Treatments available at the Grenada Centre
There are three stages to effective stress management - they include the
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.
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")
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.
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.
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
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
- 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.
- 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,
- 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.
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.
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
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.
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.
Cognitive Restructuring i.e. challenging the negative automatic thoughts
associated with the feared situations and substituting more balanced alternatives.
Modifying deep core-beliefs associated with shame and guilt in early life.
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.
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.
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
CBT treatment for the problems underlying this spiral of yo-yoing of weight
gain/loss will improve: -
1) Self esteem/worth
3) Social skill/communication
Overall improvement of mood
5) Identity problems
CBT works to improve the following areas in relationship counselling: -
- Empathy (understanding)
- Intimacy (closeness)
- Expressed affection
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
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.: -
- household chores
- shared-child rearing
- physical intimacy
- time together
- time apart
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.
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.
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.
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.
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