Therapy and Support Options
The Practice MK is able to provide a wide range of therapy and support services that are specially adapted for looked after, adopted children. For more information on our services please contact a member of the team who will be happy to discuss the full range of services with you.
Mindfulness Based Cognitive Therapy
Mindfulness has been defined as: “Paying attention, on purpose, in the present moment and non-judgementally” (Kabat Zinn, 1990). It is orientation to thoughts and feelings which involves observing inner experiences without attaching to them, but instead accepting them and allowing them to pass.
Mindfulness practice helps us to better understand patterns of thinking and feeling so that we can recognise at an early stage when we start to feel distressed. Mindfulness can help people move away from the tendency to get drawn into automatic reactions to thoughts by increasing awareness that thoughts are just thoughts and not an accurate reflection on reality. By learning to focus attention on what is happening right now, we can avoid being drawn into dwelling on past events, which often brings up feelings of sadness or regret, or thinking about the future, which often triggers anxiety about ‘what ifs’. In learning mindfulness, which encourages an attitude of kindly curiosity towards inner experiences, we can also avoid getting caught in an internal struggle with thoughts and feelings, which can often be counterproductive.
Evidence-Base for Mindfulness
Mindfulness is a well-researched treatment approach with a strong evidence-base for improving mood as well as for reducing the negative impact of pain and health conditions. Comprehensive information on the mindfulness studies, including details of numerous published papers, can be found here: http://www.mindfulexperience.org
Eye Movement Desensitisation and Reprocessing (EMDR)
EMDR is a psychotherapy approach which integrates elements of a number of evidence-based treatments. The approach addresses:
- The past experiences that have triggered trauma symptoms
- The resulting self-beliefs, feelings and physical sensations
- The positive, adaptive cognition's.
Treatment follows a standardised protocol which is only commenced after a careful period of preparation and resource-building. A key element of EMDR treatment is the ‘dual stimulation’ – the client is asked to focus on a bilateral stimulation (e.g. tracking left and right) whist simultaneously attending to past memories and associated feelings and physical symptoms. During that time, clients generally experience the emergence of insight, changes in memories, or new associations.
Evidence-Base for EMDR
EMDR (along with CBT) is recommended in the National Institute of Clinical Evidence (NICE) guidelines for the treatment of PTSD. There is a significant body of research, including 20 randomised controlled trials, indicating the efficacy of EMDR for the treatment of PTSD after a range of traumatic experiences. Further information about efficacy research including full references can be found at: http://www.emdr.com/refs.htm and http://www.emdr-europe.org.
Cognitive Behavioural Therapy
Cognitive Behavioural Therapy is one of the most commonly used psychological therapies. It is a collaborative, goal-focused intervention which helps clients to:
- Better understand how beliefs, thoughts and behaviours affect feelings and physical symptoms.
- Change thoughts and behaviours so as to improve emotional well-being.
CBT theory suggests that personal experiences (often in childhood) can lead to negative views of ourselves, the world and other people. In certain situations these beliefs trigger negative thoughts to automatically pop into our minds, causing a downward spiral in mood.
During CBT sessions, clients are helped to identify, record and challenge unhelpful or inaccurate thoughts. Effective strategies for managing difficult feelings and unpleasant physical symptoms are also taught including relaxation strategies and paced goal setting. Practical ‘behavioural experiments’ are also important in CBT; these give opportunities to systematically test out predictions in real life scenarios.
Evidence Base for CBT
There is extensive evidence supporting the efficacy of CBT for a range of emotional difficulties. CBT is recommended as a treatment of choice for difficulties such as anxiety and depression by The National Institute for Health and Clinical Excellence (NICE).
As the name suggests, this form of therapy focuses on the meaning people make of their experiences in the stories they tell about their lives. Narrative therapy views people as experts in their own lives and assumes that people have skills and strengths that will help them to alter the relationship with problems in their lives. It is a very non-pathologising approach and client and therapist work collaboratively together. Diagnosis and labels are not important, instead, emotional difficulties are often ‘externalised’ or described as if separate entities, for example a narrative therapist may ask “when anxiety bothers you, what does it have you doing?”, rather than “when you are anxious, what do you do?” This is because anxiety is not viewed as a stable trait but rather as a separate entity. In helping clients to view problems as not part of them, this approach can be very empowering; freeing people from the potentially self-restricting and shaming impact of diagnostic terms. Clients are encouraged to see that they are not confined by their stories, opening up the possibility for change.
Narrative therapy is appropriate for both adults and children. Children can respond particularly well to the creativity of narrative therapy and the externalising approach. The shift in a child is often dramatic when a problem is given a name and its influence mapped out. A child who is ashamed and reserved when adults use words such as “you are very anxious” will quickly engage with enthusiasm in a conversation about the “worry monster”. The child can then rally with indignation against the difficulty, rather than being frozen with shame or overwhelmed by feelings of hopelessness.
Evidence Base for Narrative Therapy
There is a growing body of evidence regarding the effectiveness of narrative therapy. Further information about evidence for this approach can be found here: http://www.dulwichcentre.com.au/narrative-therapy-research.html
Family and Systemic Psychotherapy
Family and Systemic Psychotherapy or the abridged term, ‘Family Therapy’ helps people within a close relationship to safely share and reflect on thoughts and feelings so that they develop a better understanding of each other’s perspectives. Family Therapy aims to draw on people’s combined strengths so as to improve communication and bring about constructive, positive change. Family therapy doesn’t necessarily involve a therapist working with the whole family. Family therapists often work with couples and individuals as well as their wider family members and any other people who are important in the client’s life.
- Family therapists may support people around:
- Relationship difficulties including divorce and separation
- The impact of illness on the family
- Family conflict
- Adjustment at life transitions and difficulties around school and college.
Evidence Base for Family Therapy
The Family Therapy and Systemic Research Centre, based at the Tavistock Clinic (an NHS Foundation Trust and national centre of training) aims to develop, support and promote research in the systemic family therapy. The website for the FTSRC includes an overview of evidence-based research on Family and Systemic Therapy
An attachment-focused play intervention to help children feel safe and secure, better regulate their emotions and build parent-child relationships through fun and physical activities. It was designed for parents and their children aged 0 - 12 years old, involving weekly sessions for 18-24 weeks; however, the intervention has expanded to other target groups and settings.
Relationship counselling integrates several evidence based psychological approaches to explore problematic patterns in the relationship and help couples resolve problems. Therapists or counselling working with clients to create a shared perspective of their relationship. They may work with a couple to give them strategies to improve their communication, manage their emotions and give them strength and resilience in their problem solving. Therapists may also encourage a couple to reflect on thoughts and feelings and understand how they influence our patterns of interaction. The aim is to address the barriers that have stopped a couple from connecting in the way they used to.
Relationship distress is a common problem and is strongly linked to other psychological and physical health problems. Many couples find difficulties start after a painful event or illness, or following a significant life change. Couples therapy can help with depression and isolation, mental health issues and parenting issues as well as general relationship distress.
Evidence Base for Relationship Counselling
Relationship counselling is recommended in the National Institute of Clinical Evidence (NICE) guidelines for the treatment of depression. It has also been evaluated in over 30 randomized control trials and has been found to be extremely effective in treating relationship distress as well as lowering levels of depression and conflict.