My Values: Part 1

So, I am starting a blog series about my work/life values, how they developed, and how they influence my practice. It's essential to know your values. When you're living and working inline with your values, it is a form of self-care. You're making sure your needs are being met.   

I will not lie to you; identifying your core life values isn't easy. I feel like it taken me years to truly identified my values and going through the DClinPsy interview process helped me massively with this. I also want to make a disclaimer: our values are always changing. So my values now might be different in a few years, however, I will be talking about my values now. The first value I am going to talk about is Collaboration. 

 What is collaboration?  

Collaboration can mean a lot of different things. However, for me it means working with two or more people or organizations to complete a task or achieve a goal. 

 How did I develop this value?  

I first developed this value when I was younger. I was an undiagnosed dyslexic who struggled with reading and processing information throughout high school. To help me understand what I was learning and revise for exams (the task/goal), I would go around and discuss with other people who understood the topic and worked with them to support my understanding of a Topic. Furthermore, when I was struggling with managing my emotions, going to my close friends and talking it out with them always helped me manage my feelings and vice versa. These experiences have helped me develop the core belief/assumption that working with others is the best way to achieve a goal. I will use the CBT formulation below to explain these cycles.  

 Whenever I worked collaboratively with the client, their network, and other local agencies to support their needs, I saw more long-lasting positive outcomes for the client. Conversely, when I haven't worked collaboratively with the client and have just been too focused on facilitating the therapy “correctly” due to my perfectionist tendencies, long-lasting positive outcomes aren't always achieved. (don’t worry; I will be talking about this in another article) These experiences have taught me the importance of involving clients and their networks at the centre of practice and the benefit it provides for clients in supporting their needs. This reflection is always in the back of my mind, providing me with the means to work with the mindset of putting clients at the forefront of my clinical practice.  

Blog series: Psychological Therapies

Part 1 A: Cognitive Behavioural Therapy (CBT) 

There are various psychological therapies that supports clients with various conditions. This blog series discusses their use in practice. This time around I'm focusing on CBT. CBT views mental health problems as exaggerations of normal processes, (the continuum principle) and focus on supporting current difficulties for effective therapy (the here-and-now principle).   

Psychological Theory underpinning CBT 

  CBT is based on the two key theories: 

1. Cognitive Theory 

This theory states that our cognitions (our thoughts, mental images, beliefs and interpretations) about ourselves or an event or situation strongly influence our emotions and behaviours. (If you're still puzzled about what I am saying, don't worry, I will give you an example below) 

An extra thing to add, Emotions cause bodily sensations to match the emotion, such as when relaxed, our body's heart rates lower, while anxiety causes uncomfortable feelings like stomach pains. 

1)    Behavioural Theory - Learning theory

This states that people acquire behaviours through environmental conditioning, affecting emotions and cognitions through actions. Basically, our behaviour or responses to our behaviour in a situation will change or maintain our emotions and cognitions.

For example, suppose you are person 1. Because of your anxiety, you start avoiding her and others due to worries about messing up in conversation and being called dull or stupid. Avoiding situations can provide relief from fear and reduce anxiety symptoms. However, continuous avoidance may lead to a false belief that anxiety symptoms are decreasing due to threats. You also don't get to discover if your thought is true, and you underestimate your ability to interact with others. The negative self-perception and the feeling that you learnt from your behaviours is how your behaviours maintain your anxiety.

CBT Model:

The model states that we develop core beliefs and assumptions which allow us to make sense of our world and find a way through it. As a result of our experiences, we create a range of functional and dysfunctional beliefs, with the functional ones allowing us to cope reasonably well most of the time. 

However, when facing an event/multiple events that contradict our core beliefs or cannot be handled by our more helpful beliefs (sometimes called a critical incident), unhelpful assumptions can become active, triggering more unpleasant negative thoughts and emotional states like anxiety or depression.

The interactions between negative thoughts, emotions, behaviour and physiological changes may then result in persisting dysfunctional patterns, and we get locked into vicious cycles that maintain the problem (which I will refer to as maintaining processes later)

CBT formulation:

So not everyone knows what a “Formulation” is, so I will first explain what it is before going into the CBT formulation. In simple terms, a formulation is an understanding or hypothesis of a person’s current difficulties (don’t worry, I will do a whole separate blog on formulation because it is a big topic). 

The CBT formulation uses the CBT model to develop:

·       a description of the current problem(s);

·       an account of why and how these problems might have developed;

·       an analysis of the key maintaining processes hypothesised to keep the problems going.

Example of CBT Formulation:

This formulation below is an example of why a client has separation anxiety from their Mum

The key maintaining factors in this scenario are his negative thinking (worst-case scenario thinking), i.e. Mum is going to die when she leaves the house and the safety behaviours he does to manage his negative thoughts, i.e. Over texting/Calling Mum and Avoiding situations where he’s separating from Mum. This is because their Negative thoughts can increase their worry or fear, causing them to do Safety behaviours that stop them from directly testing their anxieties, and the untested fears will continue to arise in the future.

Assessment and Intervention in CBT:

When going through therapy in general there are 3 stages.

The Assessment stages

The Formulation stages

The Intervention stages

Throughout the Assessment stage of CBT, you and the clinician are building a formulation of your current problem. The treatment stage of CBT is supporting you to be your own therapist by helping you to understand and change maladaptive thinking and behaviour patterns by providing tools to change these patterns. (don’t worry again, in a separate mini-blog, I will explain some of the tools used).

So based on previous blogs, you can kind of guess what my stance on CBT is, but I thought I would just outline below the key pros and cons of CBT

CBT Pro’s

·       It has scientifically been proven to be as effective as medication in treating some mental health disorders. 

·       It is an Evidenced –Based treatment for various ages and presentations. It is delivered in a short time compared to other talking therapies.

·       The highly structured nature of CBT means it can be provided in different formats and manualised, including in groups, self-help books and computer programmes. It is also easy to train staff on this approach.  

·       The Skills you learn in CBT are useful, practical, and helpful strategies that can be incorporated into everyday life to help you cope better with future stresses and difficulties, even after the treatment has finished.

CBT Con’s

·       CBT focuses on the individual's capacity to change themselves (their thoughts, feelings, and behaviours) and does not address wider problems in systems or families' relationships which can often significantly impact an individual's health and well-being.

·       The model this therapy is based on was developed by a certain demographic of people - white, British, upper-middle-class male, and is this generalisable to everyone. 

·       CBT only addresses current problems and focuses on specific issues; it does not address the possible underlying causes of mental health conditions, such as an unhappy childhood.

·       It involves confronting your emotions and anxieties; you may experience initial periods where you are more anxious or emotionally uncomfortable.

Lastly,

What are your reflections on this blog?

What your views about CBT?

Any questions you want answered?

Comment your views below