Services for Adults
Our therapists can address the broad range of psychological difficulties that a person might be experiencing, from current situational life difficulties to more deep-rooted psychological and behavioural issues, and those originating in earlier life experiences.
When you avail of any our services you will be received into a warm, empathic, safe relational space. This is the cornerstone of our work. We also pride ourselves on tailoring our approach to meet the needs of each individual client. We will work out with you whether brief focussed work or longer-term therapy will best meet your needs.
Psychotherapy is the process of treating psychological disorders and emotional distress through the use of verbal and psychological techniques. During this process, a trained psychotherapist/psychologist helps you address specific or general problems such as a particular mental illness or a source of life stress. We can offer a range of therapeutic approaches including Psychoanalytic/Psychodynamic Psychotherapy, Cognitive Analytic Therapy and Cognitive Behaviour Therapy. Effective Therapeutic support is available for depression and anxiety, trauma, relationship difficulties and the ongoing impacts of childhood adversity.
If you are struggling in life but are uncertain what kind of therapeutic or other support might benefit you, a consultation appointment plus follow up review could be the answer. The Clinical Psychologist will review your current difficulties, history and early experiences and develop a psychological formulation or understanding of your presenting concerns, and then advise on the best type of support or intervention, based on research evidence.
What is Psychoanalytic/Psychodynamic Psychotherapy?
Psychodynamic or psychoanalytic psychotherapy refers to a range of treatments based on psychoanalytic concepts and methods that involve less frequent meetings and may be considerably briefer than psychoanalysis proper. Session frequency is typically once or twice per week, and the treatment may be either time limited or open ended. The work focusses on:
- Identification of recurring themes and patterns.
- Discussion of past experiences, with developmental focus
- Focus on affect and expression of emotion
- Exploration of attempts to avoid distressing thoughts and feelings
- Focus on interpersonal relations
- Focus on the therapy relationship
- Exploration of phantasy life
Psychodynamic therapists work to identify and explore recurring themes and patterns in patients’ thoughts, feelings, self-concept, relationships, and life experiences. In some cases, a patient may be acutely aware of recurring patterns that are painful or self-defeating but feel unable to escape them.
Psychoanalysis, which began with the work of Sigmund Freud over 120 years ago, was instrumental in developing the idea of mental suffering and symptoms as meaningful, and in need of being listened to and spoken out. The original Talking Cure, it continues to be the most elaborate and compelling theory of the mental life of humans. It is a powerful and effective means of addressing human mental suffering, and of affecting deep personality structures. Both psychoanalysis and psychodynamic psychotherapy promote change, to enable people to experience life differently and to develop their own solutions to life problems.
A considerable body of empirical research supports the efficacy and effectiveness of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies, and it has been shown that people who do psychodynamic therapy continue to improve after treatment ends. (It’s known as ‘the sleeper effect’). It has been suggested that other therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice.
What is Cognitive Analytic Therapy?
CAT stands for Cognitive Analytic Therapy, first developed by Dr Anthony Ryle in the 1990’s.It is a collaborative therapy which looks at the way a person thinks, feels and acts, and the events and relationships that underlie these experiences (often from childhood or earlier in life). As its name suggests, it brings together ideas and understanding from different therapies into one user-friendly and effective therapy. The approach involves developing maps and letters with your therapist, as tools for self-reflection and for considering alternative options when you are stuck in old ways of relating to yourself and others. A primary focus is on exploring relationship patterns as they emerge in the therapeutic relationship and as they unfold in the stories you bring into therapy about your life and experiences.
It is a programme of therapy that is tailored to a person’s individual needs and to his or her own manageable goals for change. It is a time-limited therapy – between 4 and 24 weeks, but typically 16.
At its heart is an empathic relationship between the client and therapist within the therapeutic boundaries, the purpose of which is to help the client make sense of their situation and to find ways of making changes for the better.
CAT is about:
- Forming a trusting relationship with your therapist which allows you to work together to explore the difficulties you are facing
- Identifying your current problems and how they affect your life and wellbeing
- Looking at the underlying causes of these problems in terms of your earlier life and relationships
- Understanding how you learned to survive sometimes intense and unmanageable feelings by relating to others and yourself in particular ways
- Identifying how these patterns may now be holding you back
- Discovering the choices and ways of doing things differently (‘exits’) that are available to you to make your life better for yourself and those close to you
- Finding out how you can continue to move forward after the therapy has ended
What is Cognitive Behaviour Therapy?
CBT (cognitive behavioural therapy) is one of the most common treatments for a range of mental health problems, such as anxiety, depression, bipolar disorder, Obsessive Compulsive Disorder and schizophrenia. CBT is an active and collaborative approach which typically involves self-monitoring, experiments, and tasks between sessions. As an approach, it has a strong research evidence base with both children and adults.
CBT is based on the idea that the way we think about situations can affect the way we feel and behave. For example, if you interpret a situation negatively then you might experience negative emotions as a result, and those bad feelings might then lead you to behave in certain ways that cause you more difficulty.
We can develop core assumptions about ourselves from our experiences growing up or other significant experiences in life. These assumptions are often just below our consciousness. Some common assumptions are
I’m not good enough
I can’t cope on my own
Everything new is frightening
When our core assumptions are triggered, it produces negative automatic thoughts. For example, if your core assumption is “I can’t cope on my own” and you are faced with a tricky situation, your negative automatic thought is likely to be something like “I’m going to make a mess”. You are also likely to feel anxious and afraid and both are likely to impact how you behave. You might avoid the situation, be frozen and unable to act or behave in a manner that is out of character for you.
In CBT you work with a therapist to identify and challenge any negative thinking patterns and behaviour which may be causing you difficulties. In turn this can change the way you feel about yourself and challenging situations and allow you to change your behaviour in the future.
Therapy for children and young people
We offer an integrative approach based on an understanding of child and lifespan development and knowledge of evidence-based approaches in child & adolescent mental health.
Our practice is integrative, drawing on cognitive-behavioural, systemic, narrative, and cognitive analytic and psychodynamic approaches. We endeavour to understand the origins of a problem and/or what currently keeps the problem alive. Exploring relationship patterns and using the therapeutic relationship to develop insight and try new patterns of relating can be extremely helpful for young people. Once we have a shared psychological understanding of the presenting concerns, we will, in collaboration with you (and your child/teenager) tailor a treatment approach based on that understanding. We typically meet a family for an initial assessment appointment (1.5 hrs). If individual therapy and/or joint parent-child work is indicated, we can agree a set number of sessions based on the assessment of the problem and will review progress every 2-5 sessions depending on the age of the child.
We can also offer specialist interventions. Filial Therapy aims to enhance the relationship between a parent and child through shared play and Developmental Psychotherapy Practice (DPP) is a talk-based relational therapy used primarily with children who have experienced early trauma and attachment disruptions. is a family approach to helping adolescents with mood disorders reconnect with parents for support.
What is Filial Therapy?
Filial Therapy is a time-limited intervention that typically requires 17–20 one-hour sessions for moderately difficult problems such as behavioural and emotional difficulties and parent-child relationship challenges (VanFleet, 2014). Carers are trained in four core skills that are necessary to conduct non-directive play sessions.
Core Skill 1: Structuring
Structuring teaches carers how to begin and end sessions in order to help children with these transitions.
Core Skill 2: Empathic Listening
Empathic listening helps carers to put their own feelings and thoughts to one side in order to fully attune to the child’s feelings, behaviours and intentions, and to learn how to verbally communicate this empathy to the child.
Core Skill 3: Child-centre Imaginary Play
Child-centred imaginary play involves learning how to engage in imaginary play by always following the child’s lead within safe limits.
Core Skill 4: Limit Setting
Limit-setting helps carers learn to set firm limits while being non-punitive, thus offering children opportunities to self-correct.
Carers/Parents are then supervised in holding special non-directive play sessions with children who are generally aged three to 12 years. They receive tailored feedback from the therapist after every supervised play session held with each child. The feedback sessions contribute to skill development and a growing awareness of the child’s thoughts and feelings while assisting carers in understanding what might hamper them in being fully available and attentive to the child.
After a number of observed play sessions, the carer-child play sessions are moved to the home environment where sessions are no longer directly observed. Carers continue to meet with the therapist to discuss the home play sessions together with other family issues that arise, while also focusing on generalising the skills that they have learned, to everyday family situations.
What is Dyadic Developmental Practice?
Dyadic developmental practice (DDP) developed by Dan Hughes is a framework for supporting children in foster care and adoptive families to recover from early trauma through the parenting and support they receive, supplemented by therapy when appropriate.
DDP is based on theories of attachment and intersubjectivity and aims to help family members to feel safe and connected through the development of healthy patterns of relating and communicating. A primary goal is to support parents/carers to manage challenging behaviour whilst also staying emotionally connected with the children. This is achieved by helping parents with day-to-day parenting based on principles of playfulness, acceptance, curiosity and empathy (PACE), as well as through therapeutic sessions.
The DDP framework can be used to offer therapeutic parenting sessions to carers and adoptive parents, to support teaching and residential staff who support children who have experienced adversity or to deliver psychotherapy involving carers and the child or young person together.
What is Attachment-based Family Therapy?
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Team/ Professional consultations
Where a Social Work team is uncertain what supports are needed for a child or family or are struggling to understand why a child/young person presents as they do, or where there have been assessments undertaken and it is still unclear what the optimal path is for a child, a consultation can be a helpful next step. One or 2 of our team will review reports, where relevant, and convene a meeting with all relevant Professionals. A Psychological formulation can be shared with the team at the meeting and a brief written overview of the formulation along with recommendations arising from the consultation is prepared.
Formal Psychological evaluations can be conducted in relation to mental health difficulties, adaptive behaviour, behavioural disorders, trauma and attachment difficulties, parent-child relationships. Assessment of learning and attainments can be undertaken as part of an overall assessment of a child’s psychological functioning. We specialise in attachment and trauma assessments using specialised tools such as the Child Attachment Interview and the Story Stem Assessment Profile as well as child in care-specific measures and quantitative psychological measures of trauma and dissociation.
We do not currently offer assessments for ADHD or ASD.
A consultation is a 1.5 hour remote or in-person meeting with parents, with a view to developing a psychological understanding of difficulties and concerns and offering advice and recommendations. This can be followed up with a 1-hour review appointment. A consultation is helpful if you are unsure where to go with your concerns and unsure what type of evaluation or therapy might be indicated. It is useful where there are mild to moderate difficulties and can sometimes be enough to get things back on track with a child or young person.
Therapeutic parenting is most often offered to parents/carers or residential staff caring for children with trauma and/or attachment related difficulties. A Dyadic Developmental Practice approach is adopted in helping parents/carers develop an understanding of and meaningful connection with their child. This is usually a medium to long term intervention which can also involve a child/young person.
Our own experiences of being parented impact on how we in turn parent and it is helpful to take time to explore our own patterns and strategies and what we might be unconsciously bringing from our own childhoods into our current families. Parent mentoring allows for this exploration, but with an emphasis on enhancing relationships with our child/children.
Parents may sometimes struggle with behavioural challenges or in managing their children’s emotional states. Parent mentoring provides a space to understand why our children may feel or behave as they do and to consider and try out alternative parenting strategies.
Clinical/Consultative supervision is provided through the practice. Individual and small group supervision can be facilitated. Some members of our team have additional qualifications in supervision. We can offer supervision to Clinical and Counselling Psychologists, Psychoanalytic Psychotherapists or other Counsellors or Therapists working with adults or children and young people.
Other Professionals working in Health, Education, Residential or Social Care settings where mental health issues are present in their setting can also benefit from Clinical Supervision. We offer a supportive environment in which to both reflect and learn in order to enhance a Professional’s capacity to fulfil his/her role.
Supervision serves the dual function of supporting good practice in the interests of the client and supporting the supervisees professional development. Our highly experienced clinicians offer supervision geared toward each supervisees developmental level and we aim to provide a restorative, evidence-based and ethical approach to the provision of supervision.
Consultation to teams, GPs & other professionals
Consultation to teams and other professionals in relation to challenging or complex cases is available. This approach gives a team or individual professional space to reflect on the case, its impact on them and what may be triggered by a particular case. The goal is to free up the team or individual to continue working more effectively, with new ideas to overcome the challenges.
The consultation process can target issues arising for teams of mental health professionals, or teams involved in the social care of young children, adolescents, and young adults, and their families or foster carers. These consultations enhances the efficacy of the team’s work by a process of analysis and reflection, and by making recommendations for future actions. We can also provide consultations for GPs in relation to their work with patients affected by psychological difficulties.