbox of skills and techniques to apply to old patterns of thinking and behaving, also to help you stay well by learning to deal with new issues or difficulties which may arise.
CBT is collaborative, meaning it is a joint venture between you and the therapist. The therapist brings expertise in the therapy and you bring knowledge of yourself and of the particular difficulty you have. The therapist does not make judgements, but works with you to achieve change.
Back to topWhat Happens in CBT Sessions?
The CBT approach focuses on the difficulties you are having in the here and now. Although it is important to examine how the problem originated the focus is on how it affects you currently.
At the beginning of CBT you may be asked to complete some self-report forms to enable the therapist to gather as much information as possible to learn quickly the nature and extent of your difficulties.
The therapy is structured and active, meaning that the sessions run to an agenda and involve work and homework on your part. This may involve keeping a diary of thoughts, feelings and behaviours, or conducting a task to test out the validity of a particular belief.
Cognitive Behavioural Therapy is time-limited and brief, usually lasting between 6 and 20 sessions. Sessions may be weekly or fortnightly, usually lasting an hour. Towards the end, the sessions may taper off gradually.
Back to topDoes CBT Work?
CBT is an approach based on evidence of its effectiveness. Evidence from NICE (National Institute for Health and Clinical Excellence) suggests that CBT is as effective as medication for treating depression and more effective than medication in preventing relapse. It has been identified as the treatment of choice for generalised anxiety disorder, obsessive compulsive disorder and for depression. It has also been shown to be effective in the treatment of eating disorders, panic attacks, pain and childhood emotional disorders.
Back to topDialectical Behavioural Therapy (DBT)
- What is Dialectical Behavioural Therapy (DBT)?
- What Happens in DBT Sessions?
- Does DBT Help for Other Difficulties?
What is Dialectical Behavioural Therapy (DBT)?
Dialectical Behaviour Therapy (DBT) is a therapy originally developed by Dr Marsha Linehan to treat individuals with borderline personality disorder (BPD) and was the first therapy experimentally demonstrated to be effective. DBT combines cognitive-behavioural techniques for emotion regulation and interpersonal effectiveness with concepts of mindfulness, distress tolerance and acceptance derived from Buddhism.
For DBT to work well the client needs to be willing to change (at least some of the time!) and the development of a successful therapeutic alliance is key. The therapist aims to accept and validate the client’s feelings at any given time while nonetheless informing the client that some feelings and behaviors are maladaptive, and showing better alternatives.
Back to topWhat Happens in DBT Sessions?
DBT involves two parts – therapy and skills acquisition. In weekly one to one therapy the therapist and client discuss issues that come up during the week, recorded on diary cards, and follow a treatment target hierarchy. Self-injurious and suicidal behaviors take first priority, followed by therapy interfering behaviors. Then quality of life issues and then working towards improving one's life generally. During the individual therapy, the therapist and patient work towards improving the use of skills. The second part focusses upon learning to use specific skills that are broken down into four modules: core mindfulness skills, interpersonal effectiveness skills, emotion regulation skills, and distress tolerance skills. In DBT programmes, e.g. in the NHS, the skills component is taught in a weekly group and this is of course preferable.
Back to topDoes DBT Help for Other Difficulties?
The components of DBT are increasingly being used to help in other areas. Research indicates that DBT is also effective in treating patients who have varied symptoms and behaviours associated with mood disorders, including self-injury. For example, learning Mindfulness skills has been shown to work particularly well for anxiety problems and certain types of depression.
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Psychodynamic Therapy
What is Psychodynamic Therapy?
Psychodynamic and person-centred approaches focus on gaining understanding and insight about yourself and your past as the key to change. Psychodynamic Psychotherapy uses the assumption that everyone has an unconscious mind and that feelings held in the unconscious mind are often too painful to be faced. We consciously or unconsciously create defences to protect us knowing about these painful feelings. In Psychodynamic therapy we work with the unconscious processes as they are shown in the client's present behaviour and the therapist will offer interpretations for the client to consider about what is happening.
The goals of psychodynamic therapy are self-awareness and understanding of the influence of the past on present behaviour. In its brief form, a psychodynamic approach enables the client to examine unresolved conflicts and symptoms that arise from early and past relationships - once you are aware of what is really going on in your mind the feelings will not be as painful.
Back to topHow Long Does Psychodynamic Therapy Last?
The healing and change process in long-term psychodynamic therapy can require at least 2 years of sessions. This is because the goal of therapy is to change an aspect of one's identity or personality or to integrate key developmental learning missed while the client was stuck at an earlier stage of emotional development.
As practitioners of brief psychodynamic therapy, which can be as few as 6 sessions up to 20 or so, we believe that some changes can happen more quickly and that an initial short intervention will kick-start an ongoing process of change that does not need the constant involvement of the therapist. For brief therapy to be effective there should be one major focus for the therapy identified in the assessment session.
Back to topPositive Psychology
The study of positive psychology was started because it has come to be realised that whilst psychology tells us how to relieve misery and suffering it does not necessarily help us to find what is best in life and how to enjoy it and become happier. That is the goal of positive psychology.
Martin Seligman PhD, a professor of psychology at the University of Pensylvania and a past president of the American Psychology Association, founded the study of positive psychology. As he has said
'a science of positive subjective experience, positive individual traits and positive institutions promises to improve quality of life and prevent the pathologies that arise when life is barren and meaningless. The exclusive focus on pathology that has dominated so much of our discipline results in a model of the human being lacking the positive features that make life worth living. Hope, wisdom, creativity, future mindedness, courage, spirituality, responsibility, and perseverance are ignored…'.
Research is increasingly finding that if we approach life with optimism then we are happier, healthier, more resilient and successful. Positive psychology has drawn on CBT principles and psychological research to find ways of helping people to learn to become more optimistic (when it will be helpful to them) and thus happier.
Back to topHumanistic or Person-Centred Therapy
Person centred therapy was developed by psychologist Carl Rogers in the 1940s and 1950s. It's one of the most widely used models in mental health today. The person-centred approach views the client as the expert on their own experience, and as being fully capable of fulfilling their own potential for growth.
The aim for the therapist is to provide the ‘core conditions’ for growth and learning in the therapy - a comfortable, non-judgemental environment. The therapist must demonstrate congruence (genuineness), empathy, and unconditional positive regard with a non-directive approach. This enables clients to find their own solutions to their problems.
Person centred therapy as well as being used as a therapy in its own right is also used as the ‘bedrock’ for other therapeutic approaches such as CBT and DBT to build upon.
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As Chartered Counselling Psychologists we are bound by the Code of Conduct and Ethics of the British Psychological Society.