Inital Consultation (Assessment)
During our first (and sometimes second) session together, we will talk through your difficulties in order for us to gain a better understanding of what it is that is maintaining your current mood and/or anxiety, the effects this is having on your life and any relevant history. This is also an opportunity for us to discuss what CBT is, how it can help and what your expectations are from therapy.
Depending on the anxiety presentation, we will begin with understanding what anxiety is and then start to work through a number of techniques to reduce your anxiety whilst increasing the feeling of your ability to cope. This could be in the form of exposure based practice, behavioural experiements to test out anxious predictions, relaxation and thought challenging to name a few.
After understanding the development and maintaining factors of your low mood, we will often look at 'behavioural activation' which involves us looking at your activities when feeling low, knowing that motivation and energy are at an all time low when depressed. We may also look at challenging and changing some of our automatic negative thoughts and core beliefs which can feed into depression, as well as looking at tackling rumination. We will also include imagery and mindfulness if appropriate.
CBT is not just about talking; an important part of the treatment is to put into practice some of the ideas and techniques discussed in the therapy sessions in the ‘real world’ and we sometimes call these 'intersession' or 'homework tasks'. These can be anything from keeping a record of your negative thoughts to carrying out and documenting experiments to test out negative predictions. These tasks can make a real difference to the success of your therapy, as it allows you to put into practice what you have learned and for us to be able to reflect on this together.
As part of your treatment package, I offer a complimentary follow-up session one month after you complete therapy. This is to ensure that you can feel confident that should there be any barriers, difficulties or set-backs, you have the support to discuss these and implement the necessary changes/ discuss further support.
Child and Adolescent Therapy
CBT for young people generally has a more systemic focus and is adapted to each young person and their family (depending on their level of involvement), ensuring understanding of a young persons cognitive and developmental age, therefore tailoring treatment to ensure appropriateness. This means that a number of different approaches to CBT may be used, for example, using a more creative style, rather than standard "talking therapy".
During your child's initial assessment the therapist will gather information from both you and your child (or will have arranged to discuss parental concerns on the phone prior to the appointment). We sometimes do this altogether but sometimes it is helpful to talk to parents and children separately, however, this is something we will discuss to see what you think might work best for your family. Together, we will find out more about the current difficulties and we may also gather information about your child’s development, school and family background. This is all dependent person to person and sometimes, adolescents are happy to be seen without full parental involvement.
Following the assessment, if appropriate, we will agree a series of treatment sessions. Each session lasts between 50 and 60 minutes. For younger children, it is usually helpful to have parents involved in treatment, however, this usually (but not always) lessens with older adolescents. Children under seven or eight years of age are generally less able to engage in CBT independently and for children of this age, working directly with parents can be beneficial.