Before psychological therapy can begin, I need to have a clear understanding of your difficulties, and so your first appointment will be mainly for assessment (this sometimes continues into your second session). I will ask you about your difficulties and when they began, and about what you would like to change. This will include some questions about your childhood, as it is during our early years that many of our beliefs about ourselves and others are formed. I may ask you to fill in one or two questionnaires to aid assessment. By the end of your second session, we will have agreed on your therapy goals and on how many sessions to have together.
Helping you to make sense of your psychological difficulties is a very important part of therapy, and I aim for us to have an open and shared ‘formulation’ of why the difficulties began and what keeps them going, Once you have this personal understanding, it becomes clearer what positive changes you can make to reduce your distress and improve your psychological well-being.
Therapy sessions are typically held weekly at The Therapy Room or Beechwood Practice Cambridge, and last for an hour. Most people have between six and twenty sessions, although of course there are exceptions to this. I find it helpful to have regular therapy reviews (typically after six sessions), to check that we are ‘on track’ and that our work together is bringer you closer to your goals (e.g. ‘to feel brighter in mood’, ‘to be less self-critical’).
Compassion Focused Therapy (CFT)
CFT was developed by Professor Paul Gilbert in Derby, and it is informed by evolutionary psychology and the latest findings in neuroscience. CFT helps us to understand out emotional difficulties in the context of our ‘tricky’ brains, and our personal experiences, such as our early relationships, which influence how our brains and minds develop. For many of us, self-criticism is a common way of relating to ourselves, and this can have a powerful negative effect on our mood, motivation, self-confidence and ability to feel ‘safe’ in the world. For many people, self-criticism plays a significant role in feeding their anxiety or depression.
Learning to stimulate a more helpful and compassionate part of yourself (perhaps the part that is there when comforting a friend) can enable you to face life’s challenges with strength and wisdom, so that you can actively address them, rather than either avoiding them or feeling overwhelmed by them.
In CFT, various exercises are used to stimulate this compassionate mentality, including imagery and breathing practices. Mindfulness can also be a helpful tool, which enables us to notice our feelings and thoughts in a non-judgemental way.
As an important part of CFT is ‘compassionate mind training’, you will probably be asked to practice breathing and imagery exercises between sessions.
Cognitive-behavioural therapy (CBT)
In CBT, there is an emphasis on understanding how our thoughts and beliefs impact on how we feel emotionally (e.g. the thought ‘I’m going to mess this up, I'm a failure' leading to low mood), and how these drive us to act in ways that keep the problem going (e.g. avoiding taking on new projects at work, leading to more ‘I’m a failure’ thoughts and so on). These thoughts/beliefs about ourselves and others may well be longstanding and are often related to early experiences. Once the impact of these is understood, it is possible to learn ways to challenge the thoughts/beliefs and so be less emotionally affected by them, and to learn how to develop more helpful and realistic ways of thinking.
An important part of CBT is ‘homework’ which enables you to increase the effectiveness of therapy significantly, by taking positive action based on what has been discussed in sessions (e.g. observing and writing down how certain activities affect your mood). This is a great way to help you make the changes outside of the therapy room that are necessary to bring about long term psychological growth.
Confidentiality and professional practice
During therapy, I write notes to help me remember what we have talked about. Everything you tell me is kept confidential, unless I have concerns that you or someone else is at risk of harm (e.g. risk of suicide, knowledge of children in an abusive situation).
In line with good practice guidelines, I have regular supervision with another clinical psychologist, and I attend training events to ensure my knowledge is up to date. I also offer supervision to other qualified psychologists.