In-Conference Workshops

Delegates at the BABCP Conference will be able to attend to register to attend one or more of the 11 half day workshops (3 hours). There is a small extra charge of £20 for each of the workshops.  You can register for the workshops when you register for the conference or at the conference registration desk at Imperial when you arrive.

However, places on the workshops will be limited to just 20 or 30 delegates and will be allocated on a first come first served basis so you are advised to pre-book as soon as possible in advance pf the conference.

Thursday 9.30 – 12.30

Workshop 1:

Whose avoidance is it anyway? Formulating client AND therapist emotional avoidance in CBT

Vickie Presley, Coventry University, UK

Whilst CBT is not primarily conceptualised as functioning via emotional processes per se, there is growing evidence that emotional processing is fundamental to psychological change and client recovery (Baker et al., 2011). The role of experiential or ’emotional’ avoidance in the maintenance of psychopathology has increasingly been considered in the psychological literature. Research has shown that accepting emotions rather than avoiding them, results in lower levels of negative affect (Shallcross et al., 2010), with intolerance of distress being highlighted as a transdiagnostic maintenance factor across disorders (Michel et al., 2016).

Given that many clients present with difficulties related to emotional experiencing and expression, it is important that therapists are equipped with the skills to intervene effectively (Follette and Batten, 2002). However, therapists may have their own unhelpful beliefs about the role of emotions in therapy which impede this process (Leahy, 2015). The impact of therapist schemata has been documented (Haarhoff, 2006; Presley et al., 2017) and more attention given to the benefits of therapists reflecting upon the interaction of their own schema with their therapeutic work (Leahy 2001; Young, Klosko and Weishar, 2003).

In summary, whilst there is an argument for helping clients to reduce emotional avoidance as part of cognitive-behavioural treatment, therapist beliefs about emotions are also important as part of this process.

Key Learning Outcomes:

This workshop will enable participants to consider ways to identify and formulate emotional avoidance in CBT, from the perspective of both client and therapist beliefs.

  • Improve understanding of emotions and their significance in cognitive-behavioural treatment
  • Consider the impact of unhelpful beliefs about emotions and their behavioural manifestations (client and therapist)
  • Improve ability to identify and formulate emotional avoidance with clients as part of CBT treatment
  • Improve ability to recognise and formulate therapist emotional avoidance as part of CBT treatment and clinical supervision

Vickie Presley is the Course Director for the Postgraduate Diploma in Cognitive Behavioural Therapy at Coventry University. Vickie has worked in psychological therapy services for 18 years, spanning roles in the NHS, forensic services and private practice. Vickie has worked predominantly with adult clients, and has a particular interest in transdiagnostic processes in psychopathology such as perfectionism and emotional avoidance. Vickie’s research activities to date have focussed more on therapist factors, and the relationship between therapist schemas and therapeutic outcomes in CBT.

Key References

Haarhoff, B. A. (2006) The Importance of Identifying Therapist Schema in Cognitive Therapy Training and Supervision. New Zealand Journal of Psychology, 35 (3): 126-131.

Leahy, R. L. (2015). Emotional schema therapy. The Guilford Press.

Michel, N. M., Rowa, K., Young, L., & McCabe, R. E. (2016). Emotional distress tolerance across anxiety disorders. Journal of anxiety disorders, 40, 94-103.

Shallcross, A. J., Troy, A. S., Boland, M., & Mauss, I. B. (2010). Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Behaviour research and therapy, 48 (9), 921-929.

Workshop 2

Behavioural experiments for intolerance of uncertainty: A new treatment for generalized anxiety disorder

Michel Dugas, University of Quebec in Outaouais, Canada and Roz Shafran, University College London

Cognitive-behavioural therapists have many treatment options for adult clients suffering from GAD. Examples of treatments include metacognitive therapy, acceptance-based behaviour therapy, attention/interpretation training, and CBT with a focus on intolerance of uncertainty. Although these treatments are conceptually and procedurally distinct, they all share the following features: (1) they are based on models that involve multiple affective, cognitive, and behavioural components; (2) they include several intervention strategies that target the model components; and (3) although they have empirical support, their efficacy lags behind that of CBT protocols for other anxiety disorders. Consequently, our group developed a new, highly focused treatment for GAD: Behavioural Experiments for Intolerance of Uncertainty. The treatment draws upon 25 years of research on the role of intolerance of uncertainty in GAD, as well as on recent theorizing on the mechanisms of fear reduction. In brief, the new treatment uses the structure of behavioural experiments to explicitly test client hypotheses and thus enhance new learning during exposure to uncertainty. The treatment has now been tested in two clinical trials, with results showing that it promotes impressive change in negative beliefs about uncertainty, the symptoms of GAD and general psychopathology. The goal of this workshop is to present the new treatment’s underlying theory and to illustrate its strategies and procedures.

This workshop will enable participants to consider ways to identify and formulate emotional avoidance in CBT, from the perspective of both client and therapist beliefs.

Key Learning Outcomes:

  • Improve understanding of emotions and their significance in cognitive-behavioural treatment
  • Consider the impact of unhelpful beliefs about emotions and their behavioural manifestations (client and therapist)
  • Improve ability to identify and formulate emotional avoidance with clients as part of CBT treatment
  • Improve ability to recognise and formulate therapist emotional avoidance as part of CBT treatment and clinical supervision

Michel Dugas is Professor of Psychology at the University of Quebec in Outaouais. Over the past 25 years, he has conducted research on the aetiology and treatment of GAD with a specific focus on intolerance of uncertainty. Roz Shafran is Professor of Translational Psychology at the UCL Great Ormond Street Institute of Child Health. Her research has focused on the development and evaluation of cognitive behaviour theories and therapies, in particular those involving behavioural experiments.

Key References

  1. Hebert, E. A., & Dugas, M. J. (2019). Behavioral experiments for intolerance of uncertainty: Challenging the unknown in the treatment of generalized anxiety disorder. Cognitive and Behavioral Practice, 26(2), 421-436.
  2. Robichaud, M., Koerner, N., & Dugas, M. J. (2019). Cognitive-behavioral treatment for generalized anxiety disorder: From science to practice (Second edition). New York, NY: Routledge.
  3. Dugas, M. J., Charette, C. A., & Gervais, N. J. (2018). Generalized Anxiety Disorder. In J. Hunsley & E. J. Mash (Eds.), A Guide To Assessments That Work, Second Edition (pp. 293-310). New York: Oxford University Press.Ormond Street Institute of Child Health. Her research has focused on the development and evaluation of cognitive behaviour theories and therapies, in particular those involving behavioural experiments.

Thursday 13.30 – 17.00

Workshop 3:

‘Best Practice’ in Digital Mental Health Support: Benefits, Challenges and Opportunities (in development)
Hannah Wilson, MediaCity Psychology and Mary Welford, Compassion in Mind, UK

Whilst utilising technology or digital platforms to support the delivery of mental health therapies is not new, the COVID-19 pandemic has forced services to rapidly adopt digital mental health care provision (e.g. Gratzer et al. 2021). As a result, both practitioners and services are seeking guidance as to what constitutes ‘best practice’ within digital mental health care. There is currently a research-to-practice gap within the evidence (Mohr et al, 2017), which this workshop seeks to address. It is also important that digital delivery does not seek to exactly replicate face-to-face care but via digital platforms; rather, more successful digital interventions will accommodate and exploit the opportunities available in the cyber environment.

Key Learning Outcomes:

  • Review the overall benefits and challenges of digital mental health care, including: Accessibility and flexibility; reducing stigma and shame.
  • Consider the different ‘types’ of digital delivery e.g. asynchronous vs synchronous, video/telephone/text based/apps, with some guidance and suggestions for each.
  • Consider both digital only, and blended, options
  • Explore therapeutic factors and how they translate into digital work, including: Risk and safeguarding; therapeutic relationship and boundaries.
  • Address common challenges of digital mental health care.
  • Consider universal and also distinctive features of CBT and CFT that merit attention.
  • Overcome personal blocks and barriers to using digital technology.
  • Consider blindspots and a hybrid future.
  • Consider self-care as a digital mental health practitioner.

Dr Hannah Wilson is a Clinical Psychologist who recently edited the book ‘Delivering Mental Health Therapies Using Digital Platforms: A Guide to the Benefits and Challenges, and Making It Work.’ The book includes chapters on cross-therapy factors such as building the therapeutic alliance, safeguarding, and self-care, as well as therapy specific factors including computerised and human facilitated CBT. Hannah works in private practice, and also for a digital mental health service within the UK.

 Dr Mary Welford is a Consultant Clinical Psychologist, and a founding member of the Compassionate Mind Foundation. She has authored books such as ‘CFT for Dummies’ and ‘The Compassionate Mind Guide to Building Self-Confidence,’ as well as recently co-authoring ‘The Kindness Workbook.’ Mary and Hannah co-authored a chapter in Hannah’s recent edited book, exploring digital delivery of CFT.

Key References

Wilson, H. (Ed). (2022). Digital Delivery of Mental Health Therapies: A Guide to the Benefits and Challenges, and Making It Work. London, UK: Jessica Kingsley Publishers.

BABCP. (2021). Online Provision of CBT. Accessed at

BACP. (2019). Working Online in the Counselling Professions. Accessed at

Workshop 4:

Fifty years of Cognitive Therapy for depression: What have we learned about helping our trickiest cases?
Richard Moore , Private Practice, Cambridge, UK

Over the last 50 years, CBT has established itself as an effective therapy for depression and a mainstay of mental health services. Despite this, too many patients are left with significant and disabling difficulties following therapy or respond to therapy only then to relapse. This presentation considers the implications of the evidence base for how to help people with such persistent depression and what to do when the evidence wears thin. Suggestions of how to adapt the basics of therapy to engage people when there is no quick progress to be made will be explored. Formulation of persistent difficulties to include self-protection, emotion regulation and longstanding schemas will be described and illustrated. The presentation will discuss the difficulties of addressing longstanding negative patterns of thinking and their effect on experience, and helpful targets and techniques will be considered. The potential benefits of focusing on fostering positive experience as well as decreasing negative experience will be advanced. The therapeutic model and the relative paucity of evidence have important implications for service delivery and organisational culture that will be outlined.

Key Learning Outcomes:

Through attending this workshop, participants will learn:

  1. To consider the nature of the evidence base for therapy for depression and its implications for treating people with persistent difficulties
  2. To recognise factors in persistent depression that may impede engagement in therapy and to consider how to adapt the basics of establishing a therapeutic relationship to address these obstacles
  3. To formulate the nature, content and impact of longstanding cognitive patterns in depression and consider how these might be addressed
  4. To advance the potential benefits of fostering positive experience in persistent depression as well as decreasing negative experience

Richard Moore is a clinical psychologist with a specialist interest in CBT for depression born from many years’ experience of conducting therapy, of training and supervising and of research. He is currently working in private practice in Cambridge. Many years ago, he qualified in Cambridge and Edinburgh, before training at Beck’s Centre for Cognitive Therapy in Philadephia. He has been therapist and researcher on three successful RCTs of Cognitive Therapy for depression in the UK, which all demonstrated the benefit of CT in addressing the problems of persistence of depression. He worked for 20 years in various settings in the NHS, including in a psychological treatment service, in community teams, in a specialist depression service and in in-patient wards. He is an experienced trainer and supervisor and, with Anne Garland, wrote the book ‘Cognitive Therapy for Chronic and Persistent Depression’. He likes to ground his workshops in the day to day clinical realities of addressing these hard to treat difficulties, but tries to bring some humour and passion to what can otherwise be a gloomy topic.

Key References

McCullough, J.P. (2000). Treatment for Chronic Depression: Cognitive Behavioral Analysis System of Psychotherapy. New York: Guilford Press.

Moore, R., & Garland, A. (2003). Cognitive Therapy for Chronic and Persistent Depression. John Wiley: Chichester, West Sussex.

Barton, S & Armstrong, P (2019). CBT for Depression: An Integrated Approach. SAGE: London.

Friday 9.30 – 12.30

Workshop 5:

Brief CBT for non-underweight patients with eating disorders: An introduction to CBT-T and its key skills
Glenn Waller and Madeleine Tatham, University of Sheffield and Hannah Turner, Southern Health Care NHS Foundation Trust

In 2017, NICE identified a need for briefer evidence-based therapies for eating disorders. This was followed by evidence that CBT for eating disorders (CBT-ED) can be delivered effectively for most patients in a much shorter format than previously recommended. The resultant 10-session therapy (CBT-T) has now developed a substantial evidence base, demonstrating that it can be as effective as 20-session therapy, with equally large effect sizes and recovery rates. The therapy is based on a protocol that stresses the need to flex therapy to the individual patient, without losing sight of the key tasks of that therapy. It differs from previous, longer forms of CBT-ED in using more intensive methods of producing change.

This protocol has been used to train large numbers of clinicians in eating disorders services in the UK and internationally. This workshop will introduce clinicians to the ways in which CBT-T addresses the core competences and metacompetences of CBT for eating disorders. It will outline the therapy and the skills needed for working with adults and adolescents, demonstrating key skills and how they can be adapted to patients with different presentations (e.g., comorbidity; Avoidant/Restrictive Food Intake Disorder; Autistic Spectrum Disorders) and using different presentation modes (e.g., online presentation; group work).

Key Learning Outcomes:

  1. a) Understand the evidence base for CBT-T relative to other forms of CBT-ED
  2. b) Understand the principles of CBT-T
  3. c) Be able to explain CBT-T to patients, trainees and supervisees
  4. d) Be aware of the key techniques involved in delivering brief but effective CBT-ED, including the inhibitory learning approach to exposure, methods addressing emotional triggers, and patient-centred body image interventions

Madeleine Tatham is Consultant Clinical Psychologist at the Lincolnshire NHS Eating Disorders Service, and a lecturer on the University of Sheffield CBT for eating disorders course. She has extensive experience of clinical work and research in the field of eating disorders, and has published widely on the topic.

Hannah Turner is Consultant Clinical Psychologist at Southern Care NHS Eating Disorders Service, and an honorary academic at the University of Southampton. She has extensive experience of clinical work and research in the field of eating disorders, and has published widely on the topic.

Glenn Waller is Professor of Clinical Psychology at the University of Sheffield, UK. His clinical and academic specialty is evidence-based CBT for eating disorders. He has published over 330 papers and four books on the subject.

Key References

Tatham, M., Hewitt, C., & Waller, G. (2020). Outcomes of brief and enhanced cognitive-behavioural therapy for adults with non-underweight eating disorders: A non-randomized comparison. European Eating Disorders Review, 28, 701-708. DOI: 10.1002/erv.2765

Waller, G., Tatham, M., Turner, H., Mountford, V. A., Bennetts, A., Bramwell, K., Dodd. J., Ingram, L. (2018). A 10-session cognitive-behavioral therapy (CBT-T) for eating disorders: Outcomes from a case series of non-underweight adult patients. International Journal of Eating Disorders, 51, 262-269. doi: 10.1002/eat.22837

Waller, G., Turner, H. M., Tatham, M., Mountford, V. A., & Wade, T. D. (2019). Brief cognitive behavioural therapy for non-underweight patients: CBT-T for eating disorders. Hove, UK: Routledge.

Friday 13.30 – 17.00

Workshop 6:

Fear of dementia: CBT for anxiety in people with subjective cognitive impairment, mild cognitive impairment or early stages of dementia
Georgina Charlesworth, University College London, UK

Dementia is now the most feared diagnosis in later life, having overtaken cancer. Increased dementia awareness and past experience of dementia care both heighten sensitivity to ‘senior moments’ and reinforce beliefs that these are harbingers of dementia. There is a growing body of evidence of an association between mid- and late-life mood disorders and later cognitive impairment; in addition to depression being a known risk factor for dementia, recent evidence suggests that the likelihood of progression to dementia is increased in those who have significant anxiety alongside subjective cognitive concerns. Models of fear of dementia include past trauma of dementia caregiving projected onto a feared future and the looming vulnerability of the 4th age ‘event horizon’. Clients’ realistic, future-focussed concerns are often shared by therapists leading to ‘paralysis’ or mutual avoidance in therapy. The ‘fear-maintenance’ cycles from the generic cognitive model of anxiety disorders can be used as a basis for case formulation and intervention.

Key Learning Outcomes:

(1) to increase knowledge of models of ‘fear of dementia’ and their application in CBT practice

(2) to develop skills in CBT for anxiety where the primary fear(s) relate to cognitive deterioration and associated concerns (e.g. abandonment, loss of self, dependence)

(3) to enhance awareness of barriers to working with people with probable or possible dementia, to consider strategies to manage or address personal-professional concerns and to enhance personal growth

Georgina is an Associate Professor at UCL and a Consultant Clinical Psychologist with 30 years NHS experience in old age psychology, including work in Memory Services, in-patient, mental-health liaison and community psychology. She completed the post-qualification diploma in Cognitive Therapy in Oxford in 1997, and was awarded a clinical distinction for her casework with older people. Her research work has included evaluations of psychological and social interventions for people with dementia and their carers, funded by the NIHR, HTA, ESRC and Alzheimer’s Society, including a randomised controlled trial of CBT for anxiety in people with dementia (with Aimee Spector). Her current work is on ‘stigma resistance’ and decision-making by people with dementia and family supporters around disclosure of the diagnosis to their wider social networks. She is an experienced deliverer of workshops, and a past BABCP keynote speaker (2019).

Key References

Charlesworth, G., Sadek, S., Schepers, A., & Spector, A. (2015). Cognitive behavior therapy for anxiety in people with dementia: A clinician guideline for a person-centered approach. Behavior Modification, 39(3), 390-412.

Desai, R., Whitfield, T., Said, G., John, A., Saunders, R., Marchant, N. L., … & Charlesworth, G. (2021). Affective symptoms and risk of progression to mild cognitive impairment or dementia in subjective cognitive decline: A systematic review and meta-analysis. Ageing Research Reviews, 71, 101419.

Workshop 7:

Understanding and treating death anxiety
David Veale, Kings College London and (by video) Rachel Menzies, Sydney University

Death anxiety is a term used to describe people’s fear or negative feelings towards death or dying. Some people may focus on their own death, such as ruminating on all the things they will miss out on after they die, or what it will be like to not exist anymore. Some people may experience doubts about the nature of existence itself, such as questioning what will happen to them after death. Others may worry about the process of dying, such as whether their death will be painful, or what their final moments will be like. Some may be distressed at the idea of losing a loved one. They may worry about how they will cope with their loved ones’ death or that they will somehow cause the death of their loved one without meaning to. For some there is a phobic avoidance and fear of anything related to death (e.g. going near cemeteries or funeral parlours). All the experiences above are in many ways part of being human, but death anxiety is a problem when it is either sufficiently time-consuming, distressing or interfering in one’s life. The concept cuts across different diagnoses including some types of Health Anxiety, OCD, specific phobias, and panic disorder. Unfortunately, death anxiety may not be adequately targeted in standard protocols for these disorders and this workshop will try to remedy this with a specific focus on the fears of death and dying. Treatment components will be discussed, centring on CBT, which is the most evidence-based treatment for death anxiety.

Key Learning Outcomes:

By the end of the skills class, participants will
1) Understand the context and phenomenology of death anxiety, and its relationship with relevant diagnoses
2) Be knowledgeable about a cognitive behavioral model and have a understanding of the cognitive processes and behaviours that maintain death anxiety. This includes the intolerance of uncertainty, magical thinking, the awfulness of dying, as well as avoidance, safety seeking and checking behaviours related to death.
3) Develop alternative ways of thinking about common beliefs in death for example thoughts about the awfulness of not existing or the intolerance of not knowing will happen.
4) Use appropriate exposure/ behavioural experiments for death and dying and consider what expectations are being tested. Fifteen different tasks will be discussed from writing out one’s funeral wishes and obituary, painting one’s coffin or collecting “memento mori”.
5) Focus on living life to the full now as an alternative to focussing on death and dying

David Veale is a Consultant Psychiatrist and leads a national outpatient and residential unit service for people with severe anxiety disorders at the South London and Maudsley Trust and the Nightingale Hospital London. He is a Visiting Professor in Cognitive Behaviour Therapies at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London. He is a member of the group that revised the diagnostic guidelines for ICD11 for Obsessive Compulsive and Related Disorders for the World Health Organisation. He was a member of the group that wrote the NICE guidelines on OCD and BDD in 2006. He is an Honorary Fellow of the BABCP, a Fellow of the BPS and of the RCPsych. He is a Trustee of charities, OCD Action, the BDD Foundation and Emet Action. He has co-authored a self help book on death anxiety and a book chapter with Rachel Menzies.

Rachel Menzies is a Clinical Psychologist and Postdoctoral Research Fellow at The University of Sydney, Australia. She won the Dick Thompson Thesis Prize for her work on death anxiety and its relationship with OCD. Her article on death anxiety was featured in The Conversation Yearbook 2016, a collection of the top 1% of ‘standout articles from Australia’s top thinkers’. In 2021, Rachel’s PhD thesis exploring death anxiety and its treatment was awarded the Australian Psychological Society (APS) Award for Excellent PhD Thesis.

Key References

Menzies, R.E., & Menzies, R.G. (2021). Mortals: How the Fear of Death Shaped Human Society. Sydney: Allen & Unwin.

Menzies, R.E., & Veale, D. (2021). Free Yourself from Death Anxiety: A CBT Self-Help Guide for a Fear of Dying. Jessica Kingsley Publishers London and Philadelphia

Menzies, R.E., & Veale, D. (2021) Creative approaches to treating the dread of death and death anxiety. In: Existential Concerns and Cognitive-Behavioral Procedures: An Integrative Approach to Mental Health. Menzies, R.G, Menzies, R,E, Dingle, G. (Eds). Springer: New York.

Menzies, R.E., Zuccala, M., Sharpe, L., & Dar-Nimrod, I. (2018). The effects of psychosocial interventions on death anxiety: A meta-analysis and systematic review of randomised controlled trials. Journal of Anxiety Disorders, 59, 64-73 .

Workshop 8:

Brief Cognitive Therapy for Adolescent Panic Disorder

Polly Waite and Lizzy Hughes, University of Reading and Emily Sands, Oxford Health Foundation NHS Trust

Panic disorder occurs in 1-3% of adolescents, has high rates of comorbidity, and a negative impact on functioning at school and with friends. Left untreated, it appears to have a chronic course. Currently the most common psychological treatment approach for adolescents with panic disorder is a generic form of cognitive behaviour therapy (CBT), developed for a range of anxiety disorders. However, many treatment trials of this general approach have excluded young people with panic disorder, and existing treatments specifically for adolescents with panic disorder require a considerable amount of therapist time (between 11 and 22 hours of therapy). As such, there is a clear need to develop effective, scalable treatments. In adults, individual cognitive therapy based on Clark’s (1986) cognitive model for panic disorder has been shown to be highly effective, including in a brief format. We have recently evaluated the brief version of this treatment, adapted for use with adolescents, within the PANDA feasibility randomised controlled trial ( Cognitive therapy was delivered 1:1 (face to face and remotely) by children’s wellbeing practitioners within an NHS-commissioned clinic. It involved 5 treatment sessions and 2 booster sessions. Prior to each of the first 4 sessions, the young person was given a self-study workbook to read, which also included written exercises and homework activities. This approach will be presented within this workshop.

Key Learning Outcomes:

By the end of the workshop, participants will be able to:

  • Assess panic disorder in adolescents and use sessional measures to guide treatment
  • Understand the key elements of cognitive therapy for panic disorder
  • Put together an individualised model of panic disorder for a young person
  • Understand the role of education about the nature of anxiety and the meaning of different body sensations
  • Undertake behavioural experiments to test out young peoples’ beliefs in action
  • Consider how to involve family members and school staff in treatment

Dr Polly Waite is a Clinical Psychologist and Associate Professor at the University of Reading and Oxford. She has led the NIHR-funded PANDA feasibility randomised controlled trial, evaluating the efficacy of an adapted form of Clark’s brief cognitive therapy for panic disorder in adolescents. Lizzy Hughes and Emily Sands are both Senior Children’s Wellbeing Practitioners (CWPs) and delivered brief cognitive therapy to adolescents within the PANDA study.

Key References

Clark, D. M., & Salkovskis, P. M. (2009). Panic Disorder. Retrieved from

Clark, D. M., Salkovskis, P. M., Hackmann, A., Wells, A., Ludgate, J., & Gelder, M. G. (1999). Brief cognitive therapy for panic disorder: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 67(4), 583.

Waite, P. (2021). Protocol For a Randomised Controlled Feasibility Study Examining the Efficacy of Brief Cognitive Therapy For the Treatment of Panic Disorder in Adolescents (PANDA). Research Square, Preprint.

Saturday 9.30 – 12.30

Workshop 9:

An introduction to Dialectical Behaviour Therapy skills training for Adolescents (DBT-A)
Marie Wassberg, BABCP

DBT Skills Training is an essential part of the DBT treatment programme developed by Marsha Linehan for the treatment of Borderline Personality Disorder over 30 years ago. Since then, there have been numerous studies exploring and validating this approach for different populations.

This workshop will introduce the DBT for Adolescents formulation and look at the 5 sets of skills taught in the DBT-A programme. I will discuss the particular group processes involved in working with adolescents who present with emotion dysregulation and relationship difficulties.

Mindfulness is key to the development of effective functioning and self-management. Distress Tolerance and Emotion Regulation skills are essential for understanding and regulating emotions, while Interpersonal Effectiveness and Walking the Middle Path are based on conflict resolution and uses standard assertiveness skills. DBT-A takes a very practical and accessible approach to increasing effectiveness in many areas, which often requires the skilful blend of all 5 skill sets.

While DBT-A was initially developed for adult patients with Borderline Personality Disorder, many of its principles and practical interventions have been taught to adolescents with good effect. Teaching adolescents DBT-A skills for use in their every-day life, can help them deal with difficulties such as how to understand and regulate strong emotions and recognise harmful friendships in a better way.

Key Learning Outcomes:

Participants will acquire the following skills:

  1. To introduce DBT-A Skills Training in the context of the DBT-A formulation, which hypothesises skills deficits in people with BPD and other disorders featuring emotion dysregulation.
  2. To introduce the 5 DBT-A skills, Core Mindfulness (the skills that underpin all DBT skills and practice), Distress Tolerance, Walking the Middle Path, Emotion Regulation and Interpersonal Effectiveness. We will address how these are taught in groups.
  3. To model and invite delegates to practice the teaching of key DBT-A skills.

Marie Wassberg has been a DBT Therapist since 2010. She trained with Dr. Elizabeth Malmquist and Dr. Anita Linnér in Sweden, as well as with Professor Alan Fruzzetti and Professor Jill Rathus (USA), both leading clinicians in the field of DBT for adolescents.

Marie is also a BABCP accredited CBT therapist. She qualified in 2003 and studied at Goldsmiths University in London with Professors Windy Dryden and Michael Neenan. She is also trained in Trauma Focused-CBT (TF-CBT), including Supervisor training, in 2013 with Dr. Laura Murray (USA); Prolonged Exposure (PE) 2012 with Professor Edna Foa (USA); and DBT for Schools (STEPS-A), 2018 with Dr. Elizabeth Dexter-Mazza and Dr. James Mazza (USA). Marie qualified as a social worker in 1998 and has experience of working in the profession in both Sweden and England.

Marie has been involved with developing many DBT- informed programmes in different settings, mainly for children, adolescents and young adults aged from 18-25 years, both in Sweden and in England.

Marie has been a very welcomed guest lecturer at universities in Sweden, a facilitator at workshops, conferences and training events throughout the UK (NOTA 2015, 2016, 2017, 2018 and BABCP 2018), in Sweden (Schools, Social Services and Care homes) and the USA (ATSA 2016 and 2018). She has also offered training and supervision to other professionals who work with children and adolescents on how to improve relationships and regulate emotions in a DBT-informed approach.

Key References

  1. Rathus, J. and Miller, A. (2015). DBT Skills Manual for Adolescents
  2. Mazza, J. J. and Dexter-Mazza, E. T. (2016). DBT Skills in Schools
  3. Linehan, M. (2014). DBT Skills Training Manual

Workshop 10:

Cognitive Therapy for PTSD following sexual assault
Sharif El-Leithy, Traumatic Stress Service, London and Hannah Murray, Oxford Centre for Anxiety Disorders and Trauma, University of Oxford

Up to 50% of women who have been sexually assaulted will develop PTSD. Sexual assault is the most frequent cause of PTSD in women, and tends to lead to particularly severe symptoms (Smith et al., 2016).

We will outline some of the challenges in working with survivors to treat PTSD following sexual assault, and formulate them within the cognitive model of PTSD (Ehlers & Clark, 2000). The following areas will be discussed:

• Working with cognitive themes such as self-blame, ‘rape myths’, mental contamination, shame, defeat and loss of trust.
• The nature of trauma memories following sexual assault, with particular reference to drug-facilitated rape, non-fatal strangulation and multiple victimisation.
• Working with the consequences of sexual exploitation and grooming, including secrecy, ambivalence and loyalty to the perpetrator.
• Coping strategies following sexual assault, including avoidance, self-harm, risky sexual behaviour and dissociation.
• The relational impact of sexual assault, including reclaiming intimacy and sexuality.
• The impact of media coverage, social and political discourses.
• Issues within the therapeutic relationship, including obstacles to disclosure, therapist gender and adapting for diversity.
• Practical issues such as legal processes and safeguarding.

Key Learning Outcomes:

We will describe and demonstrate how to adapt cognitive therapy for PTSD to address these issues, and invite participants to practise key skills

  • Identify common themes and challenges in treating PTSD in women following sexual assault
    • Apply principles from existing cognitive models of PTSD to formulate these presentations
    • Learn practical ways to implement cognitive therapy techniques with survivors of sexual assaults.

Dr Sharif El-Leithy is a Consultant Clinical Psychologist and Clinical Lead for the Traumatic Stress Service in South-West London.
Dr Hannah Murray is a Research Clinical Psychologist based at the Oxford Centre for Anxiety Disorders and Trauma, University of Oxford.
Between them they have 30 years of experience in working with PTSD using Cognitive Therapy and both supervise, teach and research widely in the field. They have authored a number of research and practice papers in aspects of treating PTSD. Their forthcoming clinical handbook, “Working with complexity in PTSD: A cognitive therapy approach”, will be published in July 2022.

Key References

Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319-345.

Gauntlett-Gilbert, J., Keegan, A., & Petrak, J. (2004). Drug-facilitated sexual assault: Cognitive approaches to treating the trauma. Behavioural and Cognitive Psychotherapy, 32(2), 215-223.

Smith, H. L., Summers, B. J., Dillon, K. H., & Cougle, J. R. (2016). Is worst-event trauma type related to PTSD symptom presentation and associated features?. Journal of Anxiety Disorders, 38, 55-61.

Workshop 11:

Coping with adversity: a question of focus
Stirling Moorey, Consultant Medical Psychotherapist, London, UK

The concept of safety seeking behaviour has been one of the most valuable contributions to understanding and treating anxiety disorders and other conditions. When the perceived threat is unrealistic, such as in panic disorder or health anxiety, identifying and testing safety behaviours is relatively straightforward. When facing adversity, however, the difference between adaptive and maladaptive coping can be more nuanced. It is often the degree and flexibility with which coping methods are applied that differentiates helpful from unhelpful coping. This workshop will draw on scientific evidence from research on coping and in behavioural medicine to help participants understand the factors that facilitate effective coping.

Key Learning Outcomes:

  1. To understand the correlation between particular coping styles and adjustment – The ‘3 Cs’ of control, coherence and connection.
    2. To be able to use the concept of ‘focus of coping’ to enhance their work with people facing adversity – focus on the problem, the emotional reaction to the problem, or focus on maintaining and building their life beyond the problem.
    3. To differentiate between effective coping and safety behaviours by examining the function and flexibility of the coping strategies employed.

Stirling Moorey is a Consultant Medical Psychotherapist. He recently retired from the South London and Maudsley NHS Trust where he had been Professional Head of Psychotherapy and lead for the CBT training of psychiatrists. He is co-author with Dr Steven Greer of “The Oxford Guide to CBT for people with Cancer” and has written on many aspects of cognitive behaviour therapy including its application to physical illness and adversity in general. He has researched the efficacy of psychological treatment in cancer ranging from early to advanced disease. Building on this work on physical illness he has explored the ways in which standard CBT can be adapted clinically for people coping with real life adverse situations in general. He has been involved with the Institute of Psychiatry, Psychology and Neuroscience PgDip in CBT since its inception in 1987 and has many years experience of teaching CBT to a range of professionals.

Key References

Moorey S (1996) When bad things happen to rational people: cognitive therapy in adverse life situations. In Salkovskis P(ed.) Frontiers of Cognitive Therapy. Guilford Press.
Moorey S & Greer S (2011) The Oxford Guide to CBT for People with Cancer Oxford: Oxford University Press.
Polizzi, C., Lynn, S. J., & Perry, A. (2020). Stress and coping in the time of covid-19: pathways to resilience and recovery. Clinical Neuropsychiatry, 17(2).
Reich, J. W. (2006). Three psychological principles of resilience in natural disasters. Disaster Prevention and Management: An International Journal, 15(5), 793-798.