Therapeutic approach

Cognitive Behavioural Therapy (CBT)

Cognitive-Behavioural Therapy (CBT) is a form of therapy that has proven to be highly effective for a wide range of problems. It is particularly helpful for depression and anxiety disorders.

CBT is based on the idea that the way we think, feel and behave are interrelated. It explores how patterns of thoughts, feelings and behaviours might inadvertently maintain current psychological distress.

The therapist and client work together to develop a treatment plan to achieve the client's goals.

Treatment will usually include:

• psychoeducation about the client's difficulties
• learning how to identify and challenge unhelpful thoughts and assumptions
• reduction of avoidant behaviour by gradual exposure to fear situations (with the support of the therapist)
• learning new problem solving skills

CBT can help clients to:

• feel more confident in their ability to cope with difficult situations
• reduce symptoms of anxiety or depression
• increase positive beliefs about themselves, others and the world
• increase their sense of personal wellbeing

Schema Therapy

Schema Therapy integrates elements of cognitive-behavioural, experiential, interpersonal, and psychoanalytic therapies into a single therapeutic approach.

It was initially created by Dr Jeff Young, who found a subset of clients that did not find standard cognitive therapy effective. These clients had long-term patterns of thinking or feeling about themselves and the world that required a different approach.

Schema Therapy is a more moderate-to-long term therapy. It is particularly effective in helping individuals with more complex, long-standing difficulties. Schema Therapy focuses on treating the cause of problems and not the symptoms.

It focuses on identifying emotional needs that might have gone unmet for the client when they were younger, and how this may have contributed to patterns of unhelpful behaviours over a client’s lifetime.

Sarah has been using schema therapy for many years, and is currently undertaking training to become a Certified Schema Therapist.

Emotionally Focused Therapy for Couples (EFT)

EFT is an evidenced based therapy that focuses on adult relationships and a couple's ability to develop a healthy emotional attachment.

The therapist helps couples to identify negative patterns in their relationship and to develop a safer connection to each other.

This has proven to increase relationship satisfaction, intimacy, closeness and positive patterns of interacting.

The therapy focuses on emotion as one of the key ingredients that affects an individual's internal experience and the interactions within their relationship.

Sarah first started her training in EFT a number of years ago, and really enjoys seeing couples grow closer together and develop a stronger bond.

She is currently undertaking ongoing training to become certified in Emotionally Focused Therapy.

Dialectical Behavioural Therapy (DBT)

Dialectical Behaviour Therapy is a type of treatment that was initially developed for people with a diagnosis of Borderline Personality Disorder (BPD).

In its truest form, DBT has four components comprising:

• weekly individual sessions
• skills training (group format)
• phone consultations
• consult team for the therapists

As its name suggests, DBT focuses on dialectics - which means synthesising or integrating opposite ends of a spectrum - such as the question "How can I accept that my life is currently very hard AND strive for change at the same time".

People with BPD reported they felt that traditional cognitive therapy could be invalidating of their feelins. On the other hand, counselling was validating of their feelings but didn't help them change unhelpful behaviours.

DBT aims to help validate a person's experience and help them to make changes to unhelpful patterns of behaviour.

Nowadays, DBT is used to help a variety of types of problem.

The skills focus on mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation.

Some limitations come with not working as part of a larger team in Private Practice, and as a result Sarah cannot offer DBT in its truest form.

However, she is able to offer therapy informed by DBT, which can utilise many of the skills outlined above.

These have proven particularly effective when combined with access to group therapy from other service providers (eg Perth Clinic or the Marian Centre).

Mindfulness

John Kabat Zinn has described mindfulness as paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.

As we develop mindfulness, we learn to have an awareness of our thoughts and bodily sensations without getting caught up in them.

This can help us to develop a new relationship with our own internal (and external) experience, helping a person to become more compassionate, accepting and gentle.

We can learn to be more intentional about our responses and life choices, and break free from unhelpful reactions learnt through habit.

People who learn to incorporate mindfulness into their daily lives often find they become more relaxed and that their mood improves.

Mindfulness has been shown to be effective in helping with psychological problems such as recurrent depression, anxiety and physical pain.