Frequently asked questions
CBT is a form of psychotherapy that has been known to be valuable in facilitating the essential changes needed to overcome a wide variety of difficulties, including depression and anxiety. CBT explores our response patterns to situational triggers by examining our underlying maladaptive (negative) belief systems. These belief systems are thinking patterns we have formed to make sense of ourselves and our world, and therefore become the filters we use when interpreting things that happen to us and subsequently drive our emotional, behavioural and physical reactions. By using the cognitive model we are able to identify and change what is maintaining our maladaptive belief systems and thinking patterns, and therefore our problems. CBT is solution focussed and aims to provide the client with tools to deal with both current and future difficulties.
The average number of sessions required for adult and adolescent therapy is more or less 12, but this all depends on the individual, the difficulty they are experiencing and the progress made in each session. Sessions are usually scheduled every week or second week, but as therapy reaches its end stages, sessions are spaced further apart. For Teddy Bear Therapy and Play Therapy an average of 6-8 sessions have been found to be the required number to address the presenting complaint but it depends on the nature of the complaint and the progress of the child.
For individual therapy a session usually lasts about 60 minutes, for couples or families I recommend a 90 minute session.
On arrival you will be asked to complete a document with your information, please allow for a few minutes prior to your session for this. The first session takes the form of an interview, this allow me to gain an understanding of you as an individual, the difficulties you are experiencing and the effect of these on your life. From this understanding we will outline a plan with the different identified dimensions we can address. This plan is not set in stone but allows for a general direction for therapy. If any difficulty is shown to be causing immense distress which needs to be addressed immediately, time is made for this.
I prefer that couples to attend the first session together, as the dynamics of the couple are easier to observe with both parties present. During the session I allow for both parties to share their views on the difficulties they are experiencing. I find that allowing both parties to hear the others concerns is essential in building a platform for change. However I understand that some couples may prefer separate sessions to highlight difficulties they may not want to air in front of their partner. If the couple prefers individual sessions may be scheduled.
Yes, your confidentiality will be maintained at all times. I work in such a way to ensure you as an individual are protected, no information will be disclosed without your consent. Any possible limits to therapeutic confidentiality (required by law, how confidentiality is handled in couple sessions, reports, etc.) will be discussed if the need arises.
An ADHD assessment for children firstly requires an interview with the parents to gain an understanding of the child and the displayed behavioural and emotional symptoms. Thereafter an assessment session is booked for the child, and will require an average of 3 hours. I prefer the assessment to be booked early morning as I am then able to observe the child’s concentration as it would be during his/her school performance. The assessment utilizes a variety of tests that measure a wide range of factors that may influence a child’s school performance, such as memory, concentration, IQ, verbal and nonverbal memory, as well as emotional difficulties. After the assessment I will compile a report and schedule a feedback session with the parents, in which we discuss the findings and recommendations.
A 60 minute session is recommended. When working with children an average of 40 minutes are usually sufficient however it should be kept in mind that the parents will be part of all stages of therapy and will be seen for the remainder of the session for feedback on the progress of the child. The only exception to the 60 minute session is the first session that takes about 90 minutes.
On arrival you will be asked to complete a document with your information, please allow for a few minutes prior to your session for this. The first session takes the form of an interview with the parents in order to obtain a full developmental history of the child. Hereafter the child will be seen for the remainder of the session to establish a relationship and put the child at ease so that he/she can familiarise him/herself with the surroundings.
Psychotherapy, often referred to as ‘talk therapy’, is not simply just talking about your problems, it is also developing a therapeutic relationship with a professional who assists you in finding solutions to psychological distress. Some therapy may involve homework, such as tracking your moods, writing about your thoughts or engaging in activities that frequently cause anxiety and distress. You might be encouraged to view things in a different way and/or learn alternative ways to respond and communicate with others. There are various different schools of thought from which a diverse and broad range of different psychotherapeutic methods emerged. The underlying idea behind most psychotherapeutic methods is that people can create the changes they desire in their lives by promoting healthier ways of thinking about themselves and others, and encouraging more adaptive ways of relating to their world. Most modern psychotherapy is brief and focused on current thoughts, feelings and life issues. Focusing on the past can help to understand your current thoughts, feelings and behaviours, and focusing on the present can help you manage current stressors and prepare for future endeavours. The most important parts of any type of therapy are a good therapeutic alliance between client and therapist, communication, collaboration, trust and empowering action. Successful therapy can assist a person to change thoughts, beliefs, perceptions, behaviours and moods in a manner that enhances the quality of their lives.
Cognitive-Behavioural Therapy (CBT) CBT combines cognitive therapy, which involves examining how thoughts affect emotions, and behavioural therapy, which involves changing a person’s reaction to challenging situations. It is goal orientated and works best when the client plays an active role. The therapist, using certain techniques and exercises, assists the client to see that certain thoughts may be having a negative impact on his/her emotional well-being, and helps implement methods that challenge these negative thoughts. The behavioural aspect of CBT involves empowering the client to take actions that reinforce that more adaptive thoughts promoted in therapy, and to gain a sense of realistic control over their behaviour. Often clients are assigned homework so that progress made during sessions can be extended outside of therapy. Interpersonal Psychotherapy (IPT) IPT is a time limited psychotherapeutic method that focuses on modifying disrupted relationships or expectations about those relationships with the aim of relieving symptoms, improving interpersonal functioning, resolving acute interpersonal crises and increasing social support. It is primarily concerned with the interpersonal context (the relational factors that predispose, precipitate and perpetuate psychological distress) and uses attachment theory and a biopsychosocial model to conceptually frame these factors. IPT focuses on what is happening in the here and now and attempts to help a person understand and modify his/her ways of thinking, feelings and behaving towards him/herself and others within the therapeutic relationship. IPT looks at conscious action and social adjustment with the aim of developing skills that enhance relationships with others, and one’s relationship with the self.
Play therapy is a specific psychotherapeutic approach in which toys, games and various creative mediums are used to help a child express emotions, thoughts, desires and needs. It assists them in developing a secure sense of and mastery over self-expression and how to communicate effectively with others. The aims, therefore, are very similar to adult psychotherapy but the means of communication are different as children function at varying levels of development, and play is often the most effective and expressive means according to which children communicate.
The first session is with the primary caregivers so that the therapist is able to obtain a thorough developmental history and gather other information relevant to understanding the presenting problem. Following this the child is assessed in a non-threatening, playful environment. The purpose of this is to gather direct information about the child that helps to formulate the problem in a meaningful way, and to introduce the child to the therapist so that they may begin building the therapeutic relationship. Feedback will then be given to the caregivers in terms of possible diagnosis, treatment plan and their involvement in executing the treatment plan.
The primary focus of the initial stages of therapy is to start building a secure therapeutic relationship between the child and therapist, which forms the basis of all psychotherapeutic interventions. These initial sessions are largely unstructured and encourage the child to trust the therapist to listen and securely contain overwhelming emotions and thoughts. During the sessions the therapist will use specific therapeutic techniques to assess how the child experiences and communicates with his/her world, and to help improve awareness of their own thoughts and feelings. Through this awareness the child is encouraged to learn more about who they are, to express themselves in clear and satisfying ways, to explore their world and to be self-supportive; skills they will use throughout their development.
Directive and non-directive techniques are used depending on the nature of the problem, and the psychological resources available to the child, and so the structure and aims of therapy differ. For example, I may be very selective with the type of toys available to the child, and encourage a certain type of play if the child is emotionally secure and the aim of therapy is skill development and mastery. If the child is emotionally insecure, the focus of the therapy will be building a secure relationship and using therapy as a tool for the child’s emotional expression, and so therapy will be largely non-directive.
During the final stage of therapy structured techniques are used less and the child is encouraged to play a more directive role in therapy. The purpose here is to prepare the child for the end of therapy and reinforce the newly learned skills so that they are easily transferred to situations outside of the therapy sessions.