Volume 47 Number 4 • December 2019

Giving us all of the feelsPatricia Murphy speaks with poetry therapist and writer Victoria Field

© Copyright 2019 by the British Association for Behavioural & Cognitive Psychotherapiesunless otherwise indicated. No part of this publication may be reproduced, stored in aretrieval system nor transmitted by electronic, mechanical, photocopying, recordings orotherwise, without the prior permission of the copyright owner.

Volume 47 Number 4December 2019

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2 December 2019

Welcome to the final issue of CBT Today for 2019. I'mdelighted that we have been able to include PatriciaMurphy's interview with poet Victoria Field for this issue,as well as continuing Sarah Rees and Heather Howard-Thompson's series on working in private practice. As always, our members continue to show their willingnessto help others around the world, so it is my pleasure tohave had Kirstie Fleetwood and Tara Murphy writeabout working in Uganda.As always, thank you to everyone who has contributedduring the year.All the very best to you for the festive season and thenew year.

Peter ElliottManaging Editorpeter.elliott@babcp.com

Contributors

Pauline Akello Bachayaya, James Blacklock, Abigail Bradbury, EleanorChatburn, Cathy Creswell, Lauren Cox, Barnaby Dunn, Kirstie Fleetwood,Lucy Hart, Zaid Hosanye, Heather Howard-Thompson, Pamela Jacobsen,Taf Kunorubwe, Tom Kent, Jessica Kingston, Maria Loades, PatriciaMurphy, Tara Murphy, Charlotte Ready, Sarah Rees, Shirley Reynolds,Rosie Stevens, Tamara Wiehe

CBT Today is the official magazine of the British Association forBehavioural & Cognitive Psychotherapies, the lead organisation for CBTin the UK and Ireland. The magazine is published four times a year andposted free to all members.

Back issues can be downloaded from www.babcp.com/cbttoday

DisclaimerThe views and opinions expressed in this issue of CBT Today are those of the individualcontributors, and do not necessarily reflect the views of BABCP, its Trustees or employees.

Next deadline9.00am on 27 January 2020 (for distribution week commencing 24 February 2020)

AdvertisingFor enquiries about advertising in CBT Today, please email advertising@babcp.com.

BABCPImperial House, Hornby Street, Bury BL9 5BN

Tel: 0330 320 0851Email: babcp@babcp.com

www.babcp.com

3 News

4 Mental Health & DiabetesCharlotte Ready writes about integratingservices in North East Essex

6 Our year in UgandaKirstie Fleetwood and Tara Murphy onvolunteering in Kampala

10 Insight into an IAPT Service/HigherEducation Institute PartnershipCould partnerships between these bodiesprovide important CPD opportunities, askLucy Hart and Tamara Weihe

12 CBT in Private PracticeOur series on working in private practice -Sarah Rees and Heather Howard-Thompson look at referral sources

14 Giving us all of the feelsFollowing on from the benefits of poetrytherapy in the last issue, Patricia Murphytalks to poet Victoria Field

18 Turning research ideas into realityHow can we better support 'on theground' clinicians to become researchactive?

21 Workshops

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Expressions of interest are requested to be support a proposed Special Interest Group -Migrant, Asylum Seeker and Refugee SIG

Refugees and asylum seekers often arrive in the UK having experienced trauma in their owncountry and sometimes on the way to the UK, loss of possessions and family, loss of culturalidentity, loss of role and stability and often physical health problems.

This presents a challenging profile for therapists by itself, but many also experience difficultyaccessing support and may reject support initially due to the shame involved in seeking help foremotional problems, externalising and somatising expressions of mental ill health, languagebarriers, service attitudes towards ability to treat, or psychological models, concepts andframeworks having a western bias which may not fit with the client’s formulation of the problem.

This presents significant difficulties for many therapists trying to work with this client group.This SIG proposes to address and manage many of these issues:

Provisional aims of the group -

• To provide support and guidance to BABCP members in the area of migrants and refugees• To provide clinical guidance to BABCP in the area of best practice on issues relating to

migrants and refugees • To educate members on a range of issues related to migrants and refugees through CPD,

conference presentations, pamphlets, etc.• To co-develop research and an evidence base in the areas of CBT with migrants and refugees• To disseminate research findings to members

If you are interested in being involved in this group, please contact Matt Wilcockson atmattwilcockson@hotmail.com

Let’s talkabout CBT

Our latest podcast episode wasreleased recently. Dr LucyMaddox spoke with Ben Adamsabout his experience of CBT forchronic fatigue syndrome, andto Professor Trudie Chalderabout how CBT for CFS works.You can find the podcast atletstalkaboutcbt.libsyn.com

If you have ideas for futuretopics or would like tocontribute, you can email Lucyat lucy.maddox@babcp.com

Adam MayWe were saddened to hear ofthe death of Adam May just asthis issue was going to press.Adam was one of the originalsignatories to the formation ofthe Independent PractitionersSpecial Interest Group, had beenchair of the SIG since 2016 andwas very well respected bythose who knew him. Ourthoughts are with his family andfriends. A tribute to Adam willfeature in the February 2020issue of CBT Today.

Submissions are now open The closing date for Symposium outlines, Symposium abstracts, Workshops, Skills Classes, Panel Debates and Roundtables is midnight on 12 January, while Open Papers and Posters can be submitted by midnight on 20 March.

www.babcp.com

4 December 2019

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Diabetes can have a profound impact onemotional and psychological wellbeing.Depression and anxiety are the most commonmental health illnesses amongst diabetes patients.These psychological conditions can affect people’sability to self-manage their diabetes. For example,it is common for diabetes patients to worry aboutkeeping their diabetes under control. Effectivemanagement may require personal motivation andlifestyle changes such as diet and exercise.

The National Institute for Health Care Excellence(NICE) recommends the use of psychologicalinterventions for people with long-term conditions such as diabetes. Access topsychological interventions has beendemonstrated to improve patient outcomes,reduce health care costs and enhance patients’quality of life.

The North East Essex IAPT service offers variousNICE-approved interventions, including CBT andadapted psychological interventions for diabetespatients. The service works in collaboration withNorth East Essex Diabetes Service (NEEDS) who arethe local diabetes provider that offers support foradults living with diabetes in the area. NEEDS haveidentified psychological barriers for diabeticpatients accessing treatment with their service forvarious reasons, including depression, anxiety,needle phobia, eating disorders, fear ofcomplications, fear of hypoglycaemia and PTSDafter a hypoglycaemic episode.

North East Essex IAPT Service offer a specialiseddiabetes pathway, which runs in collaboration withNEEDS, for diabetic patients in the service if theirmain difficulty is related to their diabetes. Thediabetes pathway offers psychologicalinterventions at step 2 or step 3, which are eitherface-to-face therapy or group therapy.

The project reviewed scores for measures ofanxiety, depression and diabetes specific measures,for diabetic patients in the North East Essex IAPTService.

By integrating support from NEEDS, with thepsychological care from the IAPT service, this canbreakdown psychological barriers for diabetespatients accessing medical care, resulting inimproved glycaemic control and a reduction inpsychological stress, ultimately resulting in areduction in health service costs.

Collaborative working with localdiabetes provider’s NEEDSreduces psychological distress,improved self-management ofdiabetes and ultimately reduces NHS costs.

Findings

The North East Essex IAPT Service reviewed thesources of referrals and recovery rates for diabetespatients between 1 April 2018 and 31 March 2019.The main source of referrals were self-referrals,followed by referrals from GP’s, Colchester GeneralHospital and NEEDS. Out of the range ofpsychological interventions offered by the IAPTservice, most patients received treatment from thespecialist diabetes pathway within the IAPT service.

North East Essex IAPT service found that:

- 64% of diabetes patients had a primary diagnosisof depression

- 26% of diabetes patients in the service had aprimary diagnosis of generalised anxiety disorder(GAD)

- A reduction was seen in pre and post anxiety anddepression scores following psychologicalintervention with recovery rates of 65.96% fordepression and 68.09% for GAD

Mental Health & DiabetesService Integration in North East Essex

The association between diabetes and mental health is well recognised and this co-morbidityleads to worse outcomes for both conditions writes Charlotte Ready, an Assistant Psychologistworking for Health in Mind (North East Essex IAPT Service).

A strongcorrelationexists betweendiabetes andmental healthdiagnoses.

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“North EastEssex IAPTService receiveson average 300diabetesreferrals ayear.

2% 2%

26%

4%

2%

64%

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Psychological interventions areeffective in reducing diabetesrelated emotional distress.

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Figure 1. Primary diagnosis for diabetes patientswithin the IAPT service over time period of 1 April2018 to 31 March 2019

- For patients who attended a diabetes co-locationclinic at step 3 over the time period of 7 February2018 to 17 May 2019, the average reduction forthe depression measure was 8.29 and 8.86 for theanxiety measure.

- A reduction was seen in diabetes specificmeasures (Diabetes Distress Scale and/or ProblemAreas in Diabetes Scale) for patients whoattended the diabetes co-location clinic,highlighting the effectiveness of psychologicaltalking therapies for reducing emotional burden,regimen distress, interpersonal distress, physiciandistress and diabetes-related emotional distress.

The benefits of an IAPT service working with adiabetes provider are a reduction in psychologicaldistress which results in improvements in self-management of diabetes, in turn reducing healthcare costs and improving patients’ quality of life.

Case reviews from the co-location clinic:

‘Kathy’ didn’t always remember to take her insulin and would sometimestake it hours later. She worried about keeping diabetes under control. Sheworried about taking diabetes medication in public as she thought thatpeople would mistake her for a drug-user.‘Kathy’ engaged very well withexposure therapy. When her anxiety started to come down, she triedbehavioural experiments to take her injection in a coffee shop – lookingaround from her seat (she didn’t normally look) to see if anyone wasnoticing. She realised that no-one was paying attention to what she wasdoing and became a lot more comfortable with injecting in public. ‘Kathy’s’anxiety and depression scores were in recovery following treatment.

‘Pete’ was avoiding checking his blood sugar levels frequently enough. He wasless active and low in motivation for things in general.Through usingbehavioural activation techniques ‘Pete’ became a lot more accepting of thefact that he couldn’t cram lots and lots of activities into each day andfocussed on what he could do instead. He also started taking more of a longerterm view of diabetes and kept diabetes related paperwork in a folder. Pete’sscores for anxiety and depression were in recovery following treatment.

Future work

- To continue co-location between the North East Essex IAPT Service and thelocal diabetes service, to further enhance work towards better integration ofmental and physical health treatment.

- To increase diabetes and long term physical health condition referrals to NorthEast Essex IAPT Service.

Primary Diagnosis

Agoraphobia

Social phobia

Generalised anxiety disorder (GAD)

Post traumatic stress disorder (PTSD)

Specific (isolated) phobias

Depression

Charlotte Ready works as part of an innovative long-term physicalhealth conditions team that is led by Dr Rebecca Clodfelter (LTC LeadPsychologist). This article was written with thanks to Pat Raven andKate Goodge (Psychological Therapists leading diabetes co-locationclinics) and North East Essex Diabetes Service (NEEDS).

BABCP Spring Conference and Workshops

Living with UncertaintyThursday 16 & Friday 17 April 2020 King’s College London

Registration details to be announced soon

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6 December 2019

With almost a third of the population of Ugandaestimated to be living in poverty and with reducedlife expectancy, the prevalence rate of mentalhealth conditions is high (estimated to be 35%), soaddressing the mental health of children andadolescents is essential.

In conjunction with Makerere University, ButabikaNational Psychiatric Referral Hospital providestraining for the psychiatrists, psychiatric nurses andother mental health professionals employed inmental health units in regional hospitals andcommunity services throughout Uganda. Ourvolunteership was organised through the Butabika- East London link, a multi-disciplinarycollaboration with East London NHS FoundationTrust. There were several planned roles andresponsibilities for the funded child and adolescentmental health (CAMH) project and others that weidentified during our time there.

We were involved in weekly outpatient clinics inthe children’s ward, which mostly involved

assessment of commonly presenting conditionssuch as anxiety, depression, autism, somatisationdisorders, learning disabilities and epilepsy. Inaddition, a significant part of our role was to assistwith the facilitation and teaching on an AdvancedDiploma in Child and Adolescent Mental Health,provided by Mbarara University of Science andTechnology at Butabika. The program wasestablished in 2013 by the East London NHSFoundation Trust, with funding from DFED. Thediploma enables qualified mental healthprofessionals (mental health nurses, psychologists,psychiatric clinical officers, social workers,psychiatrists) and more recently professionalsworking in child health to specialise in child andadolescent mental health.

We travelled to locations across Uganda to joinpeer support meetings enabling staff to share theirown successes and challenges, and to feel lessisolated – as many workers might be the only childspecialist in their hospital. Educational events forstaff and the local community were well attended

One of the mostenjoyable andencouragingparts of therole was toprovidesupervision forpsychologicaltreatments...

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Counselling Psychologist Dr Kirstie Fleetwood and Consultant Clinical Psychologist Dr Tara Murphy spent 2018 volunteering in Kampala, Uganda. Along with TraineePsychologist Pauline Akello Bachayaya, they report on their experiences at Butabika NationalPsychiatric Referral Hospital, Uganda’s only dedicated mental health hospital.

Our year in Uganda

7December 2019

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and a great opportunity to spread the messageabout the importance of psychological treatmentsin CAMH. The meetings enabled us to get a goodoverview of the health and mental health systemsthroughout Uganda, and were also a fantasticchance to see the country!

Our fundraising efforts enabled us to facilitatemany practical projects, including repainting theinterior of the children’s ward, as well asestablishing a new speech and language clinic,where Joseph Isimbwa, our SLT, is only one ofabout 60 speech therapists in the whole of EastAfrica. We also received donations from Miss Prideof Africa (UK), which facilitated a social worker toresettle 18 children back to their families.Inappropriate admissions and the extendedoverstay of children on the ward once treatmentwas completed creates overcrowding, one of thebiggest problems faced by ward staff. Many of thechildren had neurodevelopmental or intellectualdisabilities, rather than mental health problems.However, as a number of the children werebrought by police or members of the community,and some were unable to speak, the whereaboutsof the children’s families were often unknown.Donations enabled a social worker to travel todifferent locations and go door to door to try tofind the child’s family.

One of the most enjoyable and encouraging partsof the role was to provide supervision forpsychological treatments and research for mentalhealth workers, nursing and medical students, aswell as undergraduate and trainee psychologists,which left us feeling positive about the future ofpsychology in Uganda. One of the trainees weworked closely with is Pauline Akello Bachayaya,who co-wrote this article. The CAMH diploma has asignificant focus on promoting evidence-based

talking therapy in Ugandan services. We were keento briefly discuss one particular treatment casewhich focused on an intervention for tics, whichhas not been well recognised or understood inUganda to date.

The case details the treatment journey of a 15-year-old female in Kampala. The girl was seen byseveral members of the multi-disciplinary teamand previously misdiagnosed with otherconditions (depression, conversion disorder andepilepsy) before being correctly diagnosed withTourette syndrome (TS). She did not appear tohave any additional co-occurring conditions butthe tics had bothered her and her familythroughout her later childhood and intoadolescence. As a result, she was the first personthat we know of at Butabika Hospital to be treatedwith behavioural therapy for tics, with otherpatients subsequently identified and also treated.

A key lesson from our time in Uganda is to be ableto improvise creatively in assessments andtherapeutic work. We learnt how to understandthat our emphasis in treatment was sometimesdifferent to our supervisees and patients. At times,we were limited in relation to toys and resourcesavailable in assessments, often finding the printernot working, or having no paper to copy materials.Power cuts and water outages were relativelyregular. This presented us with an opportunity todraw on well-honed therapeutic skills forcommunicating, understanding and interpreting.This was quite a steep learning curve withdifference in language, communication, beliefsystems, values and many other factors.

Below leftEntrance to ButabikaNational PsychiatricReferral HospitalPhoto credit:Dr Kirstie Fleetwood.

Opposite topChildren’s Ward and staffPhoto credit:Dr Kirstie Fleetwood

Photographs:

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Our capacity to manage these differences grewover the course of the volunteership and oftendiscussion between the two of us from a similarculture and training facilitated this and ourcapacity to cope. We were consistently viewed asbeing from another culture. This led to differentassumptions sometimes that we must knowcertain information (e.g. models, theory,professional skills) and have specific competenciesand at other times that we could not possiblyknow certain information (e.g. understandingabout Ugandan life and culture).

Psychology is still in its infancy in Uganda, andsome families were disappointed when referred fortalking therapies rather than receiving medication,

or medical investigations such as scans. But thisenabled us to develop our skills in succinctlyexplaining and selling psychology! It was both alearning curve and a privilege to worktherapeutically with Ugandan families and childrenduring the year. Through adapting our clinical skillsand therapeutic approaches to the varied culturaland religious beliefs, we were able to witnesspositive change.

We would like to thank the staff at ButabikaHospital and our colleagues on the Diploma inChildren’s Mental Health, Dr Alyson Hall, ConsultantChild Psychiatrist and Mr Edmund Koboah fromButabika and East London Link for theirenthusiasm, support and collaboration.

Key reading

Bennett, S. M., Beaumont, R., Catarozoli, C., & Kushman, A. M. (2018). Problem-solving strategies toovercome common challenges associated with Tourette syndrome. In J. F. McGuire, T. K. Murphy, J.Piacentini, & E. A. Storch (Eds.), The clinician's guide to treatment and management of youth with Tourettesyndrome and tic disorder (pp. 201-223). San Diego, CA, US: Elsevier Academic Press.

Dekker, M. C., Urasa, S. J., Kellog, M., and Howlett, W. P. (2018) Psychogenic non?epileptic seizuresamong patients with functional neurological disorder: A case series from a Tanzanian referral hospitaland literature review Epilesia Open, 3(1): 66–72.

Kigozi, F., Ssebunnya, J. Kizza, D., Cooper, S., Ndyanabangi, S. and the Mental Health and Poverty Project(2010) An overview of Uganda's mental health care system: results from an assessment using theworld health organization's assessment instrument for mental health systems (WHO-AIMS)International Journal of Mental Health Systems 4:1

Molodynski, A., Cusack, C., & Nixon, J. (2017) Mental healthcare in Uganda: desperate challenges butreal opportunities BJPsych International 14(4): 98-100

Ndyanabangi S., Basangwa D., Lutakome J., & Mubiru C. (2004) Uganda mental health country profile.International Review of Psychiatry. 16(1-2):54–62

Nussey C, Pistrang N, Murphy T. How does psychoeducation help? A review of the effects of providinginformation about Tourette syndrome and attention-deficit/hyperactivity disorder. Child Care HealthDev. 2013;39(5):617–27. doi:10.1111/cch.12039.PubMedView ArticleGoogle Scholar

Robertson, M., Eapen, V., and Eugenio Cavanna, A. (2009) The international prevalence, epidemiology,and clinical phenomenology of Tourette syndrome: A cross-cultural perspective Journal ofPsychosomatic Research 67; 475–483

Wu, M.S. and McGuire. J.F. Chapter 2 - Psychoeducation About Tic Disorders and Treatment. Editor(s):Joseph F. McGuire, Tanya K. Murphy, John Piacentini, Eric A. Storch, The Clinician's Guide to Treatmentand Management of Youth with Tourette Syndrome and Tic Disorders,Academic Press,2018,Pages 21-41,ISBN 9780128119808,https://doi.org/10.1016/B978-0-12-811980-8.00002-9.

For more information about the Butabika – East London Link seehttps://www.butabikaeastlondon.com or email Edmund Koboah e.koboah@nhs.net

Our year in Uganda continued

9December 2019

10 December 2019

Due to increasing pressures across mental health care, IAPTservices are facing the problem of retaining PsychologicalWellbeing Practitioners (PWPs). This could in part be relatedto limited career development opportunities and poorworkplace wellbeing which can have adverse implications forpatient care.

The evidence-base for Low-Intensity CBT (LICBT) tells us thatcollaborative care – a multifaceted model where healthcareprofessionals work with the patient, around the patient – isessential in IAPT for optimising patient care and treatmentoutcomes. Mirroring this approach for local IAPT services andHigher Education Institutions, we partnered trainee PWPs withPWP Clinical Educators to together re-design an assessment usedon a PWP training programme. Students and staff had previouslyhighlighted issues with the existing assessment, sparking our re-design process.

We theorised that enabling PWPs to engage in CPD projects suchas this could act as a preventative strategy to their burnout andattrition through increased engagement in the workplace. Amore engaged, empathic and sustainable workforce willcontribute towards higher quality patient care, and towardsachieving IAPT’s targets in line with national key performanceindicators.

Making connections

Due to the nature of the programme, trainee PWPs have limitedcontact time with the Higher Education Institution and are morelikely to live closer to their service. This provided several barriersmeaning that more traditional methods of partnership workingwere not suitable.

We applied our PWP skills to collaboratively troubleshoot thebarriers to engagement and came to a shared decision to usetechnology and remote working to form a meaningfulpartnership. As the PWP training programme is grounded inevidence, it was appropriate to utilise this approach throughoutthe project, especially self-reflective and collaborative practice.

An overview of the three key steps used to re-design theassessment can be seen in the Partnership model.

Outcomes and reflections

A new assessment was created as a result of this meaningfulpartnership that better reflected the views and needs of traineePWPs. This should, in theory, lead to better engagement with theassessment as it would with our patients and their inter-sessiontasks in clinical practice.

Insight into an IAPT Service/Higher Education InstitutePartnership Could partnerships between IAPT services and Higher Education Institutions provideimportant Continual Professional Development (CPD) opportunities and serve as part of apreventative strategy to burnout and attrition in the PWP workforce? PWP Lucy Hart andPWP Clinical Educator Tamara Wiehe share their experiences.

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Both sides ofthe partnershipwere able todevelop a rangeof transferrableskills andreported thatbeing a part of a meaningfulpartnershipgave them asense ofbelonging to theIAPT service andHigher EducationInstitution.

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“Both sides of the partnership were able to developa range of transferable skills and reported thatbeing a part of a meaningful partnership gavethem a sense of belonging to the IAPT service andHigher Education Institution. The latter finding inparticular helped to address an issue both traineePWPs and PWP Clinical Educators face aroundhaving a dual identity as a student or member ofstaff within a Higher Education Institution and as ahealthcare professional.

Diversity and inclusivity were key considerationsthroughout as we implemented methods thatengaged as many trainee PWPs as possible whorepresented PWPs from a range of backgrounds.Surveys enabled high levels of engagement duringthe consultation stage, but participation decreasedsignificantly during the review stage. Despite this,members of the focus group were able to applytheir skills from their PWP training to consider theimpact of the new assessment on students withone or more protected characteristic (Equality Act,2010). On reflection, we could time futurepartnership opportunities better to increaseengagement as this one coincided with the end ofthe PWP training year and also include qualifiedPWPs who are interested in this type of CPD.

Impacts of partnership

Enhancing the connection between IAPT servicesand High Education Institutions can have a widerange of benefits for all stakeholders.

The Higher Education Institution benefits byimproving the student experience – the PWPtraining year can feel disjointed for trainees attimes, but there is scope for a more fulfillingexperience for all involved if IAPT services andHigher Education Institutions better complementeach other and involve trainees in their journey ina more meaningful way.

Offering more career development opportunities toPWPs – such as contributing to the PWP curriculum– can lead to an increased sense of belonging andpurpose greater than ‘trainee’ status, whichpromotes wellbeing and retention. Partnershipscould improve the transition from trainee toqualified PWP as it is not uncommon for trainees torelocate after their training year to alternativeservices or entirely different roles. Retaining PWPsin IAPT services reduces financial burden spent onrecruitment – funds that could be better utilised toupskill and invest in employees. In turn, ensuringthat PWPs are able to contribute towards meetingthe service’s key performance indicators set bycommissioners and securing additional funding formore complex, co-morbid presentations such aspatients with long term conditions.

A more academically, emotionally andpsychologically sound workforce is better able tomeet its purpose of improving access topsychological therapies. Even higher standards ofpatient care can be achieved if our PWPs can offera more compassionate and consistent service withless cancelled appointments or the need to re-allocate cases due to burnout-related sickness and attrition.

In summary, partnerships between IAPT servicesand Higher Education Institutions offer importantbenefits to PWP wellbeing, retention and patientcare. Let’s bring our PWPs to the forefront so thatthey can continue to deliver the essential work ofsupporting thousands of people with commonmental health problems.

“In training we learn that the patient is the expert of their experience and the PWP is the expert of the LICBT techniques. Through thecollaborative partnership, we can reverse this relationship and be considered as the ‘expert’ in our learning and clinical practice. As aresult, our needs as trainees are appropriately met from both academic and clinical perspectives. A balanced and collaborative approachmeans we do not feel out of our depth when conducting assessments and treatment sessions with patients. Our confidence in ourcapabilities and delivery of interventions means the patient has a smoother journey and is better able to utilise the techniques both nowand for the future.”Lucy HartTrainee, now Qualified PWP

“Working alongside our trainee PWPs felt natural due to my training in collaborative care. It was essential to not only hear about theirexperiences but to take it a step further by involving them in a more meaningful way. Projects like this one benefit not only those directlyinvolved but also the key stakeholder, our patients! We will continue to work in partnership with local IAPT services to offer this CPDoption to PWPs as a way to increase engagement in the workplace with the hope that this helps to promote wellbeing and retention.”Tamara WiehePWP Clinical Educator

ConsultationCourse reps used electronic surveys to gather ideas.

Sample assessment materials were createdbased on students’ ideas.

Students participatedin a virtual focus groupto review the proposal.

Partnership model

Design

Review

In the previous article, we talked aboutinvesting time in creating a business plan.This work will provide a solid foundationfor your referral stream, helping you tolearn the type of clients you would like toattract and where you hope they will comefrom. This will help you direct your energyin terms of marketing your business.

When we are starting in private practice weoften become focussed on gaining referralsand don’t really mind where they comefrom. We can happily shape our businesslater on down the road through finding outwhat works and what doesn’t. Be preparedto make mistakes if this is the path youtake but we have to start somewhere.

Good starting questions to ask yourselfare: How will potential clients be able tofind me? How will my business be visible?If I was looking for a therapist what are thesteps I would take?

Overview of referral sources

Your website Having your own websitereally establishes you as a business in yourown right. When you are just setting outyou don’t need a website with all the bellsand whistles. You can get away with abasic site if the images are professionaland logos have been well designed. Spendtime on your website content, consideringwhether it reflects your values andpersonality. This ensures that you willattract clients that are in line with theservice you offer.

You can build a website for free or paythousands. How much you spend is apersonal decision and depends on howmuch you would like to earn from yourwebsite – if your referrals will begenerated from other avenues there is notmuch point in investing too much. If you

CBT in Private Practice plan to earn the majority of your wagefrom your website, more investment willensure a better return. An important pointto remember is that it’s not just how awebsite looks, it’s how it’s maintainedgoing forward and the SEO quality. SEOstands for ‘Search Engine Optimisation’,which is how easily your website can befound on Google. There is no point havingan amazing site if no-one can find it.

There are cheap options for building yourown website yourself like Wix, Wordpressor Squarespace. Alternatively, there arededicated services for therapists likepocketsite.co.uk and webhealer.co.uk oryou can go to an independent webdesigner. It’s a lot to think about but yourwebsite is your own platform to sellyourself, and if nurtured well it will serveyou well.

Social media platforms We have mixedviews about social media. Heather has asolid following on Facebook and generatesa good amount of referrals, but Facebookdecided a few years ago not to prioritisebusiness pages anymore, so lots ofbusinesses who depended on Facebookfor referrals really began to struggle.Therefore, it can be very hard to build anaudience with Facebook pages. If you areconsidering building a business on a socialmedia platform, always bear in mindsomebody else owns the platform and canchange the rules at any time. It’s a greatway to be visible and people do expectyou to have a social media presence.Heather’s top tip around social media is tothink of it as a chance to build yourtribe…let people know a little bit aboutyou, your practice, share photos of yourroom, even your dog!

Referral agencies These are companiesthat you can sign up with as a treatment

Sarah Rees and Heather Howard-Thompson continue theirlook at setting up in private practice. After looking at yourbusiness plan in the last issue, this time they focus on gettingthose all-important referrals.

provider and they will contact you whenthey have a referral in your area. The prosof this is that you don’t have to put anyeffort into finding the referrals and there isno cost for you. The cons are that rates ofpay can be low and invoices can take awhile to be paid, paperwork demands canbe high and it can generally be morecomplex dealing with emails and otherdemands that insurers bring. If they gointo administration you could also lose outor if another therapist in the local area isoffering better rates you could see yourreferrals suddenly drop. They can be agood way to get started while you buildown your online profile.

Insurance companies Similar pros andcons to referral agencies, the logos on yourwebsite can improve your authority andthey can serve as another regular incomestream. Having a few income streams canbe helpful so you don’t have all yourreferral source eggs in one basket as themarket is always changing.

Local community Getting to know yourlocal community has been very valuablefor referrals for myself and Heather,popping into shops and using the servicesof other therapists and health andwellbeing practitioners allows them to getto know you and when they do they aremore likely to refer you to their clients.There’s no harm in having lots ofreflexology, acupuncture or massageseither!

Heather has consistently written to localservice providers and while this has takentime to show a return she has nowestablished some good relationships withgeneral practitioners, local businesses,schools and solicitors. The key here is to beconsistent. A one-off letter might just hitthe bin but if you plan a mail drop every

The number one question we hear in our CBT in Private Practice Facebook group is

“Where do therapists get their referrals from?”

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13December 2019

six months, services will become more familiar withwho you are. We get so few letters these days thatpeople seem to be taking more notice when theydo get them.

Research indicates that people need to see yourservice seven times before they make a referral or a purchase.

Directories There are a number of directorieswhere you can pay to be listed such as theCounselling Directory. The most popular one at themoment is Psychology Today. They have somegood introductory offers so you can try it out for awhile. Alongside paid directories, do a search forlocal business directories in your area - the moreplaces you can be the better. There are alsoprofessional directories to consider for differentprofessional bodies, check out BABCP’s CBTRegister for accredited members and IPSIG.

Paid advertising Google adverts or Facebookadverts can be a great way of generating traffic toyour website to improve it’s SEO and to getyourself known. However, people can spend a lot ofmoney and if you don’t know what you are doingyou may not get the returns you hope for. It’s oftenworth paying someone who knows their stuff toget the campaigns going for you. We’d advise totread with caution.

Google My Business is your new best friend. If weare relying on our websites for even part of ourreferral source then we want to be found onGoogle. So give Google some love, use Google’smaps on your websites and create a Google MyBusiness account. Update it regularly and popphotos and blogs on your account. Google reviewswill attract more people to your profile andwebsite and push you up the Google searchengine. Google will reward your efforts with more visibility.

The gold standard of referrals is word of mouth,when people have heard about you what you doand how amazing you are! It’s also high pressure

when people come withhigh expectations but veryrewarding. It takes time forword of mouth referrals tocome through because we arestill fighting the stigma ofmental health and we don’t oftentalk about the therapy we have.One way to encourage some wordof mouth is to ask for anonymousfeedback following therapy or sendthe link to your Google businessaccount, make it easy for people togive feedback and often they will. Thiscan then be shared on your website.

This has been an overview and I’m surethere are many other avenues. It’simportant to remember that what workswell for one person might not foranother, there is no right way so dowhat feels right for you. If you hatesocial media, don’t do it - you won’tenjoy it and won’t give it your bestenergy, so create a business that’sunique to you and a business youlove.

If you would like to keep up-to-dateyou can join our little community onFacebook CBT in Private Practice,where you can discuss referralsources and learn from fellow CBTTherapists!

Sarah Rees is in full-time private

practice in Wilmslow, Cheshire

(sarahdrees.co.uk) and

Heather Howard-Thompson is in

private practice in Barnsley

(yorkshirepsychotherapy.co.uk)

It takes time for word of mouth referrals to comethrough because we are still fighting the stigma ofmental health.

”“

Patricia Murphy: Can you tell us a bit about the thinking behind setting up a communitypoetry group?

Victoria Field: The answers to that question aremulti-layered – much like a poem! I have alwaysbeen an advocate for libraries ever since I was ayoung child. My mum dropped me off in AshfordLibrary every Saturday while she did theshopping and I would always come home withthe maximum number of books. I think librariesare key to a civilised society and offer genuinepublic space welcoming everyone and can helpbuild society. When I lived in Cornwall, I workedon many projects in the library service andmoving to Kent I was surprised there was noprovision and so applied for a small grant to setthe ball rolling – the group has run on and offnow for six years.

More generally, I have worked with poetry therapyand expressive writing in many settings and aminterested in the theoretical justification for it. Is it a‘treatment’? A set of techniques like CBT? A form ofgroup psychotherapy? I think there are elements ofall these but for this particular community group, Isee it as a ‘maintenance model’ – like exercise –which can help us maintain good psychological,spiritual and social health. The pattern ofattendance seems to confirm this.

PM: I am regularly amazed by what we create as agroup but also by the ways in which these activitiesfoster a connection with the self at a very profoundlevel. What do you think it is about poetry thatappears to speak so directly about and to people?

VF: Yes, one of the great pleasures of this work isseeing and sensing these connections. There aremany things happening when we connect withpoems - some identifiable, some mysterious.

Writing in groups, trusting the process and havingsome gentle time pressure enables us to bypassthe various personae we adopt and often get tothe heart of the matter very quickly.

A poem is typically concise, often with strikingmetaphors and satisfying artistically so we get asense of completion and meaning. Here I thinkpoems are analogous to dreams, where an imagecan offer deep insights. A metaphor can oftenreveal more than a straightforward description andprovides a bridge between our conscious andunconscious thought processes. Even a simpleexercise like describing your anger as an animalcan tell us a lot about how we see ourselves.

Giving something form, like the container of apoem in fourteen lines or a piece of writing thattakes six or ten minutes is also a way of making the

In the last issueof CBT Today(October 2019) Patricia Murphyintroducedreaders to thebenefit thatpoetry brings to us all. In thisissue, she speaks with poetrytherapist andwriter Victoria Field

14 December 2019

Vicky Field (Ranald Mackechnie)

Giving us all of the feelsGiving us all of the feels

I think poetry, story and song are examples of thecreative and expressive impulse that makes us human.We have lost something profound in our culture thatthese things are no longer part of everyday life. Weneed to make meaning and create beauty out ofour experiences.

”“

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15December 2019

unmanageable manageable. The materialof our lives is infinitely rich and can beoverwhelming so being able to look at it inbite-sized pieces can help establish asense of mastery and control.

There’s also a sense of community whenwe read a poem or listen to one wheresomeone has articulated an emotion orexperience on our behalf. We realise thatwe are not alone. An example of this‘isoprinciple’ is the way sad poems ormusic can be comforting when we alsofeel sad. Knowing that our own trials andtribulations are part of the widerenterprise of being human can help usmanage them better.

Finally, I think poetry, story and song areexamples of the creative and expressiveimpulse that makes us human. We havelost something profound in our culturethat these things are no longer part ofeveryday life. We need to make meaningand create beauty out of our experiences.

PM: One of my favourite things about thegroup is when we take it in turns to readour own or a selected piece of poetry. Iimagine that many of us have probablynot had an opportunity to read aloud toothers since we were either in school orreading to children. Many of my patientshave had aversive school experiences andlack confidence in speaking out in frontof others so the opportunity to lay downfresh memories of communal speaking ina safe place can be really healing. What

do you see as the value of reading aloudas a group?

VF: I think ‘unsilencing’ and giving voice tothe voiceless is an important aspect ofhealing, both of individuals and society. Asyou say, many people have lost confidencein their voices.

Reading aloud is a simple and powerfulway of regaining that confidence and I ampleased to see that shared reading groupsare proliferating. One of my CornwallLibrary groups simply consisted of readingaloud novels week-in-week-out andgradually people gained confidence andwould read longer passages and starttalking about things that mattered in theintervals and many reported reductions indepression and anxiety.

Reading aloud also slows the world rightdown. It’s an immersive process and verymindful in that you have to concentratenot to miss your turn. This can be veryhelpful for people who may have atendency to ruminate.

The converse of reading is listening which

is restorative for many people who maynot have been listened to in their lives.There are many ways of setting up poetrytherapy sessions but increasingly I thinksimply having words listened toattentively and kindly by others is apowerful experience.

Finally, we are reading carefully chosenwords which has an impact on us thereader. A poem has been described as amachine for remembering itself and‘remember’ has an interesting etymology– as if we are putting ourselves backtogether. As these words come throughus, I think we are subtly changed. I had arecent profound experience when a friendasked me to read the words of diarist EttyHillesum at a lecture he gave and it was asif I felt them for the first time. We’veprioritised silent reading in our culturebut reading aloud means both taking in –like breathe and inspiration – and thenexpressing and even tasting the words onour tongues. In other words, it’s embodiedand again modern life has created a

Reading aloud is a simple and powerful way of regaining thatconfidence and I am pleased to see that shared reading groupsare proliferating.

”“

Continued overleaf

Giving us all of the feels disconnect between our intellects andbodies which reading aloud re-establishes.

PM: You have had extensive experience of working in health and social care settingswith many different client groups.Whatbenefits from poetry therapy do patientsreport and what impact do you think it hason physical and psychological well-being?

VF: I’m going to quote here from thereport of a previous iteration of the WiseWords for Wellbeing group. There is astrong social component to these answerswhich I think is central to poetry therapy –although poetry and writing can be usefulin one-to-one psychotherapy, I think thebenefits are multiplied in a group setting.

• The group allows an opportunity formembers to express their individualspirituality in an environment ofacceptance and openness.

• I have enjoyed sharing my work andhearing others' work. It is a kind ofintimacy that I don't normally have withmy friends. I have been more open insharing my creative side with my friendssince doing the wise words sessions, andit has been rewarding. I could also saythat my mental health has improved alot, as I have a lot more calm and clarity,and actually a lot more self-confidence. Iam more aware of, and appreciative, ofmy own unique voice. Having this writingpractise is a great outlet for stress andpent-up emotions.

• Throughout the various workshops I haveattended, I've been fortunate to be ableto interact with a variety of differentpeople from a variety of different culturaland social backgrounds, across a wideage range. Our enjoyment of writing hasenabled me to begin forming newrelationships which I may not have madeoutside of the workshops

• I have a 25 minute walk each way sothat's good exercise. I meet up with anold friend who also comes.

• I have unexpectedly gained new friendsand felt stimulated to look after myphysical health

• Have reconnected with people I've notseen for years and met new people. I havea chronic anxiety problem, this is givingme the confidence to help combat this.

• I did not really expect a writing group tohave such an influence on my emotionaland social wellbeing, and not at all on my

physical wellbeing, but as these areconnected it unavoidably influenced allof them.

• Reawakens a writing habit.

PM: I am greatly admiring of your abilityto contain the space inhabited by thegroup. You have a very light touch and areable to set clear boundaries whist alsobeing acutely aware of and managing theindividual sensitivities of each member.How the devil do you do that?

VF: It feels like a bit of high-wire act at timesas with an open group you never know whomight be in the room and what experiencesand expectations they are bringing. I try tobe a facilitator rather than a tutor ortherapist in that I want to allow individualsto shape and express their own material andsimply witness it, rather than get intoprocessing or analysing what’s emerged.

Groups in a hospital or dementia settingwhich tend to be closed might have adifferent dynamic but will also entail thebalancing of the needs of individuals andthe group as a whole. People need to feelboth safe and free to take risks and thistension is paramount – both in groups andin daily life. A colleague and I teach anonline course called Running WritingWorkshops. We’ve drawn on theexperience of other facilitators in a seriesof interviews as well as our own andrelated that to the literature on groupprocess – it’s fascinating stuff!

On a personal level, I’ve discovered overthe years that I have a bodily sense ofpeople’s moods and emotions. A lot ofwhat happens, even in a poetry groupwhere our business is words, is non-verbal.We are giving subtle messages all the timethrough posture, gesture, eye contact andso on. I’ve found that to be especiallyapparent when I’ve worked one-to-onewith someone with dementia and felt howthey might open up or close down inresponse to different poems – hard toexplain but once you tune in, it’s very clear.

PM: It is fascinating to see the range ofresponses to the material you share withthe group but also how shared themes canemerge. For example, this Spring youbrought in a daffodil for everyone and wehad to write a poem for it and then write apoem from the daffodil’s perspective. How

interesting that it brought to mind formany of us themes of being undervaluedand transience. Can you say somethingabout how poetry can create a commonbond, decrease a sense of isolation andincrease affiliation with our fellow humans?

VF: In our secular society (although someargue that we’re now post-secular),questions such as what happens afterdeath, how to find meaning and whatvalues we should live by are all up forgrabs and as individuals we can feelisolated as we grapple with thesequestions. This can be especially apparentat times of loss and change when life ischallenging or simply when we have toconfront - as all of us will - mortality andaging. Whatever the surface stimulation is– in this case a daffodil – it’s likelyeventually to bring us back to thoseimportant questions about our transienthuman existence.

In poetry therapy, we often draw onpoems and images from the natural worldas this provides a background that hints ateternity and puts our own concerns intosome kind of perspective. The cycle of theseasons, the way flowers and trees dieback and then return to full bloom can becomforting and make us feel part ofsomething larger. Many people who aredisenchanted with organised religion maysay that for them, nature gives a sense oftranscendence and wonder. Theseresponses can be cultivated by closeobservation – as we did with the daffodiland subsequent reflection. In many waysthe practice of poetry therapy relates tothe current enthusiasm for mindfulness.Paying attention and staying with thepresent moment can be transforming.

Time is a perennial theme in people’sexpressive writing. Such writing is a way ofengaging with the question of what weshould do with (in Mary Oliver’s words)‘this wild and precious life’. Exploring thesequestions collectively and without anyagenda in a kind and supportive groupcan help counteract the atomistic,disconnected sense nature of modern life.

PM: The poet, novelist and teacher KateClanchy recently gave an interviewregarding her recent book based on herwork in a small comprehensive schoolwhere the children speak 30 languages. A

16 December 2019

Giving us all of the feels continued

comment was made about the degree ofreverence shown toward poetry by the childrenand she acknowledged that it was part of being amulti-cultural community.

VF: I love Kate Clanchy’s work and have heard herspeak about ‘the very quiet foreign girls’ she workswith at her Oxford comprehensive.

I think inclusivity and diversity are an issue in manyareas of the arts and of course society moregenerally, whether we are talking about race,gender, sexuality, being differently-abled or class.As KC says in your quotation above, if we can seeourselves reflected in the poems, then we are morelikely to engage.

Your question is one that I have grappled with for along time – both as a practitioner and when I wason the Board of Lapidus and various Arts for Healthorganisations where it often felt as if we werelooking in the mirror, and I’ve yet to find an answer.

On a more positive note, in the wider world ofpoetry publishing and performance, there’sdefinitely been an increase in the diversity of thosewinning prestigious prizes or appearing at festivals.And there are also movements like Survivors’ Poetryand The Deaf Poets Society which are user-led andprovide platforms outside of the mainstream.

PM: Last year I went to hear Lemn Sissay,Canterbury’s Poet Laureate perform his ‘A poem forCanterbury’ in the Cathedral. It was utterly magical.Sissay’s traumatic experiences of being in care ledhim to become involved in ‘Warrior Poets’, acollaboration between artists from across Kent andthe South East working with young people in careand young refugees to explore and celebrate theresilience that develops through facing adversity atsuch a young age.

What do you think can be done to change theperception of poetry as not just entertainment butas a powerful agent of change in health care?

VF: I think people have always known that poetry

is important. Many people I’ve learned are secretpoets, possibly only writing at times of heightenedemotion such as a bereavement or falling in loveand many people carry a poem that’s given themhope, inspiration or solace. It’s free, requires nospecial equipment and I think we instinctivelyknow that shaping our thoughts is therapeutic –many teenagers start writing diaries and listeningto music that reflects their current feelings.

The above though is part of the problem in thatpoetry is as varied, diffuse and accessible as musicso getting it recognised as a powerful agent ofchange in healthcare is difficult. The challenge isboth to define what’s happening and also todemonstrate its efficacy in promoting health. I wasan adviser on a systematic review of the literatureon therapeutic writing for long-term conditionspublished in 2016 which, not surprisingly, wasinconclusive. For me, poetry therapy andtherapeutic writing, especially in groups, is aholistic intervention not susceptible to randomisedcontrolled trials and wellbeing measures like theWarwick Scale. One of the challenges is thatbenefits are likely to be long-term and cumulativeand we may feel ‘worse’ but paradoxically moreauthentically ourselves initially (not dissimilar toexercise).

The best way to change perceptions is for peopleto experience the power of the process directly. It’sdifficult for busy, senior people to have thatopportunity so I am always delighted if I canpresent a session at a conference or on a trainingcourse as even with a short demonstrationexercise, I get a sense of the penny dropping aspeople see how their own written responses cangive them powerful insights into an issue.

But to answer your question, there are optimisticsigns now that the NHS has embraced socialprescribing as one aspect of more personalisedcare, especially for people with long termconditions and complex needs. Community writingand poetry groups fit well into that model.

You can follow Patricia on Twitter @Mspmurphy

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17December 2019

In poetry therapy,we often draw onpoems and imagesfrom the naturalworld as thisprovides abackground thathints at eternityand puts our ownconcerns into somekind of perspective.

”

“

18 December 2019

CBT has a strong scientific tradition, with on the groundpractice being informed by basic science and trial findings(evidence-based practice) and research theory and modelsbeing informed by on the ground practice (practice-basedevidence). Our greatest advances as a field have comefrom an interaction between the laboratory and the clinic(Clark, 2004; Salkovskis, 2003). For this tradition to continuerequires symbiotic working between clinically informedresearchers and research informed clinicians in the NHS(and other applied) settings.

This article considers what can be done to help support ‘onthe ground’ clinicians to become research active,recognising that this can be a challenge because of theever-increasing pressures of the ‘clinical coalface’. The ideafor this article emerged during a skills workshop run byBarney Dunn and Shirley Reynolds at the BABCP AnnualConference in Bath about how to help clinicians turn theirresearch ideas into reality. The session identified a range ofopportunities and challenges for clinicians wishing to beresearch active and brainstormed a number of ideas abouthow the BABCP might be able to intervene, which wereelaborated on in a follow-up survey sent to all attendees.The attendees at the workshop (and others whocontributed to the debate) agreed to co-author this articleto share these discussions.

The themes identified can be usefully organised aroundthe COM-B framework of behaviour change (Michie, vanStralen & West, 2011). This argues that key to successfulbehaviour change (in this case, getting research active inclinical practice) is individuals having the necessary

reality:

Turning

researchideas into

How can we better support ‘on the ground’ clinicians tobecome research active?

19December 2019

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motivation, capability (knowledge), and opportunity (time,money and support) to carry out the target behaviour.

In terms of motivation, there was no shortage of intrinsic interestin research of those attending the workshop, with people feelingresearch is clinically important, theoretically interesting andwould help them remain fresh and engaged with their clinicalroles. However, people did describe sometimes lackingconfidence about whether they were the right person to carryout research and that ‘middle management’ in the NHS did notalways see the value of research so were reluctant to support it.In terms of capability, people described lacking sufficientresearch knowledge (how to choose a question; how to write anapplication, grant, or publication; which specific methodologiesto use; how to analyse data); that research felt like an ‘alienlanguage’ to those who were not already immersed in it; and thatit was hard to navigate the research funding landscape.

There was a recognition that those from different professionalbackgrounds have had different degrees of research training (andin particular it is important for the BABCP to ensure its researchsupport endeavours do not become ‘psychologist centric’ giventhat currently a majority of active CBT researchers have a clinicalpsychology background). In terms of opportunity, the critical ratelimiting step was a lack of time, with very few people having anyresearch time in their roles. People also felt isolated in theirresearch endeavours and did not know who to turn to forresearch support and mentoring. There was little or no fundingavailable to support early stage projects to get off the groundand for some it was hard to gain access to journal articles in NHS Trusts.

This analysis of barriers to becoming research active has theseeds of change within it. In terms of building capability, it wouldbe helpful for the BABCP to support systematic research training(for example, establish online resources, adding a research skillsstream to the Annual Conference, running research skills eventsin regional branches). In terms of building motivation, it wouldhelp for clinicians, researchers, and research participants to writeposition papers that clearly articulate the value of research to alllevels of the NHS and to help promote and showcase role models(ideally beyond clinical psychologists) that illustrate how it ispossible to get research active in routine clinical practice.In terms of resources, it would be helpful to establish a register ofpotential mentors or academics willing to support clinicians toget research active (or who would value collaborations aroundspecific projects); to provide seed-corn funding for early stageresearch or research methods training; and to establish a forumfor research-interested clinicians to share ideas with each other.

Moreover, clinicians should be encouraged to reach out toacademic departments who often are very keen to establish NHSlinks (and may have students looking for a research project tocomplete as part of their training). It would also be useful to raiseawareness in the BABCP membership of research fundingschemes they could potentially apply for. For example, theNational Institute of Health Research (NIHR) has established theIntegrated Clinical Academic (ICA) scheme that offers fellowshipsfrom pre-doctoral to senior lecturer level for allied healthprofessionals (including psychologists, nurses, social workers andoccupational therapists).

The NIHR has appointed training advocates to support alliedhealth professionals become research active (see the NIHR

training advocates website for details).‘Clinical PsychologyResearch Opportunities’ is a useful twitter feed source ofinformation (@Clin_Psy_Res), providing regular updates aboutresearch jobs, sources of funding, case studies of activeresearchers, and tips about how to get research active. Clinicianscan also contact NIHR Research Design Services (RDS) to seekadvice about developing research ideas and applying for funding.

A good place to start if you are a clinician wishing to become

Advertisement

Continued overleaf

20 December 2019

research active is to focus on an aspect of yourroutine clinical work that you think other peoplewill be interested in and explore this area with agreater degree of methodological rigour. Forexample, this could include characterising theclients presenting to services, reporting a casestudy of an unusual clinical presentation, running acase series of a novel therapeutic approach, oranalysing routine clinical outcomes to see howthese benchmark against randomised controlledtrial data. Such studies can be conducted withoutextensive time and funding and tend to have clearoperational value to NHS management.

It is important for the CBT research community toreflect the diversity of the BABCP membership(and the clients it serves). A cursory review ofrecent BABCP conference keynote speakers andfunded CBT researchers suggest progress has beenmade with gender diversity but that the majorityof speakers are of White ethnic origin. Given theadditional, and intersectional, structural barriersapplicants from ethnic minority backgrounds face,what could we do to better support them tobecome research active and develop clinical-academic careers? Increasing ethnic diversity hasbeen identified as a priority area by a number ofresearch funders and it will be important for theCBT community to consider how to take thisagenda forwards.

Our hope is that this piece will ‘whet the appetite’of interested clinical researchers, inspire debate inclinical services about how to support ‘grass roots’research, and encourage already research activemembers of the BABCP to consider what they cando to further support the creation of a researchcapable (and diverse) CBT workforce for now andthe future.

Contributors

Barnaby Dunn (Mood Disorders Centre, Universityof Exeter), Shirley Reynolds (Department ofPsychology, University of Reading), James Blacklock(Mental Health Matters, Sunderland), AbigailBradbury (CBT therapist in private practice),Eleanor Chatburn (Department of Psychology,University of Bath), Cathy Creswell (Department ofExperimental Psychology, University of Oxford),Lauren Cox (North West Boroughs NHS FoundationTrust), Zaid Hosanye (University of West Londonand Berkshire HealthCare NHS Foundation Trust),Pamela Jacobsen (Department of Psychology,University of Bath), Taf Kunorubwe (TalkPlus NorthEast Hants & Farnham), Tom Kent (School ofPsychology, University of Surrey), Jessica Kingston(Department of Psychology, Royal Holloway), MariaLoades (Department of Psychology, University ofBath) & Rosie Stevens (Mood Disorders Centre,University of Exeter).

References

Clark, D. M. (2004). Developing new treatment:on the interplay between theories,experimental science and clinical innovation.Behaviour Research and Therapy, 42, 1089-1104.

Miche, S., van Stralen, M .M., & West, R. (2011).The behavior change wheel: A new method forcharacterizing and designing behavior changeinterventions. Implementation Science, 6: 42.

Salkovskis, P. M. (2002). Empirically groundedclinical interventions: Cognitive Behaviouraltherapy progresses through a multi-dimensional approach to clinical science.Behavioural and Cognitive Psychotherapy,30, 3-9.

Turning research ideas into reality:How can we better support ‘on the ground’ clinicians to become research active?

Continued It is importantfor the CBTresearchcommunity toreflect thediversity of theBABCPmembership(and the clientsit serves).

”

“

21December 2019

To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com

London Branchpresents

Brief Parent-ledCBT for ChildAnxiety Disorderswith Professor Cathy Creswell

27 March 2020London

CBASP Special Interest Grouppresents

Three -DayIntensiveCBASPTraining

with Marianne Liebing-Wilson,Dr Massimo Tarsia, Erin Graham & Jonathan Linstead

5-7 February 2020Sheffield

West Branchpresents

Advanced CBT Skills for TreatingBDD and OCDwith Dr Anna Smith & Lisa Williams

2 & 3 April 2020

Bristol

Couples Special Interest Grouppresents

Group Supervisionand Networking forCouples Therapists with the Couples SIG committee

16 January 2020

London

branches and special interest groups

22 December 2019

branches and special interest groups

Devon & Cornwall Branchpresents

Chairwork in CBT with Tobyn Bell & Matthew Pugh

25 & 26 February 2020

Buckfastleigh

To find out more about these workshops, or to register, please visit www.babcp.com/events or email workshops@babcp.com

Supervision SIG & North East and Cumbria Branchpresents

Jo Stace Memorial Workshop:

Holding Hope: Clinical Supervisionfor CBT therapists and supervisorsworking with depressionwith Anne Garland28 February 2020Newcastle-upon-Tyne

Scotland Branchpresents

Getting in on the ACT:An introductory Acceptanceand Commitment Therapyworkshopwith Dr David Gillanders

21 February 2020Stirling

Manchester Branchpresents

CBT for multiple traumawith Martina Mueller18 February 2020Manchester

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24 December 2019

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26 December 2019

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28 December 2019