Modern life in and of itself does not have the power to make us sad. If it did it would have the same effect on everyone. It is how we think about things and the way we respond to them that effects how we feel.
Those who have a strong sense of their own worth are able to think about the challenges that face them in a way that allows them to make choices based on their needs so that they get the best out of life. For example the new mother faced with the challenge of juggling her career and her new commitments to her child thinks ‘I am only human, there is only so much I can do, so I am going to do what suits me and my baby”. These thoughts allows her to makes choices that help her to get the most out of what faces her and as her goals are tailored to her, leads to a favourable outcome which reinforces her sense of self worth.
Those who question their worth and doubt their value (those with low self esteem) are unable to do this. Instead of using themselves as a reference point they look to others; a risky strategy as other people’s goals are only designed to make them happy. Faced with the same challenge of juggling commitments this new mother thinks ‘everyone else seems to be able to do both so I must too, if I can’t I am a failure’. This leads to unrealistic and unachieveable goals, designed for someone else, which leads to unfavourable outcomes and further self doubt.
In modern life there are many more opportunities to compare ourselves to others and in the case of those with low self esteem, to do this negatively, but those people would have always been more vulnerable to feeling sad, not because of what is going on outside of them but because what is going on inside of them.
The Britsh CBT & Counselling Service
Monday, 5 September 2011
Saturday, 3 September 2011
Will Trying To Be Happy Make You Miserable?
There is only one success – to spend your life in your own way – Christopher Morley
Part of the reason we are so successful as a race is our drive to improve and develop. We are always
striving for the next thing, to be more, richer, thinner, healthier, younger, maybe happier.
Goals create anxiety or pressure which motivates us to move forward, to improve and develop, so it
is important to set them for ourselves. However they need to be both achievable and measurable,
so that there is a clear point at which the goal is reached, the anxiety/pressure can be allowed to
dissipate and be replaced by a sense of achievement.
Happiness is subjective (personal and idiosyncratic)and thus very hard to define and to measure,
so when setting this as a goal we need to be careful that we are not just setting ourselves up to fail
i.e. exposing ourselves to the anxiety and pressure with no hope of this being replaced by a sense of
achievement.
Setting happiness as a goal is not a bad thing, especially when you consider all the benefits that
research has shown to be linked to it (better relationships, health, sleep better, more creative, view
more positively by others), and the fact that it is not just a sign that things are going well but a factor
that will increase the chances that they will continue to do so. But there are potential pitfalls so
when setting happiness as a goal, consider doing the following:
1. Have a clear personalised definition of happiness and what this will actually look and feel like
for you.
2. Identify what will make you happier then identify achievable and most importantly realistic
steps that you can follow to achieve your goal
3. Measure your progress against your personalised vision and not against someone elses: the
subjective nature of happiness makes the social pursuit of it complex.
4. Do not make the pursuit of happiness your primary objective – the pressure this will create
will undermine what you are trying to achieve. Make this one of many goals including being
a good friend, wife/husband, mother/father, developing interests /having experiences that
expand your horizons.
5. Be realistic, do not strive for perfection ;consider the theory of Yin and Yang - It is impossible
to be happy all the time and actually in order to be happy we need to also experience
unhappiness; the existence of one relies upon the other
The Britsh CBT & Counselling Service
Part of the reason we are so successful as a race is our drive to improve and develop. We are always
striving for the next thing, to be more, richer, thinner, healthier, younger, maybe happier.
Goals create anxiety or pressure which motivates us to move forward, to improve and develop, so it
is important to set them for ourselves. However they need to be both achievable and measurable,
so that there is a clear point at which the goal is reached, the anxiety/pressure can be allowed to
dissipate and be replaced by a sense of achievement.
Happiness is subjective (personal and idiosyncratic)and thus very hard to define and to measure,
so when setting this as a goal we need to be careful that we are not just setting ourselves up to fail
i.e. exposing ourselves to the anxiety and pressure with no hope of this being replaced by a sense of
achievement.
Setting happiness as a goal is not a bad thing, especially when you consider all the benefits that
research has shown to be linked to it (better relationships, health, sleep better, more creative, view
more positively by others), and the fact that it is not just a sign that things are going well but a factor
that will increase the chances that they will continue to do so. But there are potential pitfalls so
when setting happiness as a goal, consider doing the following:
1. Have a clear personalised definition of happiness and what this will actually look and feel like
for you.
2. Identify what will make you happier then identify achievable and most importantly realistic
steps that you can follow to achieve your goal
3. Measure your progress against your personalised vision and not against someone elses: the
subjective nature of happiness makes the social pursuit of it complex.
4. Do not make the pursuit of happiness your primary objective – the pressure this will create
will undermine what you are trying to achieve. Make this one of many goals including being
a good friend, wife/husband, mother/father, developing interests /having experiences that
expand your horizons.
5. Be realistic, do not strive for perfection ;consider the theory of Yin and Yang - It is impossible
to be happy all the time and actually in order to be happy we need to also experience
unhappiness; the existence of one relies upon the other
The Britsh CBT & Counselling Service
Wednesday, 16 March 2011
How Is CBT Different From Other Types Of Counselling
1. The Evidence
The most important distinguishing feature of CBT is the evidence that supports it. The National Institute of Clinical Excellence (NICE – the government body responsible for providing national health care guidance on the promotion of good health and the prevention and treatment of ill health) recommends it as the treatment of choice for a range of mental health problems including Anxiety, Depression, Obsessive Compulsive Disorder, Post Traumatic Stress Disorder and Eating Disorders. CBT’s effect has been proven time and time again in randomised control trials (the most rigorous way of determining whether a cause-effect relation exists between treatment and outcome) and a wealth of published research studies exist supporting its efficacy (e.g. Cochrane Review - a group of over 10,000 volunteers in more than 90 countries who review the effects of health care interventions tested in biomedical randomized controlled trials). CBT is the only psychotherapeutic approach with such a robust evidence base across a range of mental health problems.
2. A Short Term Treatment.
CBT is frequently presented as a ‘short term treatment’ and although in comparison to other types of ‘talking therapy’ it is certainly time limited, it is important to dispel the myth that it offers a quick fix. CBT is used to treat problems that are interfering with a person ability to function in one or more areas of their life. These problems are real, significant and often long standing and so it stands to reason that to resolve such problems a certain amount of time and energy is going to be needed. A problem that is quick and easy to resolve would not need a course of therapy from a highly trained professional. The number of CBT sessions that a person needs depends on the severity and chronicity of symptoms but an average minimum is between 15-20 sessions. Many other psychotherapeutic programs (e.g. psychodynamic psychotherapy) can continue for years.
The features that enable CBT to be a ‘short term’ treatment are also important in distinguishing it from other psychotherapeutic approaches.
2.1 Problem Focused And Goal Oriented
CBT focuses on resolving specific problems. During the initial assessment (first 1-3 sessions) the therapist will develop a Problem Formulation which will enable both therapist and patient to understand how the problem has developed and why (up until this point) it has not been resolved. This formulation is then used to guide treatment towards specific goals (identified collaboratively by therapist and patient) that when reached will signify the resolution of the presenting problem. Throughout treatment the initial problem formulation will be reviewed and updated to included additional information that may come to light and treatment is reviewed at regular intervals to ensure that progress towards the end goals is being made. This shared understanding of the problem and a clearly defined end goal ensures that treatment is as effective and efficient as possible.
2.2 Becoming Your Own Therapist
The ultimate goal of CBT is for the patient to become their own therapist. In some types of counselling the therapist is set up as the ‘expert’ who imparts knowledge of a seemingly inaccessible nature which can leave the patient feeling dependent upon the therapist and can undermine their confidence in their own capacity to resolve problems. In CBT therapist and patient work together so that the patients can learn a set of skills (practical and psychological) which can be integrated with their existing a knowledge so that they are eventually able to independently resolve not only current problems but tackle future ones without the need for additional counselling. This means that usually only one course of treatment is necessary thus reducing the likelihood that ‘longer term’ input will be needed. The following analogy illustrates this goal:
"An oyster creates a pearl out of a grain of sand. The grain of sand is an irritant to the oyster. In response to the discomfort, the oyster creates a smooth protective coating that encases the sand and provides relief. The result is a beautiful pearl.
For an Oyster, an irritant becomes the seed for something new. Similarly (CBT Counselling) can help you develop something valuable from your current discomfort. The skills taught... will help you feel better and will continue to have value in your life long after your original problems are gone". Greenberger & Padesky 1995
2.3 A ‘Here and Now’ Therapy
CBT is often described as a ‘Here and Now’ therapy however it is important to be clear about what this means as this term is frequently misunderstood and used to imply that CBT is not suitable for resolving complex problems. In the initial phase of CBT the focus is on alleviating the symptoms that the patients is currently experiencing (e.g. panic attacks, low mood) by addressing the factors that are maintaining them. This is done not only to bring relief to the patient but where appropriate (i.e. for severe/long standing problems) to release some capacity for the patient to focus on exploring and resolving the factors that have contributed to the problem developing in the first place. In this second phase of treatment (often thought of as the domain of longer term psychotherapeutic approaches) an extended (but less popularised) version of CBT is utilised (Schema Focused CBT) which has been specifically developed to ensure that ‘here and now’ improvements are consolidated and to protect against future relapse. Although this second phase extends the length of treatment, as it continues to utilise the feature outlined above it represents a significantly more time efficient way of resolving long standing problems than other types of counselling traditionally used to tackle such issues.
The Britsh CBT & Counselling Service
The most important distinguishing feature of CBT is the evidence that supports it. The National Institute of Clinical Excellence (NICE – the government body responsible for providing national health care guidance on the promotion of good health and the prevention and treatment of ill health) recommends it as the treatment of choice for a range of mental health problems including Anxiety, Depression, Obsessive Compulsive Disorder, Post Traumatic Stress Disorder and Eating Disorders. CBT’s effect has been proven time and time again in randomised control trials (the most rigorous way of determining whether a cause-effect relation exists between treatment and outcome) and a wealth of published research studies exist supporting its efficacy (e.g. Cochrane Review - a group of over 10,000 volunteers in more than 90 countries who review the effects of health care interventions tested in biomedical randomized controlled trials). CBT is the only psychotherapeutic approach with such a robust evidence base across a range of mental health problems.
2. A Short Term Treatment.
CBT is frequently presented as a ‘short term treatment’ and although in comparison to other types of ‘talking therapy’ it is certainly time limited, it is important to dispel the myth that it offers a quick fix. CBT is used to treat problems that are interfering with a person ability to function in one or more areas of their life. These problems are real, significant and often long standing and so it stands to reason that to resolve such problems a certain amount of time and energy is going to be needed. A problem that is quick and easy to resolve would not need a course of therapy from a highly trained professional. The number of CBT sessions that a person needs depends on the severity and chronicity of symptoms but an average minimum is between 15-20 sessions. Many other psychotherapeutic programs (e.g. psychodynamic psychotherapy) can continue for years.
The features that enable CBT to be a ‘short term’ treatment are also important in distinguishing it from other psychotherapeutic approaches.
2.1 Problem Focused And Goal Oriented
CBT focuses on resolving specific problems. During the initial assessment (first 1-3 sessions) the therapist will develop a Problem Formulation which will enable both therapist and patient to understand how the problem has developed and why (up until this point) it has not been resolved. This formulation is then used to guide treatment towards specific goals (identified collaboratively by therapist and patient) that when reached will signify the resolution of the presenting problem. Throughout treatment the initial problem formulation will be reviewed and updated to included additional information that may come to light and treatment is reviewed at regular intervals to ensure that progress towards the end goals is being made. This shared understanding of the problem and a clearly defined end goal ensures that treatment is as effective and efficient as possible.
2.2 Becoming Your Own Therapist
The ultimate goal of CBT is for the patient to become their own therapist. In some types of counselling the therapist is set up as the ‘expert’ who imparts knowledge of a seemingly inaccessible nature which can leave the patient feeling dependent upon the therapist and can undermine their confidence in their own capacity to resolve problems. In CBT therapist and patient work together so that the patients can learn a set of skills (practical and psychological) which can be integrated with their existing a knowledge so that they are eventually able to independently resolve not only current problems but tackle future ones without the need for additional counselling. This means that usually only one course of treatment is necessary thus reducing the likelihood that ‘longer term’ input will be needed. The following analogy illustrates this goal:
"An oyster creates a pearl out of a grain of sand. The grain of sand is an irritant to the oyster. In response to the discomfort, the oyster creates a smooth protective coating that encases the sand and provides relief. The result is a beautiful pearl.
For an Oyster, an irritant becomes the seed for something new. Similarly (CBT Counselling) can help you develop something valuable from your current discomfort. The skills taught... will help you feel better and will continue to have value in your life long after your original problems are gone". Greenberger & Padesky 1995
2.3 A ‘Here and Now’ Therapy
CBT is often described as a ‘Here and Now’ therapy however it is important to be clear about what this means as this term is frequently misunderstood and used to imply that CBT is not suitable for resolving complex problems. In the initial phase of CBT the focus is on alleviating the symptoms that the patients is currently experiencing (e.g. panic attacks, low mood) by addressing the factors that are maintaining them. This is done not only to bring relief to the patient but where appropriate (i.e. for severe/long standing problems) to release some capacity for the patient to focus on exploring and resolving the factors that have contributed to the problem developing in the first place. In this second phase of treatment (often thought of as the domain of longer term psychotherapeutic approaches) an extended (but less popularised) version of CBT is utilised (Schema Focused CBT) which has been specifically developed to ensure that ‘here and now’ improvements are consolidated and to protect against future relapse. Although this second phase extends the length of treatment, as it continues to utilise the feature outlined above it represents a significantly more time efficient way of resolving long standing problems than other types of counselling traditionally used to tackle such issues.
The Britsh CBT & Counselling Service
Sunday, 30 January 2011
NHS Underestimates Employee Figures By 200,000
When the previous government outsourced some of the NHS’s back office services (e.g. patient records) to the private sector, the government believed it employed 1.3 million people in the NHS. After the private IT companies started collating the information that they needed to implement the new IT structures and systems they discovered that the NHS actually employed 1.5 million people.
That means that there were 200,000 people on the NHS payroll that hadn’t been accounted for. To put this in context, Tesco (the third largest food retailer in the world) employ £250,000 in the UK.
This goes some way to explaining why the NHS has become a financial blackhole. Staff costs are by far the highest single cost in the NHS. How can accurate forecasts for patient services and future fiscal plans be made when the government doesn’t know how many people they employ?
The Britsh CBT & Counselling Service
That means that there were 200,000 people on the NHS payroll that hadn’t been accounted for. To put this in context, Tesco (the third largest food retailer in the world) employ £250,000 in the UK.
This goes some way to explaining why the NHS has become a financial blackhole. Staff costs are by far the highest single cost in the NHS. How can accurate forecasts for patient services and future fiscal plans be made when the government doesn’t know how many people they employ?
The Britsh CBT & Counselling Service
Saturday, 29 January 2011
The Most Dramatic Changes in NHS in 60yrs
Up until recently Primary Care Trusts (PCTs) were in control of NHS budgets, deciding where and how money was spent thus determining the quality and level of service that the public received for both their physical and psychological health.
On 21.01.11 the government announced that PCTs were to be abolished and their control handed to GPs. The idea behind this (and one that many GPs agree with) is that GP’s position in the healthcare chain (i.e. on the front line) places them in a better position to determine how funds are allocated. However, some GPs fear that their position on the front line means that they will not have the capacity to take on this new responsibility. What is certain is that this is a genuine change in how resources are distributed and a change is without doubt necessary. However is this a change in the right direction?
The Britsh CBT & Counselling Service
On 21.01.11 the government announced that PCTs were to be abolished and their control handed to GPs. The idea behind this (and one that many GPs agree with) is that GP’s position in the healthcare chain (i.e. on the front line) places them in a better position to determine how funds are allocated. However, some GPs fear that their position on the front line means that they will not have the capacity to take on this new responsibility. What is certain is that this is a genuine change in how resources are distributed and a change is without doubt necessary. However is this a change in the right direction?
The Britsh CBT & Counselling Service
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