THERAPEUTIC APPROACH -

Clinical Psychology, utilising CBT expertise

The London Psychology Clinic provides psychological help - assessments and treatments - based on CBT (Cognitive Behavioural Therapy), delivered by a Clinical Psychologist. Here I give you more of an insight into Clinical Psychology and CBT (Cognitive Behavioural Therapy)

What is Clinical Psychology?

Clinical Psychologists have undergone significant training in assessing and treating psychological disorders. To gain entry to the training in the UK, applicants need to demonstrate that they have a good undergraduate degree in Psychology, plus significant relevant experience of working with, or conducting research with, relevant patient populations - e.g. children with behavioural or conduct disorders, adults with depression, anxiety, trauma, long-term health conditions, serious mental illness, learning disability, or older adults with dementia, strokes...

The Clinical Psychology training is a three year, post-graduate, doctoral education programme. The training combines time studying in class seminars, workshops and tutorials, with time on placements in NHS settings, which change every 6 or 12 months. Over the course of the training, students (actually, they are called Trainee Clinical Psychologists) gain skills to work effectively with children, adults and older adults - to work with all ages. The qualification awarded is Doctorate in Clinical Psychology, or DClinPsy for short. So graduates are Doctors, but not Medical Doctors or Psychiatrists. 

 

Unlike Medical Doctors and Psychiatrists, Clinical Psychologists are not licensed to prescribe medication (in the UK, in some other countries they can). Instead, the treatments are talking therapy based - through talking, the therapist and patient (or client) work to understand and find ways to overcome psychological difficulties. 

What is CBT?

  • CBT is evidence-based and effective: In short, it works. When looking for help, it makes sense to choose a treatment which has strong evidence behind it, so it is much more likely to help you. There is a substantial volume of research evidence for the effectiveness of CBT for a wide range of psychological problems. The National Institute for Health & Care Excellence (NICE), which systematically reviews the evidence for treatments, then backs (or doesn't) these treatments, gives plenty of backing to CBT. See the NICE evidence for CBT here.

  • CBT is effective for a wide-range of psychological problems including:

    • Anxiety disorders such as social anxiety, phobias, generalised anxiety

    • Depression

    • Eating disorders (bulimia, binge-eating)

    • Health anxiety

    • Insomnia and sleep problems

    • Managing long-term health conditions (LTCs) such as chronic pain, diabetes, COPD...

    • Obsessive Compulsive Disorder (OCD)

    • PTSD and trauma

  • CBT is time-limited: It is classed as short-to-medium term, usually lasting from 6 to 16 sessions for common psychological problems (such as those listed above). It isn't open-ended, continuing for years or until your therapist thinks that you are done!

  • CBT is practical: Through CBT you learn take away strategies to better manage your mood, thinking, behaviour and body. The emphasis across these four areas will vary depending on your difficulty, experience and symptoms.

  • CBT is collaborative: You and your therapist are working together to understand your difficulties and to test-out what helps. 

  • CBT is problem (and solution) focused: This might sound obvious, but it is worth saying. CBT works to identify and help problematic thoughts, behaviours, emotions and bodily sensations. CBT is about focusing in on the problem and addressing it. 

The example of CBT for social anxiety

 

The diagram on this page shows an simplified example of how someone who is anxious in social situations (social anxiety) might think, feel emotionally, feel physically and behave in a social situation. 

 

Each element, contributes to an increase in difficulty in the social situation. 

The only thing that might help the individual will be to escape (or if wise, to learn to manage and conquer through applying CBT techniques).

What does CBT mean?

 

Let's break down the C, the B and the T.

 

The 'C' in CBT, stands for 'Cognitive' - which is really just a more formal or scientific word for our Thinking - what we think and how we think.

The 'B' in CBT, stands for Behaviour - what we do and don't do (e.g., avoidance: perhaps you avoid some things?)

The 'T' in CBT, stands for Therapy - that is improving functioning, reducing limitation, reducing distress, and overcoming problems. 

What is not captured within the C, the B, and the T, are the emotions and bodily symptoms or sensations that are part of our difficulties and elements that CBT considers and addresses.

How does CBT help our thinking or cognitions?

Let's go a bit deeper. As I've described, 'Cognitive' is the term used to capture our thinking. In CBT we consider that this has two parts:

1. Our actual thoughts:

  • The verbal stream, e.g., "I'm ugly"

  • Or an image, e.g., of being ignored or rejected at a social gathering

2. Our thought processes:

  • How we distort things so they fit our view of ourselves, other people and the world

  • How our memory becomes biased

  • How minimise and magnify our experiences so they 'fit'

  • Our awareness of our thinking

CBT brings effective techniques to address the content of our thoughts and the process of how we think, through tried and tested models and strategies.