Counselling for Stressful Life Situations

CBT is short term, focused therapy which focuses on allowing clients to identify unhelpful thinking and behaviour patterns and to change these. CBT has been extensively investigated in rigorous clinical trials, focusing on immediate difficulties as well as long term strategies, and is tailored to each individual.

CBT is an active and collaborative counselling treatment, where the client does not adopt a passive role, but rather becomes an active partner in the treatment plan with the therapist. In CBT, clients are taught about the vicious cycles of thinking, behaviour, emotions and physical reactions that maintain the disorder they are suffering from. Then counselling moves on to learning strategies such as relaxation, lifestyle changes, identifying and challenging ‘automatic’ thinking patterns, making gradual changes in unhelpful behaviours, such as avoidance of feared situations, and learning how to maintain treatment gains without relapsing.

In CBT, counselling continues outside the scheduled sessions, as research has shown the importance of clients practicing strategies and attempting tasks in between sessions. CBT incorporates these ‘homework’ tasks.

Schemas are unhelpful beliefs and patterns of thinking, feeling and acting that were formed early in a person’s life, and have continued to the present day. These beliefs are so deeply held that they are just felt as ‘the way things are’. An example of this might be the ‘mistrust/abuse’ schema, where the person believes that ‘others will just let you down, you can’t trust anyone’. Another is the ‘unrelenting standards’ schema, believing that one must always strive to be their absolute best and achieve, or else they don’t feel quite good enough in themselves. These become ways of seeing the world, oneself and other people, and then the person is driven to act in ways associated with the schema. The person who holds an unrelenting standards schema for instance, may push themselves so hard at work and in other areas that they never have time to relax and have fun, or procrastinate a lot to avoid all the tasks they feel overwhelmed by.

If your treating psychologist believes this approach will be useful for you, counselling will involve helping you understand the repeating patterns in your life and the origins of these, and then challenge them using discussion, ‘experiential’ techniques such as imagery and chair role-play, and behaviour change strategies, such as learning how to become more assertive, to set limits on work, or to change the way you approach relationships. Our clients generally find this counselling approach very helpful.

ACT incorporates two broad approaches to overcoming common psychological disorders. The acceptance approach means learning how to make room for painful emotions, thoughts and sensations, allowing them to be there without struggling against them. Commitment focuses on channeling your energies into living your life in the way that is most important to you, rather than waiting until you have controlled or overcome difficult emotions and thoughts first.

ACT is a more recently developed therapy, and its research base is building. Research evidence exists to date showing ACT to be effective in the treatment of smoking cessation, depression, anxiety, chronic pain, diabetes management, addictions, workplace stress, weight management, epilepsy control, self-harm, body dissatisfaction, and eating disorders.

Eye Movement Desensitisation and Reprocessing Therapy, or EMDR, is used for individuals who have experienced severe trauma, enabling them to recover from the symptoms and emotional distress resulting from those traumatic life experiences.

EMDR, has been proven through rigorous research to be one of the most effective treatment models for Posttraumatic Stress Disorder (PTSD). Trauma Focussed CBT and Exposure Therapy are also proven effective therapeutic models. EMDR has been verified as an effective treatment for PTSD and meets criteria for evidence-based practice in the UK by the National Institute for Clinical Excellence (2005), in Australia by the Australian Centre for Posttraumatic Mental Health (2013).

EMDR therapy demonstrates that the mind can recover from psychological trauma much as the body heals from physical trauma. Following training on detailed EMDR protocols and procedures, a psychologist can help clients activate their natural healing processes, alleviate the symptoms of post-traumatic stress disorder (PTSD), and allow them to develop more adaptive coping mechanisms.

EMDR looks at emotions, physical sensations, thoughts and beliefs all together. Following a structured eight-phase protocol, desensitisation begins with the individual’s attention being directed to the chosen target memory, negative beliefs, and body sensations, while following the therapist fingers moving from side to side. Following a set of eye movements the therapist asks the client to report what they notice now; they are then asked to either focus of what had emerged, on a body sensation or their level of distress. When distress has reduced to 0 or 1 (on a scale of 10) a preferred positive belief statement is installed with more sets of eye movements, until the positive statement is rated as highly believable. Any residual sensations are then desensitised with eye movements until there are no longer present.

During EMDR counselling sessions the individual is encouraged to “let whatever happens happen and just notice” so that freely-associated memories enter into the mind. This allows processing to take place allowing the memories to be consolidated and put into historical context. EMDR treatment encourages distancing effects that are considered effective processing of the memory; this means the memory is no longer as vivid and felt with such emotional and physical intensity.