This article is a case study about a young client struggling with anxiety. It discusses how he and his therapist found a way to communicate with one another through the use of drawing therapy.

Jake and his overwhelming anxiety

Jake was too young to be one of my clients, unfortunately he was also too old to fit into the paediatric mental health team and the teenage support group for anxiety was overwhelmed.

 Jake had a bad experience and didn’t trust therapists

Jakes mother  described a boy who every morning thought he would get up and go to school and by 9:05 had failed.  He was then stressed all day about having to go to school the next day and couldn’t concentrate on his schoolwork at home, even if his granny sat and helped him

The start of CBT therapy

Jake`s mother and I agreed not to tell the services that I was working with him in case it stopped him from obtaining more appropriate input.  We also agreed she would sit in on the sessions as a silent observer.

Jake didn’t say much either apart from telling me how he’d been let down by other therapists who had promised a phased return to school with him in control – but this hadn`t happened. I told Jake that I didn’t really care whether he went to school or not, all I cared about was helping him get through the time period until he felt ready to do so.

I did the standard CBT things using Zoom at Jakes pace, he was very anxious before our sessions and quite often came into therapy feeling upset, and sometimes he cancelled, hiding in his bedroom.

How drawing therapy became part of his CBT

Once I discovered Jake could draw things changed.  Using the shared whiteboard he could depict his feelings and could use the subsequent image to explain what he meant.

Several of these drawings changed things greatly for both of us, the first picture showed how he felt about anxiety and the treatment of it.  He drew a very cross looking person with steam coming from his ears.  After we discussed it  I asked him whether he wanted to continue working with me.  There are no words to describe the rewarding feeling I had as I watched smiley faces prop up on my computer screen as he drew, miles away, in his own sitting room.

CBT Drawings to express and understand anxiety

Today Jake and I talked about anxiety, or rather I talked and he drew. I thought I knew what it felt like to be anxious, I’d been anxious before exams, been a bit stressed if I didn’t know the outcome of a dilemma, and I’m scared of the dark. Anxiety is huge, scary, unstable and destructive. Jake drew his “ monster” on the shared whiteboard.

The first thing I noticed was the Boris hairstyle – my interpretation, Jake just wanted to make it look stupid. It wasn’t very big either but had a foot in the door. The front door which was open because the anxiety had come with a reasonable-sounding request. Once Jake allowed the anxiety in it talked and talked to him and even when he tried to make it leave by another door it never stopped telling him something was wrong. In the end, Jake simply stopped opening the door.

He wasn’t frightened though, his anxiety was stupid, annoying and persistent, but never scary, destructive or unstable.

I guess anxiety is just a word, but a picture is a thousand words.

AUTHOR: Emily Cobb

Cognitive Behavioural Therapy

If you are looking for therapists who offer Cognitive Behavioural Therapy for a range of mental health issues you can read more about it on this page. We offer therapy at Act Counselling and CBT Services and are happy to speak with you today should you wish to find out more and book in with one of our therapists. Get in touch with us today via our online contact form or call us on 0141 554 0838.

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There was a room full of people, looking as scared as me, I was nervous about what I was about to feel, do, say and see. 

As the weeks turned into months, the friendships and bonds grew, we learned about each other, and the things we’d each been through. 

We get into our groups, and each module Gillian would change us round, who knew that we’d learn so much, and the personal growth that would be found. 

Then in March the virus hit, we had to stop the club, but just for a little bit. The structure changed and we were now on zoom, we were worlds  away from our safe cosy room. 

 A world pandemic wouldn’t stop our club,  for nearly every week we all turned up. Even With all the different walks of life, facing sickness, uncertainty, heartache and strife. 

We supported each other on a Tuesday, through the week and in the chat, Gary’s Jokes made us all laugh when we felt flat. 

Now it’s the last week and we

See each other through the screen. How much I wish I could hug you, and show how much to me, you really mean. 

Some weeks have been a challenge, even to get out of bed, but I’m so glad I did, just to feel the love that was so openly spread. 

Now it’s time to say goodbye as we each go out into the world, to show off our knowledge, courage and  new self that this course has unfurled. 

I wish you all so much love and luck, it’s been so amazing being your friend. This club has been my saving grace with my heart now on the mend. 

Thank you for all you’ve done for me, you’ll never really know,  how much the power of our club, has changed me and helped me grow. 

– By Ruth Whyte

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There was a little empath named Sharon, who had witnessed many troubled times as a young girl, teenager, and young woman. She realised at an early age that she had special powers: a desire and the skills to help other people feel better.

Her dream was to reach the top of the Magic Mountain where she would achieve her Diploma in Counselling Skills. From here, she would be able to see far and wide across the land, and she felt she could reach out to help others as a qualified Counsellor. But first, she must climb to the first level of the Magic Mountain by successfully completing the COSCA Certificate in Counselling Skills. The little empath set off on her first quest.

The COSCA cave

She found a reputable course provider with excellent reviews and travelled far, into deepest darkest east end Glasgow. There, she was met by her two empath Godmothers, Alison and Claire. They were both very wise in the ways of counselling and they were to be her guides. Through the glass doors, and into the COSCA cave, she met a lovely group of other empaths. She was soon to realise that they too, had the same special powers to help other people. Very soon, the little empath felt right at home.

Lots of learning

For the next ten weeks there was a lot of learning to be done. The little empath thought she had always been a good listener, but, working more intensely with her supportive triad she realised there was much, much more to it. Always the one to give advice, she saw that she must quietly listen with a range of attending and responding skills. She must not ‘fix’ things and instead, must truly be there with her speaker. After all, the answers lie within. It was just her job to help the speaker reveal them. She loved using the Guided Fantasy and has used this back in her own kingdom with the young people she teaches. They were then able to uncover some feelings they had not known were there, and were also able to put a name to an emotion that they were unable to talk about in traditional one to one discussion.

The wise Godmothers

Soon, the wise Godmothers bestowed another gift. In order to reach level one of the quest, the little empath must truly know in her heart the core principles of counselling: Acceptance, Genuineness and Empathy. Luckily her magic powers allowed her to feel empathy for others readily. Sometimes this was a bit too much and she knows she has to protect herself in order to not feel drained and be of more use to her speakers.

Remember to relax

Genuineness was interesting to learn about as the little empath thought she came across as open and interested. However, her study of her recorded video clip revealed a stern face and closed body language. Her supportive triad said she just looked professional and was maybe a little nervous in front of the camera, and that she didn’t look stern to them at all. The little empath was relieved to hear this as she really wanted to look as genuine as she felt inside. She made a decision to remember to relax her body and face and to never cross her legs or lace her fingers again.

Acceptance

Acceptance was the real stumbling block as her deeper judgements of others were revealed. The Godmothers gave out tiny pieces of folded paper, but they held monumental discussion points. Emotive names were inside and this made the little empath shudder. Could she honestly put her triggers to one side and help the horrible trolls or the wicked witches of the world? After all, they have feelings too and someone has to help them. A lot of self-reflection is needed to answer this, and suddenly for the first time, the Diploma at the top of the Magic Mountain seemed out of reach. Would she ever get to the top to achieve something she was once so certain of?

Disaster struck

Then, one day, disaster struck! The land was cursed with a virus and all the empaths and the Godmothers were banished to self-isolation and social distancing. What was to become of them? Luckily, the Godmothers found a way to sprinkle magic Zoom dust on all the laptops and the empaths rejoiced as they were reunited by way of digital media. Hurrah!

The little empath misses the energy of her tribe in person, but is thankful for the mystical power of technology to help her continue in her quest.

How things changed…

In the beginning of Module 2 of the Certificate in Counselling Skills, the little empath and her tribe had settled into a ‘stay at home’ routine. She could not believe how quickly the sands of time had passed in the last ten weeks, and she settled down to review how that had been for her.

Having spent fifteen long weeks staying safe at home, the little empath also conducted all of her full time work as a teacher online. In addition to the COSCA course she also committed to another online distance learning course. The amount of screen time was proving to be a challenge for her and left her feeling a little overwhelmed at having to be such an integral part of the digital world. Sometimes she feared that the prophecies were coming true and that human and machine would indeed merge as one. She made a promise to herself to allow more study time for the next module and try new ways of learning to help overcome the intensity she felt around being online so much.

Positive energy…

Her new triad provided a calm and positive energy from the beginning. She loved watching the confidence of her triad grow with each skills practice as she herself even started to feel more relaxed watching her recordings. After consulting the ‘feelings wheel’, she could now identify with a feeling of optimism rather than being critical of herself. Progress already?

The cycle of change…

The middle of Module 2 was proving to be more in-depth in terms of content and discussion. Complex topics around sexuality, feelings, the grief cycle, change, values and ethics sparked lots of interesting discussion for the tribe. The cycle of change and the change curve were insightful tools for the little empath to consider. It helped her see some reasons why she had not been able to make the changes she wanted in her life, and she was eager to try this out for herself, and also within a counselling approach. The little empath likes to think about change from all possible angles and this can sometimes leave her feeling exhausted about all the ‘what if’s. She found the motivation grid very useful for this and has used it to make a decision about looking for another job in a different school. This gave her clarity and more confidence in her decision and she was thankful to her godmothers for bestowing these gifts.

A wave of emotions…

Sexuality was a topic that opened up a wave of emotions for the little empath. She realised that a wicked witch had tried to poison her mind with untruths in the past around what it meant to be a sexual being. By challenging her thoughts, she uncovered deep-rooted feelings that she had forgotten about. While saddened by this at first, she now sees it as a positive as she has been able to look back at her changed attitudes more deeply and this will hopefully help her to be more genuine and empathetic in a counselling approach.

Time to reflect…

The ending of Module 2 was mixed emotions for the little empath as she was invited to consider how to say goodbye to her triad. Following what felt like a more intense part of the course the triad had time to discuss how they felt and what progress they had made. Through this safe space the little empath realised that while she felt on one hand that the module went by so quickly, she also discovered that she had soaked up so much information that it was likely to be slow burner for her as she allowed herself to revisit the theory and reflect on how it has affected her personally as well as in a counselling approach.

Looking forward to a two-week break to recharge, the little empath knows that another beginning is just around the corner in the form of Module 3 and she is eager to explore the content with her tribe and another new triad.

The End

By Sharon Kirman

Cognitive Behavioural Therapy

If you are looking for therapists who offer Cognitive Behavioural Therapy for a range of mental health issues you can read more about it on this page. We offer therapy at Act Counselling and CBT Services and are happy to speak with you today should you wish to find out more and book in with one of our therapists. Get in touch with us today via our online contact form or call us on 0141 554 0838.

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As Therapists or other professionals move further along their journey of personal development, self-awareness and ultimately work towards self-actualisation it might be fair to say that we become less vulnerable. In relation to the vulnerability/stress model this leaves us more predisposed to taking on higher levels of stress, none more so in the stories we hear from our clients. Of course, some client’s stories touch us more than others and what of the ones about abandonment, neglect, abuse, trauma, emotional deprivation? It is our job but also in our nature to empathise with our client’s. With regards to empathy, the paradoxical theory often stands up in that our greatest strength is also our greatest weakness.

Dealing with Vicarious Trauma as a therapist

We empathise with the hard end of human suffering on a consistent basis. For some Therapists/Professionals, this might be daily. This often comes at a price. At ACT Counselling Services we often hear stories from colleagues of ‘taking the client home with me,’ which of course means thinking about the client in one’s own time. We also hear stories of colleagues having nightmares, rescue fantasies etc. A lot of professionals will take issues of vicarious trauma to Clinical Supervision and whilst this might well be helpful there is so much more that can be done.

Can we learn from Buddhism?

Traditional Buddhism has been a long advocate of the ‘suffering’ involved in being a human being, yet Buddhist Monks appear to remain compassionate and optimistic. What is their secret? Furthermore, can we as Therapists/Professionals learn from Buddhist Monks in order to offset Vicarious Trauma? Also, are there more practical steps that can be taken by Therapists/Professionals and their organisations to create a culture that protects us from the impact of Vicarious Trauma?

Do you want to learn more about Vicarious Trauma?

To find out more about the above and answers to the questions posed, visit our CPD Events page on this website and register for the ‘Vicarious Trauma’ CPD event scheduled to be delivered in Dunblane on Friday the 25th of August 2017. You can call us here at ACT Counselling and CBT Services in Glasgowon 0141 554 0838 or contact us online here.

Cognitive Behavioural Therapy

If you are looking for therapists who offer Cognitive Behavioural Therapy for a range of mental health issues you can read more about it on this page. We offer therapy at Act Counselling and CBT Services and are happy to speak with you today should you wish to find out more and book in with one of our therapists. Get in touch with us today via our online contact form or call us on 0141 554 0838.

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The ACT Counselling Services Team will shortly be delivering a 1-day CPD event titled ‘Borderline Personality Disorder, Neuroscience and Psychotherapy.’ This will take place on Saturday the 15^th of October 2016 at Stirling Baptist Church and Family Life Centre, 2^nd Floor, 61-63 Murray Place, Stirling, FK8 1AP. ACT Counselling Services Ltd are a private training provider who’s staff have a huge amount of experience of working with complex cases. Staff members have worked in the most challenging settings with the most severe and enduring types of disorder. We are passionate about sharing our knowledge, experience and conclusions to enable others to understand and/or work with complex cases.

What is Borderline Personality Disorder?

Borderline Personality Disorder or BPD for short is one of the most challenging presentations for clinicians to treat. It is, without doubt, the disorder that costs the taxpayer the most money on a yearly basis. Despite these considerations, there is still little training on working with BPD, services available to treat BPD and Clinicians remain reluctant to add the treatment of BPD to their repertoire.

People often ask us ‘what is BPD?’ ‘Can it be treated?’ and ‘how does one even begin to treat it?’ Put very simply, the person who has received a diagnosis of Borderline Personality Disorder constantly flips between different ‘schema modes.’ Modes are considered to be ‘states’ rather than ‘traits’ and are fleeting, short terms ways of thinking, feeling and behaving. Folks with a diagnosis of BPD will frequently ‘flip’ between the ‘vulnerable child,’ ‘Punitive Parent,’ ‘Demanding Parent,’ ‘Angry child,’ and ‘Detached Protector,’ although not necessarily in this order.

What does this mean?

The above means that the person who has been diagnosed with BPD spends very little time in the ‘Healthy Adult,’ ‘Nurturing Parent,’ and ‘Happy Child’ modes and this has a significant impairment on their quality of life.

BPD was for a long time considered to be untreatable but things have changed and it can easily be treated by clinicians with the correct knowledge, skills and attitude. In a universe based on opposites, one need not just ‘be,’ one can ‘become’ the person they were supposed to be.

Get in touch to find out more

If you are interested in finding out more, then please get in touch. You can call ACT Counselling and CBT Services in Glasgow on 0141 554 0838 or email us here.

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It is a well-known fact, and yes you have probably read or heard it before that Cognitive Behavioural Therapy (CBT) is the most evidenced-based psychological therapy available today and is the preferred therapeutic approach of the NHS. However, it is probably not the first modality one would associate with when working with clients presenting with substance misuse, having said that, CBT is very adaptable and can be integrated with Relapse Prevention (RP), Motivational Interviewing (MI) and Solution Focused Brief Therapy (SFBT), as well as other approaches.

What I do…

I am a qualified Cognitive Behavioural Therapist working with West Lothian Drug and Alcohol Service (WLDAS), my team is called The Moving on Service where currently, I hold the position of Counsellor/Line Manager working on a 1:1 basis with offenders and vulnerable adults. In addition, I was responsible for compiling and presenting/facilitating the first group work program, appropriately named CBT in Groups which is open to the whole WLDAS service, moreover will now be open to the Addiction Care Partnership (ACP) that incorporates WLDAS, Social Work Addictions, NHS Lothian and Cyrenians Recovery Service. This is due to the successful pilot of CBT in Groups over the past 14 months. Groups have focused on anxiety and depression after my colleagues and I conducted a survey of our clients to ascertain their preferred choice of a group work program, indeed the latest group has just ended after a 12-week run.

How the groups worked…

There have been 3 groups piloted, covering a total of 30 weeks, with accumulative referrals of 54 clients. There were 29 clients who did not attend or disengaged after 3 weeks, however, a total of 25 clients remained consistently in attendance between the 3 groups: 6, 6 and 13 respectively.

Criteria to attend CBT in Groups (pilot)is simply to have had or currently have a substance misuse issue (stable enough to attend weekly groups), or have been affected by another’s substance misuse, that being a wife, husband, partner, other family member or friend and be working on a 1:1 basis with one of the counselling team at WLDAS.

Bringing two together…

My colleagues in psychiatry will proclaim, ‘get rid of the substance misuse and your mental health will improve!’ I whole heartily agree but if only the substance misuse has gone the possibilities of relapse significantly remain as drugs and/or alcohol are extensively used as a coping strategy. Therefore, I am of the professional opinion (as are others within the field) that when there is a dual diagnosis (mental health issue and substance misuse)both require to be addressed simultaneously, obviously helping the client to establish a period of stability regarding the substance is vitally important at the beginning of any intervention.

To find out more get in touch with us on 0141 554 0838 or email us here.

Cognitive Behavioural Therapy

If you are looking for therapists who offer Cognitive Behavioural Therapy for a range of mental health issues you can read more about it on this page. We offer therapy at Act Counselling and CBT Services and are happy to speak with you today should you wish to find out more and book in with one of our therapists. Get in touch with us today via our online contact form or call us on 0141 554 0838.

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So what is the value of Imagery Assessment and why is it used in Schema Therapy?

It is important within the Assessment and Education phase of Schema Focused Therapy that the client’s Schemas are accurately identified. The mistake that a lot of Practitioners make is that they provide the client with extensive information and psycho-education as regards schemas. They then administer one or more inventories to help identify the client’s schemas. At this point, if the client’s hypothesised schemas match with the high scoring schemas on the inventories then the Practitioner is satisfied that enough information has been gathered to state with surety that ‘this is one of your schemas.’

How are Schemas stored?

The above, of course, is not enough. How can it be? All of the above is related to logic, words and numbers. This is the fundamental flaw as schemas are stored deep in the reptilian part of our brains, in the amygdala. Schemas are stored in early childhood with images and a high-level of emotion attached to them. Thus, they are not stored with any logic, words, numbers or explanations attached to them. As a result, schemas must be triggered and felt by the client on an emotional level before the client and therapist can be sure that this is a schema belonging to the client.

Imagery Assessment is the main assessment methodology that is used to identify schemas accurately. To find out more about this technique, see how it is used, and practise using it, please refer to our ‘Practising Schema Focused Therapy’ short course information section of this website, where course information and booking instructions can be found.

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The ACT Counselling Services Team have been developing and delivering a new input as part of the PG Diploma on Personal Construct Psychology (PCP). The first thing that we must remind ourselves of is that PCP is a philosophy as opposed to a theory. It is our opinion that it is crucial for CBT Practitioners to have an understanding of PCP as it enhances our understanding of CBT’s philosophical underpinnings.

What is Personal Construct Psychology?

So what is PCP all about and why are we so excitable about it. I suppose the place to begin is perception and PCP is all about perception and making sense of things. As human beings, we are meaning-making creatures and our minds are just meaning-making machines. We are driven to make sense of things. This translates into a therapeutic context as we attempt to make sense and find explanations for our client’s thoughts, feelings, behaviours and motivations etc.

The CBT Practitioners role

The trap that one must never fall into as a CBT Practitioner is to impose our sense of meaning-making onto our client. If we do, we run the risk of not understanding our client or their issues in the fullest sense. So for example, when the client states they are anxious or depressed, how do we know what this is like for them. Unless we specifically ask then we are imposing our own understanding of what anxiety or depression is like for us, or indeed how we have heard other people describe what it is like for them. This is not representative of an individual’s uniqueness. Think about how other people’s feelings, behaviours and motivations etc are explained away in day to day life: ‘He/She obviously did that because……………,’ ‘You are feeling like that because……,’ so on and so forth.

Sign up today

The technique used to gain an understanding of what another’s experience is like is called ‘Suspension.’ How to use this can be discovered by enrolling on the ACT Counselling Services PG Dip Level Diploma in CBT and Groupwork.

Cognitive Behavioural Therapy

If you are looking for therapists who offer Cognitive Behavioural Therapy for a range of mental health issues you can read more about it on this page. We offer therapy at Act Counselling and CBT Services and are happy to speak with you today should you wish to find out more and book in with one of our therapists. Get in touch with us today via our online contact form or call us on 0141 554 0838.

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We were reminded in both the writing of the materials and in last night’s delivery of the complexity of Schema Therapy but also of the power to effect change in clients with complex and enduring Mental Disorders.

Educational Phase

Last night saw us visit the educational phase involved in Jeff Young’s approach. There were a couple a few points that gave the course team cause for reflection. Firstly the unconscious drive with people with a personality diagnosis to continue to confirm the validity of the Schema, and any information which does not do so is either avoided, distorted or ignored. So the client with an Abandonment schema will unconsciously behave in a way that leaves them abandoned by others. The client with a Defectiveness schema will unconsciously behave in a way that confirms their ‘not good enough’ view of self through self-sabotage or being overly perfectionistic.

Cognitions and Schemas

The next point we wish to make is that of the gap between cognition and Schemas. This leads to cognition and emotion mismatch. So although the person with the Abandonment Schema knows that the evidence disputing their ‘people close to me will leave me’ cognitions to be true, IT DOES NOT FEEL LIKE IT. The person with the Mistrust/Abuse Schema knows the evidence disputing ‘my Partner will let me down’ is true, again, IT DOES NOT FEEL LIKE IT. It is this that leads to Schemas being largely worked on with affect and imagery. Cognitive disputing on its own will do very little to affect change.

Schemas

The last point we wish to make and this is often insightful for Practitioners is that the first 7 Schemas are the core Schemas and the remaining 11 can attempt to cope with the first 7. This often confuses Practitioners as the first 7 come from the Disconnection/Rejection domain and the remaining 11 come from other domains. The point is that domain 1 (the disconnection/rejection domain) is the conditions that lead to the formation of core schemas. The remaining 4 domains are the conditions of worth set by the family, classroom or playground for the client to escape the core schema. Still confused, then get in touch and enrol for our next course.

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I recently attended a conference on children’s services within Glasgow where 2 of the keynote speakers highlighted the need to shift away from “labelling” or diagnosing mental health problems in children and move towards “case formulations”. They proposed that we should be thinking from the outset, in partnership with the child and their family about what the difficulties are that need to change and what goals we would like to achieve (ie what changes do we want to see in the child’s mood, behaviour, presentation etc). We would then move on to think about how we are most likely to achieve these goals.

A major shift in practice in child mental health diagnosis

As a social work manager, this shift in approach is already being used within multi-agency meetings I attend within education. It has meant a major shift in practice away from long conversations about the child and their difficulties, to looking at strengths, goals and actions. This has allowed us to be more efficient in terms of use of time and more productive in terms of outcomes from the meetings. Within social work, this approach is also being used both at team meetings with staff as well as meetings with children and their families.

Focus on solutions, not the problem

This struck me as being very similar to the CBT approach. Talking through the presenting issue/problems with the person and identify what changes they would like to achieve so that they are able to live happier, more fulfilling lives. I think one of the benefits of this approach is that it doesn’t focus too much on the problem or the causes of the problem, but rather on what solutions or changes that can be made to achieve one’s goals, with clearly agreed actions being taken forward for the next week to put in place and review.

Cognitive Behavioural Therapy

If you are looking for therapists who offer Cognitive Behavioural Therapy for a range of mental health issues you can read more about it on this page. We offer therapy at Act Counselling and CBT Services and are happy to speak with you today should you wish to find out more and book in with one of our therapists. Get in touch with us today via our online contact form or call us on 0141 554 0838.

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