What is CBT (Cognitive Behavioural Therapy)?
CBT is an evidence-based short term therapy for the treatment of psychological problems including anxiety, depression, panic disorders, agoraphobia and other phobias, social anxiety, health anxiety, Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD), anger management, stress, low self-esteem, Chronic Fatigue and eating disorders.
CBT is a way of understanding how thoughts, feelings and behaviour affect each other, and how to develop strategies to better manage the way you think and feel about yourself, others, and the world around you. We will break each problem down into its separate parts. To help this process, you may be asked to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions. Together we will look at your thoughts, feelings and behaviour to work out if they are unhelpful, and how they affect each other. You will then be helped to work out how to change unhelpful thoughts and behaviour. You might start to question a self-critical or upsetting thought and replace it with a more balanced one that you have developed in CBT. You might also recognise when you are about to do something that will make you feel worse, and instead, do something more helpful.
The number of sessions will normally range from 5 to 12 sessions, depending on the nature of the problem. In the first session we will explore current problems that you experience and the background of these difficulties; together, we will then set goals for therapy. Although CBT concentrates mainly on the present, it may be relevant at times to talk about the past as this will help understand current difficulties.
We will work together in an atmosphere of transparency, aiming to create a collaborative relationship. Any therapy plan will focus on your unique situation.
Research has shown conclusively that CBT is effective for the treatment of many psychological problems. CBT is recommended by the National Institute for Clinical Excellence (NICE) in their guidelines for the treatment of most mental health problems.
What is EMDR (Eye Movement Desensitisation Reprocessing)?
EMDR is a psychological treatment to help people deal with distressing events. EMDR aims to change how people with PTSD feel about the traumatic memories, and helps them to develop more positive emotions, behaviour and thoughts. It enables people to recollect the original traumatic experience as a memory that sits in the past but is no longer disturbing.
Treatment will only start after a careful psychological assessment to establish whether EMDR is suitable for the person involved and the problems presented.
During EMDR you will be helped to examine your memories of a trauma, including all negative thoughts, feelings and sensations experienced at the time of the trauma. While doing this, the therapist will assist you in making guided eye-movements which stimulates powerful brain activity. After each set of eye movements you will be asked what you have noticed, and subsequently instructed to uncritically follow your thoughts and associations. This often leads to retrieval of old memories, rapid insights, and a systematic letting go of the traumatic event and the symptoms associated with it.
EMDR can cause the brief experiencing of high levels of emotion which are associated with the traumatic memories. It is important that you have the necessary skills to cope with this, and we will spend some time ensuring that these are in place before treatment starts.
If you have had a single incident, e.g. a recent car accident leading to fear of driving, the average treatment can be from 3 to 5 sessions of EMDR, possibly combined with some sessions of CBT. EMDR is also remarkably effective in the treatment of people who have suffered trauma such as ongoing childhood abuse, although this may require more extensive therapeutic time.
The National Institute for Clinical Excellence (NICE) recommends EMDR and CBT where PTSD symptoms have been present for over 3 months after a traumatic incident. The American Psychiatric Association Practice Guidelines (2004) has placed EMDR in the category of highest level of effectiveness.