Training In CBT & Other Evidence-Based Psychological Therapies
Introduction
It is common in secondary care settings to work with service users who find it difficult to be in certain situations or go to certain places due to anxiety. They may worry about not being able to cope or about something difficult, embarrassing or frightening happening in that situation, for example. Or they may associate particular situations with difficult experiences such as hearing distressing voices or feeling unpleasant physical feeling sensations associated with anxiety. Avoiding situations which feel difficult and unpleasant is an understandable way of coping, but in the longer-term we know that avoidance maintains the anxiety as we never learn that perhaps we are better able to cope than we expected or that the situation was not as frightening as we were expecting.
Graded exposure is a well-established and effective talking therapy for treatment of anxious avoidance and phobias. It aims to support people to gradually face their fears, one step at a time, from the least to most anxiety-provoking aspects of that situation. The GOALs programme is a structured and manualised brief therapy intervention designed specifically to allow health professionals working in secondary care settings to deliver graded exposure with service users experiencing more severe mental illness. GOALs was originally designed to support service users with psychosis, but has since been used in a range of settings for people with severe mental illness.
The event will be equivalent to 2.3/4 hrs of CPD.
Content
The webinar will include some background around graded exposure and the development of the GOALs programme, with a focus on how to deliver the work with your own clients in secondary care.
It will include building a good understanding of anxiety, its signs and symptoms and how this can lead to avoidance of certain situations for service users.
By the end of the session you should have a good understanding of how the GOALS manual and accompanying handouts can be used to guide delivery of graded exposure for anxiety, to support service users to reach important goals that they are struggling to achieve due to their fears and avoidance strategies.
The key stages covered include:
• Understanding anxiety and its link with avoidance
• Setting personal goals for service users to work towards
• Breaking goals down into manageable steps to develop a ‘hierarchy’ or ‘anxiety ladder’
• Completing and reviewing the steps
• Troubleshooting areas of difficulty
Learning Objectives
• To be able to recognise the signs and symptoms of anxiety
• To understand what graded exposure is and when this might be appropriate to try out with service users in secondary care settings
• To understand how to use the GOALs manual and handouts to deliver graded exposure
• To consider some of the possible difficulties and options for troubleshooting these, including ways of implementing this work in a busy service
Training Modalities
Training will include didactic content, demonstrations of how to deliver the work and with time for Q&As throughout.
Key References
Garety, P., Craig, T.K.J. & Iredale, C. et al. (2018) Training the frontline workforce to deliver evidence-based therapy to people with psychosis: challenges in the GOALS study. Psychiatric Services, 69(1): 9-11.
Waller, H., Landau, S. & Fornells-Ambrojo, M. et al. (2018) Improving implantation of evidence based practice for people with psychosis through training the wider workforce: results of the GOALS feasibility randomised controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 59: 121-8.
Waller, H., Garety, P., Jolley, S. et al. (2013) Training frontline mental health staff to deliver ‘low intensity’ psychological therapy for psychosis: a qualitative analysis of therapist and service user views on the therapy and its future implementation. Behavioural and Cognitive Psychotherapy, 43(3): 1-16.
About the presenter
Helen Harding (Nee Waller) is a Clinical Psychologist with over 10 years’ experience working in secondary care mental health settings in South London, mostly supporting service users with psychosis and/or Bipolar Spectrum Disorders. She was the Study Coordinator for both the GOALs pilot study and Randomised Controlled Trial, working together with an experienced team of research psychologists including the Principal Investigators, Professors Philippa Garety and Tom Craig. As part of this work Helen led the training and supervision of all health professionals taking part in the studies and the development of the manual and handouts. Following completion of the trials Helen continued to offer training and supervision to clinical staff within local secondary care services to deliver the GOALs work. Following a relocation Helen currently works in NHS staff wellbeing within a large acute NHS Trust.
Who should attend
The GOALS work has been trialled with a range of health professionals working in adult secondary care mental health settings including Assistant Psychologists, Mental Health and Wellbeing Practitioners, Support Workers and Occupational Therapists. We have found that whilst it is possible for those in a care coordination role to train and to use these methods as part of regular meetings, this has tended to be very difficult for most given high caseloads. Clinical Psychologists and CBT Therapists working in Secondary Care may also wish to attend with a view to supervising staff members in delivering this type of work.