Cognitive Behaviour Therapy (CBT) with Joel Conrad - Process of Therapy
I model my practice on procedures developed through research and promoted by leading practioners of CBT. The key process in CBT is known as "guided discovery", wherein the client learns to respond to life's challenges in a more effective way. The points below are intended to enhance this learning and maximise the effectiveness and benefits of your therapy:
Each session will have some structure and begin with agreeing an agenda or plan for the meeting.
In the first session, we'll develop a 'problem list' or identify your concerns that you want therapy to help you with. And for each, we'll identify your goals or desired outcomes. We will then decide if CBT is appropriate for you or if we need another meeting to be sure.
Each problem that is targeted in therapy is then assessed with the aim of developing a "formulation", or a shared understanding of how the problem developed and what maintains it. The formulation could be written or diagrammed and serves as an evolving guide to therapy.
At this point, I'll write to you to summarise our understanding and plan. I will also write review and discharge letters.
Part of the structure of CBT is the use of 'homework' or therapy tasks you complete between sessions. These tasks will always be decided upon together—you won't be expected to do anything that doesn't seem useful to you and within your capabilities.
I recommend that you keep notes on our sessions. It is also a good idea to record the sessions and listen to them on your own. If you'd like, I can email to you my notes on our meetings.
To manage your letters, notes and self-monitoring records and so on, it is a good idea to keep a 'CBT folder' and bring it to our meetings.
It is sometimes appropriate to bring a partner or other relative or a friend into therapy sessions. We would need to discuss this first in some detail. Clients sometimes want to have someone accompany them to their first session, which is fine.
Most CBT protocols recommend weekly sessions of an hour each and sometimes twice-weekly sessions are indicated. In some cases, home visits or meeting away from the clinic is recommended. I know that it isn't always possible to adhere exactly to these protocols, but I'll make recommendations based on what has been found through research to be effective and we'll try to keep to them as closely as we can. It may sometimes be possible to use telephones or emails when face-to-face meetings are not possible.
Like any health care professional, I will keep your private information confidential. There are a few exceptions to this, however, that you should know about:
I have to contact those I think are appropriate about any situation that indicates a danger to others or yourself.
Under the Children Act 1989, I am obliged to report to the appropriate authorities any information disclosed that might indicate that a child may be in danger or at risk of physical or emotional harm.
I must make a written summary of each therapy session. There may be information, however, that you do not want me to record for some reason. That may be possible if it doesn't indicate some kind of risk to yourself or others, but the decision has to be left to my discretion.
I will want to copy your assessment, review and discharge letters to your General Practioner and, if applicable, to your secondary mental health services care co-ordinator or private psychiatrist.
All therapists meet with another experienced therapist for "supervision". I may discuss your therapy with my supervisor. I may ask you if I can record one of our sessions for the purpose of supervision, but you will be able refuse this request without any consequences for your therapy.
Attendance, Emergencies, Payment Policies
ATTENDANCE: You may cancel appointments without charge using the telephone number or email address below. However, if I receive your message too late to cancel my room booking, I will expect you to cover the cost of the room. If I have to cancel your appointment, I will contact you at the earliest opportunity and I will suggest an alternative appointment. It is inappropriate to attend therapy under the influence of alcohol or drugs.
EMERGENCIES: As a part-time private practitioner, I cannot be available to respond to emergencies. In such cases, you should contact your doctor or other NHS clinician or statutory emergency services. The telephone number below should only be used to leave messages about cancellations or enquiries.
PAYMENT: You can pay by cash or cheque at the end of sessions or by direct debit. I cannot make another appointment for you if you have two sessions unpaid for.