Treatments available at the Grenada Centre

Stress

There are three stages to effective stress management - they include the following stages.

Stage 1

Reducing the symptoms associated with stress (anxiety, depression, losing control, insomnia, vulnerability etc.) using a holistic programme for relaxation training and recuperation. Clients often use a voice activated dictaphone to tape sessions to use at home to augment what is gained in therapy.

Coping techniques include breathing techniques, visualisation, progressive muscle relaxation, stress innoculation training, distraction techniques, mindfulness and problem-solving skills. From the first session onward the goal of the treatment is to teach clients to metamotivationally switch freely between the left and right brain hemispheres of the brain to learn to modulate the degree of response to any stress trigger.

Clients learn how to 'work smart not hard' and minimise the amount of energy expended on any one task. Clients begin early on to recognise the benefits of learning to recuperate before moving on to the next task. It has been statistically proven that the quality of work improves proportionately when clients recuperate fully. It is this more effective use of energy that is noticeable.

By learning to become more aware of physical tension levels there is an increased resistance to stress. As more advance coping skills are learned the perception of threat diminishes. Both in the preparation for possible stressful situations, and a coping repertoire for meeting unexpected stressors the client has a full coping repertoire at their disposal.

Alternative therapeutic use of aromatherapy massage - a fully trained nutritionalist, and a physical exercise programme to trigger the natural morphine response of endorphins and a stress medical designed by Dr Geoffrey Barker to assess overall levels of stress i.e. (cortisol, moradenalin etc.).

Treating the whole person has greatly increased recovery rates with a 100% success rate with clients.

Stage 2

Using standard CBT in the areas identified as causing negative thoughts, beliefs and images, clients learn to identify the themes which generate faulty thinking ("I'm not good enough", "I'm going to fail", "I'm stupid" etc.) and learn to test there thoughts as hypotheses rather than take them as facts.

Because cognitive-behavioural therapy is an information processing model, when clients restructure their thinking by rewriting thoughts in an alternative, and more balanced way, both mood and behaviour change.

By reality testing thoughts the interpretation of the event, and its meaning changes, with significant reduction in the way the stress is experienced.

Cognitive Behavioural/Therapy has been statistically proven to change brain chemistry without anti-depressant medication.

All of us experience things in life which frustrate, disappoint, and sometimes can defeat us. Learning how to manage internal self talk using CBT helps us to more effectively speak to others and feel more in control in the specific life events we encounter. Our negative automatic thought patterns interfere with our ability to judge situations realistically (i.e. "I am stupid" vs what "I did was stupid")

Stage 3

In the last stage of CBT treatment clients work on the deeper core beliefs/schemas that have been developed during their early life (up to 16 yrs of age). These deeply held beliefs function like absolutes or biases and form a template for how we see ourselves, other people, and the world around us. For example: "I'm never good enough", "I'm a failure", "I'm not lovable", "People cant be trusted" acts as a filter for how they live in the world, who they are attracted to, and what situations they avoid after a comprehensive schema questionnaire. Clients learn to modify these deeply held beliefs which mitigate against relapse.

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Anxiety

The first session for a CBT practitioner is to give a full individual assessment using diagnostic criteria, to determine the severity of symptoms commensurate with anxiety. This will determine the origin of the persons life experience which may be causing anxiety, psychological type and the length of duration of presenting problems.

A problem list of 5-6 things the client wants to change as a result of CBT treatment is collaboratively drawn up with the therapist. This acts as the aims and objectives of the therapy. Clients are clear on:-

• what their diagnosis is.
• what means the therapist will use to achieve these results.
• how to recognise when these goals have been achieved.

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Depression

Cognitive Behavioural Therapy begins with an assessment using diagnostic tests to measure the intensity of the symptoms associated with depression (see depression questionnaire). Then a problem list of five or six of the presenting problems are drawn up with the therapist. Clients collaborate with the therapist to decide how they will be at the end of the therapy.

The first stage of the therapy is aimed at bringing depression scores back to the normal range. Using a series of behavioural techniques (breathing, daily activity schedules, pleasure ratings and experiments) to help clients monitor their ability to change their life experience. Usually a minimum of 5 sessions is necessary to achieve depression scores in the normal range.

The second stage of the treatment works at the identification and challenging of negative automatic thoughts. Negative automatic thoughts are plausible, and are generated around specific themes (i.e. “I'm not good enough”, “I'm worthless”, “I'm never going to change” etc.). Clients either use a voice activated dictaphone or write them down to catch them, asking themselves “What was going through my mind just before I started to feel this way?”

These negative thoughts are then analysed against errors in logic which depressed people normally make, and through socratic questioning and guided discovery clients learn how to challenge and rewrite these thoughts in a more balanced way. Five sessions minimum are set apart to learn to identify and challenge negative automatic thoughts. The last five sessions work with deeper core beliefs and schemas which were previously known as the unconscious.

Modifying these deeply held beliefs which were formed in the first fifteen years of life mitigate against relapse. Core beliefs function like absolutes or prejudices in a persons life and identifying these through diagnostic tests target specific areas which are at the root of depressoganic thinking. They have cognitive, affective and behavioural components, and by modifying them (“I'm stupid”, “I'm not good enough”, “I'm a failure” etc.) by using evidence and experience of a new belief, over time, alters the original template at the heart of the way people see themselves, others, and the future and aid relapse prevention.

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Anger Management

When a client comes in with anger control problems they are given a complete psychological assessment using diagnostic tests to measure anxiety, depression, self esteem levels and their personality type. An anger test is used to understand the specific areas that trigger anger responses and an individual diagnosis and blueprint for treatment is collaboratively discussed with the client.

A problem list is drawn up with 5-6 problems that the client wants to change through CBT. CBT has three stages:

1. Clients often tape sessions which are initially designed to change their anger behaviours through specific techniques that are used immediately to bring anger symptoms under control. This also includes an extensive stress reduction and relaxation programme to reduce the sense of threat, violation, frustration, fear and guilt that these outbursts and loss of control can produce.

2. The second part of the treatment is designed to use standard CBT to challenge negative thoughts and beliefs about the self, other people, and their future by:-

• first identifying these negative automatic thoughts
• testing them as hypothesis rather than facts
• discovering what errors of logic are being made
• substituting them for a more balanced way of thinking.

3. The third part of CBT Counselling looks at deeper core belief and schemas from early life (up to sixteen) which are then modified to aid in relapse prevention. Areas of:-

• subjugation (being controlled or invalidated as a child)
• mistrust (feeling abused or exploited by others)
• punitive parent (criticising, shaming, verbally abusive)
• emotional deprivation (in the areas of nurture, empathy, protection, mentoring)
• vulnerability to harm from others
• not being good enough/worthy

These are often present as some of the underlying non-conscious beliefs which are at the source of anger problems.

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Career Transition

CBT works successfully in the management of redundancy/career change in the following areas: -

1. Stress Reduction

CBT treatment for the reactive symptoms (anxiety, depression, self esteem issues) associated with first line professional and personal impact of redundancy.

2. Leadership Training

A portfolio of 5 management styles reflecting 'best fit' for the potential employer. Self presentation for both the global vision of potential firms, and from concept to start-up the ability to effectively deliver this.

3. Extensive CV Writing

Each CV is designed to be tailor made to each specific job application.

4. CBT Interview Training Program

Every aspect of the interview is covered from a psychological point of view.

a. Mirroring
b. Pacing
c. Interpersonal skills
d. Tough interview questions
e. Non verbal communication

5. Review of Each Job Interview

An evaluation from a 30 point criteria check list of relevant interview criteria.

6. Occupational Testing

Use of Myers, Briggs, OPQ and Type A/B diagnostic tests as preparation for professional testing.

7. Preparing for the Stress Interview

Extensive preparation for interviews designed to intimidate and test competence/leadership abilities. Developing the ability to master this interviewing style. The answers to tough questions.

8. Psychological Reversals

CBT training in left vs right brain reversals in the interview, to create positive bias towards the interviewee.

9. Self Image Work

Creating the appropriate dress style/presentation of the self appropriate to the current workplace environment. 80% of cues between the interviewer and interviewee are non-verbal.

10. Recruitment Agents

We work with the agents themselves, across a broad spectrum of careers to help place candidates in their new jobs.

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Social Anxiety

In the first session diagnostic tests are administered to make a firm diagnosis, and to locate the specific problem areas for the client. The first part of the treatment is centred on improving the symptoms of anxiety and/or depression. A problem list is drawn up of 5-6 things the client has identified that he would like to change as a result of cognitive therapy.

CBT A relatively short term, collaborative, scientific statistically proven way to overcome social anxiety in a variety of social situations. Clients use a voice activated dictaphone to tape sessions. There is a strong emphasis on homework to augment the work done in the sessions. There is an emphasis on psycho-educational training and an individualised treatment programme is designed to suit each person's specific requirements.

CBT for social anxiety is tripartite:

1. Exposure to feared situations i.e. role plays and behavioural experiments.
2. Cognitive Restructuring i.e. challenging the negative automatic thoughts associated with the feared situations and substituting more balanced alternatives.
3. Modifying deep core-beliefs associated with shame and guilt in early life.

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Weight Reduction

The advantages of using CBT together with conventional weight loss methods is that by improving self esteem and better stress management strategies, clients use other coping skills besides food to regain and hold their weight loss gains, and this mitigates against relapse by approaching these problems both on a symptom and core belief level, instead of operating purely externally where food is the main problem.

Stage One

Assessment and treatment plan to modify symptoms, challenge negative thoughts associated with self image/worth. This includes visualisation, relaxation, stress management, left/right brain reversal and improved overall coping strategies.

Stage Two

Identifying and modifying underlying core beliefs/schemas formed up to the age of 16, which form the self concepts, especially in the areas of: -

• Emotional deprivation (nurture, empathy, and mentoring)
• Social Isolation (feeling isolated/disconnected from others)
• Defectiveness (feeling inferior to others)
• Abandonment (the problems of feeling rejected or abandoned by others growing up)

CBT treatment for the problems underlying this spiral of yo-yoing of weight gain/loss will improve: -

1) Self esteem/worth
2) Self-confidence
3) Social skill/communication
4) Overall improvement of mood
5) Identity problems

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Couples Counselling

CBT works to improve the following areas in relationship counselling: -

• Communication
• Empathy (understanding)
• Intimacy (closeness)
• Expressed affection
• Trust
• Acceptance
• Forgiveness

When couples come for CBT they are given a series of diagnostic tests which measure the above variables to get a clear blueprint for therapeutic treatment. The therapist first looks at what brought clients together and the first stage or honeymoon period of the relationship.

Clients become aware that there were a series of expectations which each person brought to the relationship (often unexpressed), and it is only when there is a relationship breakdown that this script or internal contract becomes apparent.

In the second stage of the assessment clients identify the presenting problems in the relationship, and five or six things they would like to change in themselves, their partner and/or the relationship. This problem list forms the basis of the aims and objectives for treatment.

The third part of the programme is to design a new marital contract in all areas of marital life i.e.: -

• finance
• household chores
• shared-child rearing
• physical intimacy
• time together
• time apart
• holidays

which better reflects each partners expectations in the marriage. Each of these is negotiated between partners. Then this is drawn up as a document which both clients can refer to.

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Christian CBT Counselling

Cognitive therapy is used most effectively in Christian counselling in the following ways (Probst, 1988):

1. Giving the patient a rationale for treatment procedures.
2. Changing clients self-awareness by challenging should's, must's, and ought's. Cognitive therapy helps clients to be freed from unrealistic expectations by understanding and revising the unnecessary demands they place on themselves.
3. Teaching meta-cognition so patients can think about their thinking, to understand and control their thought processes, and to replace inflexible and destructive thoughts with adaptive ones.
4. The emphasis on truth rather than happiness. Critical thinking skills encourage clients to confront the truthfulness of their thoughts and beliefs in therapy.
5. To change client's underlying beliefs about the world, to gain a new set of assumptions about themselves, others, and God. As long as effective treatment is designed which is sensitive to religious convictions there is no conflict between Cognitive Therapy and Christian counselling.

 

Email - info@centreforcbtcounselling.co.uk