Pre-Conference Workshops.

"30 Workshops for 30 Years"

Wednesday 17th July at 9.30 am

General Adult Disorders
Workshop 1 Cognitive Behavioural Treatment of Generalised Anxiety Disorder
Thomas Borkovec, Penn State University, Pennsylvania, USA
Workshop 2 Cognitive Therapy for Depression
Keith Dobson, University of Calgary, Canada
Workshop 4 Cognitive-Behavioural Treatment of Social Anxiety in Clinical Practice
Richard G. Heimberg, Temple University, Philadelphia, USA
Workshop 5 Cognitive Therapy for PTSD and Associated Emotional Responses to Trauma
Deborah Lee and Kerry Young, Traumatic Stress Clinic & University College London
Workshop 7 The Cognitive-Behavioural Treatment of Obsessions
Stanley J. Rachman, University of British Columbia, Canada
Workshop 8 Cognitively Delivered Exposure Treatment for Agoraphobia
Paul Salkovskis, Institute of Psychiatry, London and
Ann Hackmann, University of Oxford
Workshop 9 Mindfulness-based Cognitive Therapy for Depression
Mark Williams, University of Wales, Bangor
Therapeutic Issues
Workshop 10 'I Can't Get it Out of my Head' Rumination and Preoccupation
Mark Freeston, Newcastle Cognitive and Behaviour Therapies Centre, Newcastle
Workshop 11 Understanding and Working with Shame
Paul Gilbert, Institute of Behavioural Sciences, University of Derby
Workshop 12 Acceptance and Commitment Therapy
Steven C. Hayes, University of Nevada, Reno, USA
Workshop 14 Cognitive Therapy of Resistance
Robert L. Leahy, American Institute for Cognitive Therapy and Weill-Cornell Medical School, NY, USA
Workshop 15 Cognitive Therapy and Resilience
Christine A. Padesky and Kathleen A. Mooney, Center for Cognitive Therapy, California, USA
Appetive/Impulse Disorders
Workshop 16 Clinical Management of the Suicidal Patient: Interventions and Safeguards
Corey Newman, Center for Cognitive Therapy, Philadelphia, USA
Workshop 17 Cognitive Behavioural Therapy for Eating Disorders
Terry Wilson, Rutgers University, USA and Christopher Fairburn, University of Oxford
Workshop 18 Anger Assessment and Treatment
Raymond W. Novaco, University of California, Irvine, USA
Psychotic Disorders
Workshop 19 Cognitive Behavioural Intervention: Schizophrenia & Co-morbid Substance Misuse
Christine Barrowclough & Gillian Haddock, University of Manchester
Workshop 20 Formulation Based Cognitive Behavioural Psychotherapy for Psychosis
David Fowler, University of East Anglia
Workshop 22 CBT for Bipolar Affective Disorders
Dominic Lam, Institute of Psychiatry, London
Child Issues
Workshop 25 Using Stories in CBT with Young Children
Joanna Grave and Lisa Walton, Community Child Psychology Services, Birmingham Children's Hospital
Clinical Applications & Other Issues
Workshop 26 Improving Supervision Skills: A Cognitive Perspective
Gillian Butler, Department of Psychiatry, University of Oxford
Workshop 27 Medically Unexplained Symptoms: Cognitive Behavioural Approaches
Trudie Chalder, Guy's, Kings and St Thomas' School of Medicine, London
Workshop 28 Coping With Adversity: Cognitive Therapy In Adverse Life Circumstances
Stirling Moorey, Maudsley Hospital, London
  *Workshops 3, 6, 13, 21, 23, 24, 29 & 30 have been cancelled


Workshop 1

Cognitive Behavioural Treatment of Generalised Anxiety Disorder with Some Interpersonal and Experiential Psychotherapy Integrations

Thomas Borkovec, Penn State University, Pennsylvania, USA

Generalised anxiety disorder (GAD) is one of the most common anxiety disorders, both as a principal and as an additional diagnosis. Some have argued that it is the basic anxiety disorder from which the others often emerge. Despite its prevalence and importance, fewer therapeutic developments specific to this disorder have been made relative to most other anxiety disorders. This clinical presentation will introduce several cognitive behavioural techniques for GAD that have been empirically supported and developed from our clinical and experimental experience with the disorder over the past 16 years. These include: (a) self-monitoring of elements of anxiety process; (b) flexible deployment of multiple applied relaxation methods (c) in-session rehearsal of coping responses using flexible adaptations of self-control desensitisation; and (d) multiple cognitive techniques designed to facilitate more flexible and adaptive ways of perceiving, the emergence of "expectancy-free" cognitive styles, and more complete processing of present-moment experience. Finally, new developments in the treatment of GAD that involve the integration of interpersonal and experiential therapies into the basic cognitive behaviour package will be presented. Throughout the presentation, empirical information will be provided to give strong foundation for the particular recommendations of specific technique applications for GAD. Case material and video-tapes of therapy sessions will be periodically used to exemplify aspects of these therapy methods.

Learning Objectives:
• Learn ways in which to teach clients self-monitoring, multiple relaxation methods, and imagery rehearsal techniques.
• Learn novel cognitive therapy methods specifically adapted to generalised anxiety disorder.
• Understand the empirical basis for the above techniques.
• Have an introduction to methods for incorporating interpersonal and experiential psychotherapy techniques that may be particularly valuable for GAD clients.

Teaching Methods: Lecture, case material, and therapy video-tapes

Who is the workshop aimed at: Intermediate to Advanced Level.

Dr. Borkovec has been at Penn State University since 1978, where he is currently a Distinguished Professor of Psychology and Director of Clinical Training. Dr. Borkovec's research and clinical practice has focused on adult anxiety disorders. His empirical work has involved both basic and applied research, and his therapy outcome investigations on the cognitive behavioural treatment of generalised anxiety disorder have been continuously funded by NIMH since 1984. In the past, he has served on NIMH's psychotherapy grant review committee, the DSM-IV Generalised Anxiety Disorder Subcommittee, and several journal editorial boards. He is currently a member of the Scientific Advisory Board of the National PTSD Center, co-director of the Pennsylvania Psychological Associations Practice Research Network, and a Fellow in APA and APS. His efforts to integrate basic research and clinical practice were recognised in 1994 by the Pennsylvania Psychological Association with his reception of the Distinguished Contribution to the Science and Profession of Psychology Award and in 1998 by the American Psychological Association (Division 12, Section 3) with the Distinguished Scientist Award.

Background Reading:
Bernstein, D.A., Borkovec, T.D., & Hazlett-Stevens, H. (2000). New directions in progressive relaxation training: A guidebook for helping professionals. Westport, CT: Praeger Publishers.
Borkovec, T. D., & Newman, M. G. (1999). Worry and generalised anxiety disorder. In A. S. Bellack & M. Hersen (Series Eds.) & P. Salkovskis (Vol. Ed.), Comprehensive clinical psychology: Vol. 6. Adults: clinical formulation and treatment (pp. 439-459). Oxford: Elsevier
Craske, M. G., Barlow, D. H., & O'Leary, T. A. (1992). Mastery of your anxiety and worry. Albany, NY: Graywind Publications.

Workshop 2

Cognitive Therapy for Depression: Planning and Implementing Effective Change Strategies

Keith Dobson, University of Calgary, Canada

Learning Objectives:
• to understand the nature of depression, and in particular its recurrent course,
• to understand the model of cognitive therapy as applied to depression,
• to conceptualise and plan cognitive therapy treatment,
• to gain an appreciation of both behavioural and a cognitive change strategies in depression,
• to plan for long-term change and relapse prevention.

Who is the workshop aimed at: Intermediate Level: intended for a medium experienced audience, with some CBT training and practice

Teaching methods: The course will be very practical in nature, and will include lecture, video, and live role-play as instructional methods.

Keith Dobson, Ph.D. is a Professor of Psychology, the Director of Clinical Psychology, and Head of Psychology at the University of Calgary. Dr. Dobson's research is in the area of cognitive aspects of depression, and cognitive-behavioural therapy. He has been the author/ editor of seven books, including the Handbook of Cognitive-behavioural Therapies (1988; 2000), and Empirically supported therapies: Best Practice in Professional Psychology (1998). He has also published over 140 research articles and chapters, and participated widely in conferences related to his research. Dr. Dobson has also provided training both in Canada and abroad, including the United States, Mexico, New Zealand, Australia, Europe, and Eastern Europe.

Background Reading:
Beck, J.S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press.

Workshop 4

Cognitive-Behavioural Treatment of Social Anxiety in Clinical Practice

Richard G. Heimberg, Adult Anxiety Clinic, Temple University, Philadelphia, USA

Social anxiety disorder (also known as social phobia) is the most common anxiety disorder and one of the most common mental disorders. It afflicts millions of people, who may experience substantial impairment in functioning, reduced quality of life, and increased risk for depression, alcoholism, and substance abuse. It is critically important that clinicians be aware of the many ways in which social anxiety disorder may present in clinical practice and become familiar with the best methods for the assessment and treatment of this disorder. During this workshop, an overview of social anxiety disorder will be presented, including:
• a description of social anxiety disorder and its effects on quality of life;
• a biopsychosocial model of social anxiety disorder;
• techniques for the assessment of social anxiety disorder;
• techniques of cognitive-behavioural treatment (CBT) for social anxiety disorder, both in individual and group formats
• descriptions of socially anxious clients treated with CBT;
• empirical support for cognitive-behavioural treatments for social anxiety disorder;
• pharmacological methods for the treatment of social anxiety disorder.
As time allows, discussion will focus on participants' clinical cases.

Learning Objectives:
• Describe the symptoms and impairment experienced by persons with social anxiety disorder
• Describe the cognitive-behavioural model of social anxiety disorder and apply it to the formulation of a specific case
• Describe the major approaches to the assessment of social anxiety disorder
• Understand the specific components of cognitive-behavioural treatment for social anxiety disorder and their application to the treatment of a specific case
• Describe difficulties that arise in the cognitive-behavioural treatment of social anxiety disorder and suggest general strategies for their remediation
• Evaluate the pros and cons of individual versus group treatment for social anxiety disorder
• Describe the major classes of drugs used in the treatment of social anxiety disorder
• Evaluate the relative utility of combining cognitive-behavioural and pharmacological treatments for social anxiety disorder and the pros and cons of doing so

Richard G. Heimberg is Professor of Psychology and Director of the Adult Anxiety Clinic of Temple. He is currently President of the Association for Advancement of Behaviour Therapy. Dr. Heimberg is well known for his efforts to develop and evaluate cognitive-behavioural treatments for social anxiety. More recently, he and his colleagues have initiated a program for the study and treatment of generalised anxiety disorder. Dr. Heimberg was recently named one of the four most influential psychological researchers in anxiety in a survey of members of the Anxiety Disorders Association of America. He is a founding fellow of the Academy of Cognitive Therapy and the recipient of the Academy's inaugural Award for Significant and Enduring Contribution to Cognitive Therapy.

Background Reading:
Coles, M.E., Hart, T.A., & Heimberg, R.G. (2001). Cognitive-behavioural group treatment for social phobia. In Crozier, W.R., & Alden, L.E. (Eds.), International handbook of social anxiety: Concepts, research and interventions relating to the self and shyness (pp. 449-469). Chichester, United Kingdom: John Wiley & Sons, Ltd.
Turk, C.L., Heimberg, R.G., & Hope, D.A. (2001). Social anxiety disorder. In D.H. Barlow (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (3rd edition) (pp. 114-153). New York: Guilford Press, Inc.
Hope, D. A., Heimberg, R. G., Juster, H., & Turk, C.L. (2000). Managing social anxiety: A cognitive-behavioural therapy approach (Client Workbook). San Antonio, TX: The Psychological Corporation.
Turk, C.L., Lerner, J., Heimberg, R.G., & Rapee, R.M. (2001). An integrated cognitive-behavioural model of social anxiety. In S. G. Hofmann, & P. M. DiBartolo (Eds.), From social anxiety and social phobia: Multiple perspectives (pp. 281-303). Needham Heights, MA: Allyn & Bacon.

Workshop 5

Cognitive Therapy for PTSD and Associated Emotional Responses to Trauma

Deborah Lee and Kerry Young, Traumatic Stress Clinic, Camden and Islington Health Trust & University College London.

Learning Objectives:
The aim of this workshop is to examine recent clinical and theoretical developments in the treatment of PTSD. The workshop will present recent models, which aid and inform clinical practice from a cognitive therapy perspective (Brewin et al., 1996; Ehlers and Clark, 2000; Lee et al, 2002).

The workshop will emphasise the importance of formulating clinical cases, with reference to not only pre-existing beliefs, but also predominant peri- and post-traumatic emotional responses (Lee et al., 2002). Recent evidence has suggested that traditional treatment approaches to PTSD need to be adapted to incorporate techniques aimed at specifically targeting key emotional experiences, such as fear, shame, guilt, humiliation and anger (Lee et al.2002; Grey, Young and Holmes, in press).

The workshop will provide an opportunity to examine and practice cognitive therapy techniques to deal with these strong emotional responses, by presenting clinical material, using role play, video and audiotape.

Level: The workshop would be suitable for clinicians of all levels, but experience of treating PTSD would be advantageous. Familiarity with cognitive models and techniques will be assumed.

Deborah Lee (Consultant Clinical Psychologist) and Kerry Young (Clinical Psychologist) have worked in the PTSD field for 10 and 6 years respectively. Over this time, they have gained extensive clinical experience and theoretical understanding of PTSD. They have published widely in the area and regularly present workshops on the treatment of PTSD. The Traumatic Stress Clinic is a national referral centre for the treatment of psychological reactions to trauma. It is recognised as a centre of excellence in the cognitive-behavioural treatment of PTSD.

Background Reading
Ehlers, A. & Clark, D.M. (2000) A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345
Lee, D.A., Scragg, P. & Turner, S. (2001). The role of shame and guilt in traumatic events: A clinical model of shame-based and guilt-based PTSD. British Journal of Medical Psychology, 74, 451-466.

Workshop 7

The Cognitive-Behavioural Treatment Of Obsessions

S. Rachman, University of British Columbia, Canada

Who the workshop is aimed at: This workshop is aimed at clinicians who have at least two years experience of CBT and would like to learn how to tackle obsessions in complex cases.

Learning Objectives: This workshop aims to introduce participants to a new, specific treatment for obsessions. By the end of the workshop participants will have learned the theory behind this specific cognitive-behavioural intervention and how to apply it to obsessions that are otherwise treatment-resistant.

Teaching methods: The teaching will be a combination of lecturing, video and live demonstrations. Participants should bring their own cases for discussion.

Professor S. Rachman is Professor Emeritus at the University of British Columbia. He is formerly the Professor of Abnormal Psychology at the Institute of Psychiatry. He has expertise in behaviour therapy, cognitive therapy and cognitive-behaviour therapy and has worked in the field of anxiety disorders.

Background Reading:
Clark, D.M. & Fairburn, C. G. (1996). The science and practice of cognitive-behaviour therapy. Oxford University Press.
Rachman, S. (1997). The cognitive-behavioural theory of obsessions. Behaviour Research and Therapy, 35(9):793-802.
Rachman, S. (2002). The Treatment of Obsessions(2002), Oxford University Press
Steketee, G. (1993). The treatment of obsessive-compulsive disorder. Guilford Press

Workshop 8

Cognitively Delivered Exposure Treatment for Agoraphobia.

Paul Salkovskis, Institute of Psychiatry and Ann Hackmann, University of Oxford

This workshop will provide an opportunity to learn "hands on" cognitive therapy skills for use with more severe cases of agoraphobia with or without a history of panic disorder. The treatment of panic disorder with cognitive therapy has proven efficacy, excellent end state functioning being attained in the majority of cases after only 4 -12 sessions of therapy. In most published trials larger effect sizes are gained with cognitive therapy than those obtained with more behavioural interventions. Within the panic trials mild to moderate agoraphobic avoidance has also been successfully reduced, using cognitive therapy sessions in the office, plus homework, with its full complement of behavioural experiments.

The favoured treatment of more severe agoraphobia has been exposure therapy, delivered individually or in groups, frequently centred round the patient's home area. It has not been established in a randomised controlled trial that cognitive therapy adds to the effects of exposure alone. Nevertheless there have been some promising preliminary studies, on which the method described in this workshop is based. In an experimental study half of a group of agoraphobics with moderate or severe avoidance were presented with the cognitive model of panic, and encouraged to drop their safety behaviours in feared situations, and thus test their beliefs about possible catastrophic outcomes. Often predictions tested in treatment were not only about physical catastrophes, but also about interpersonal situations which might arise during panic attacks. In the control group patients were offered standard exposure treatment, in similar situations. The cognitive method of delivering treatment was shown to greatly enhance the benefits of exposure to feared situations, both during a single, brief experimental session, and during a short course of therapy. At the end of the ten day treatment period there were highly significant differences between the two groups, on measures of panic, general anxiety and avoidance, in favour of the cognitive group.

The method described in this workshop, has been described as cognitively delivered exposure for agoraphobia. It does not involve any exposure with a habituation rationale, but instead it involves multiple behavioural experiments within an individualised cognitive conceptualisation of the problem. It is conducted largely "in the field"- ie in shopping centres or other avoided places, with extremely good results. Special reference will be made to difficulties often encountered with this group which can impede progress. These include behavioural and cognitive avoidance, reluctance to do behavioural experiments, and co-morbidity. Strategies for dealing with these difficulties will be discussed. Cognitively Delivered Exposure Treatment for Agoraphobia.

Who is the workshop aimed at: those with some experience of cognitive therapy for panic, who wish to know how to apply it quickly and effectively with more avoidant clients.

Learning Objectives:
To see the way that behavioural experiments integrate the best of cognitive and behavioural skills, and study how they can be utilised to test assumptions not only about the causes and physical consequences of symptoms, but also of their interpersonal significance in agoraphobia.To see how cognitive therapy can skillfully be taken out of the office into real life, and to understand the role of the therapist in modelling and testing predictions in behavioural experiments.

Teaching methods: will include didactic material, video clips, role plays and opportunities to refine skills in carrying out behavioural experiments in the field.

Paul Salkoskis is a Professor of Clinical Psychology and Applied Science at the Institute of Psychiatry, Maudsley Hospital, London. He has vast experience in cognitive therapy for the anxiety disorders. He has conducted research trials and experimental work in many areas, and also runs a clinical service in London, where dissemination studies are now being conducted

Ann Hackmann has worked with Paul Salkovskis, David Clark and Anke Ehlers at Oxford and in London, for many years, carrying out research into the treatment of anxiety disorders. Paul and Ann have worked together on studies of agoraphobia.

Background Reading:
Salkovskis, P.M., & Hackmann, A. (1997). Agoraphobia. In G. C. L. Davey (Ed.), Phobias A Handbook of Theory, Research and Treatment. (pp. 27-61). Chichester: John Wiley & Sons Ltd.
Salkovskis, P.M., Clark, D.M., Hackmann, A., Wells, A., and Gelder, M.G. (1999) An experimental investigation into the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia. Behaviour Research and Therapy, 37, 559-574
Hackmann, A. (1998) Cognitive Therapy with Panic and Agoraphobia: Working with Complex Cases. In 'Treating Complex Cases', eds. N. Tarrier, A. Wells and G. Haddock. Wiley, England.

Workshop 9

Mindfulness-based Cognitive Therapy for Depression: A New Approach to Preventing Relapse

Mark Williams, University of Wales, Bangor

Learning Objectives: By the end of the workshop, participants will know:
• the recent evidence on the nature of cognitive risk for relapse
• why a mindfulness-based approach may be an appropriate way to address such risk
• the preliminary evidence on efficacy
And will have experienced:
• some of the MBCT practices used in the 8-week programme
• how these are integrated with CBT through dialogue and discussion of the practice

Who is the workshop aimed at: Health professionals, especially those who deal with recurrent depression in their patients. It may also be of more general interest to those interested in applying meditation-based approaches in other healthcare settings.

Teaching methods: Lecture and dialogue, video, experience of practices used in MBCT

Mark Williams is Professor of Clinical Psychology at the University of Wales, Bangor. He has been interested in cognitive models and treatment of depression for many years, and has recently been collaborating with John Teasdale and Zindel Segal in developing this mindfulness-based cognitive therapy to prevent relapse and recurrence in major depression.

Background Reading:
Kabat-Zinn, J.(1990) Full catastrophe living. New York: Delacorte.
Segal, Z.V., Williams, J.M.G., & Teasdale, J.D. (2002) Mindfulness-based Cognitive Therapy for Depression: a new approach to preventing relapse. New York, Guilford Press.
Teasdale, J.D., Segal, Z.V., Williams, J.M.G., Ridgeway, V., Lau, M., & Soulsby, J. (2000) Reducing risk of recurrence of major depression using Mindfulness-based Cognitive Therapy. Journal of Consulting and Clinical Psychology, 68, 615-23.

Workshop 10

'I Can't Get it Out of My Head' Why Does Rumination and Preoccupation Persist and What Can Be Done About It?

Mark Freeston, Newcastle Cognitive and Behaviour Therapies Centre, Newcastle

There are a range of conditions where people are troubled by ruminative thinking and excessive preoccupation that is often ego-syntonic in nature. This may be a central feature, such as in GAD and some forms of OCD, or it may be an associated feature as in some presentations of health anxiety, eating disorders, body dysmorphic disorder, chronic medical conditions, etc. The thinking typically reflects a particularly negative and upsetting content. The content includes overestimations of the likelihood, imminence, or seriousness of negative outcomes and underestimations of the person's ability to cope with the situation. Further, the persistence and apparent uncontrollability of the thinking itself generate further distress. Although the often obvious distortions in the thinking would appear to be amenable to common strategies in cognitive therapy, interventions that target the content do not always bring about reductions in the preoccupation. The workshop will provide participants with a framework for understanding why the ruminative thinking persists and will focus on the thinking processes. Drawing on cognitive models of intrusive and ruminative cognition, participants will learn how to 1) develop a shared conceptualisation of the persistence of the rumination or worry, 2) engage clients in testing out this conceptualisation, 3) implement strategies that focus on changing the processes maintaining the rumination, and 4) become aware of how some common therapeutic strategies may sometimes inadvertently contribute to the problem. The workshop will use a range of teaching methods including lecture, case presentation, role play, etc. Participants are invited to bring suitable case material to the workshop that may be worked on during the day. The workshop is addressed to professionals with a sound basis in CBT and experience in providing therapy to the types of problems listed above.

Professor Mark Freeston has researched and written extensively on intrusions, obsessions, and worry and has led numerous workshops on treating OCD, GAD and related disorders. He is currently Director of Research and Training at the Newcastle Cognitive and Behaviour Therapies Centre and Course Director for the Newcastle Diploma in Cognitive Therapy.

Background Reading:
Freeston, M. H., Léger, E., & Ladouceur (2001). Cognitive therapy of obsessive thoughts. Cognitive and Behavioural Practice, 8, 61-78.
Freeston, M. H., & Ladouceur, R. (1999). Exposure and response prevention for obsessional thoughts. Cognitive and Behavioural Practice, 6, 362-383.

Workshop 11

Understanding and Working with Shame

Paul Gilbert, Institute of Behavioural Sciences, University of Derby

Learning Objectives:
• To offer insight into the differences between internal and external shame, embarrassment, humiliation and guilt
• To consider how some symptoms, key self-other schema, coping styles, resistances and therapeutic ruptures can be related to shame.
• Conceptualising cases and intervening using both simple CBT and adaptations to basic CBT approaches

Who is the workshop aimed at: Counsellors, psychiatrists, CPN’s psychologists etc, and those who have some experience of CBT and psychopathology

Teaching Methods: Lecture, case descriptions and video, with a little personal practice on compassionate imagery

Paul Gilbert is Professor of Clinical Psychology at the University of Derby and a Fellow of the British Psychological Society, He has written extensively in the areas of mood disorder and shame (e.g., Gilbert, P., [1992] Depression; The Evolution of Powerlessness. New York, Guilford: Gilbert, P., & Andrews, B., [1988] Shame: Interpersonal Behaviour, Psychopathology and Culture. New York: Oxford University Press). He has run many workshops on shame, depression and personality disorder.

Background Reading:
Gilbert, P. (1998a) What is shame? Some core issues and controversies. In P. Gilbert & B. Andrews (eds). Shame: Interpersonal Behaviour, Psychopathology and Culture (pp. 3-38): New York: Oxford University Press.
Gilbert, P. (2000c) Social Mentalities: Internal ‘Social’ Conflicts and The Role of Inner Warmth and Compassion in Cognitive Therapy. In, P. Gilbert & K.G. Bailey (eds.) Genes on the Couch: Explorations in Evolutionary Psychotherapy (p.118-150). London: Brunner-Routledge.
Tangney, J.P. (1995) Shame and guilt in interpersonal relationships. In Tangney, J.P & Fischer, K.W. (Eds). Self-Conscious Emotions: The Psychology of Shame, Guilt, Embarrassment and Pride. (pp. 114-139) New York: Guilford.

Workshop 12

Acceptance and Commitment Therapy: Understanding and Treating Human Suffering

Steven C. Hayes, University of Nevada, Reno, USA

Acceptance and Commitment Therapy (ACT) is based on the view that most psychological suffering is caused by experiential avoidance and cognitive fusion. If so, trying to change difficult thoughts and feelings as a means of coping may be counter productive. ACT takes another course: alter how private experiences relate to overt behaviour. The workshop will discuss and demonstrate techniques designed to accomplish this goal, particularly acceptance, cognitive defusion, and behavioural commitment strategies. While the procedures are broadly useful, the workshop will focus in particular on issues of multi-problem patients dealing with such issues as anxiety, substance abuse, depression, or even psychotic symptoms. Data supportive of this approach will be discussed.

Who is the workshop aimed at: Beginning ACT, but assumes general clinical knowledge.

Learning Objectives:
• the data on the psychopathologic impact of experiential avoidance, and to relate that process to modern research in human language
• the major steps in Acceptance and Commitment Therapy and one or two techniques in each, with particular focus on cognitive defusion: techniques for reducing the impact of negative thoughts, that might be used in adult clinical outpatient CBT work, even without adopting an full blown ACT model

Steven C. Hayes is Nevada Foundation Professor and Chair of the Department of Psychology at the University of Nevada. An author of twenty books and more than 275 scientific articles, his career has focused on an analysis of the nature of human language and cognition and the application of this to the understanding and alleviation of human suffering. In 1992 he was listed by the Institute for Scientific Information as the 30th "highest impact" psychologist in the world during 1986-1990 based on the citation impact of his writings. Dr. Hayes has been President of Division 25 of the American Psychological Association, of the American Association of Applied and Preventive Psychology and of the Association for Advancement of Behaviour Therapy.

Background Reading:
Hayes, S. C., Strosahl, K. & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behaviour change. New York: Guilford Press.
Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001) (Eds.), Relational Frame Theory: A Post-Skinnerian account of human language and cognition. New York: Plenum Press.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Emotional avoidance and behavioural disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152-1168.

Workshop 14

Cognitive Therapy of Resistance

Robert L. Leahy, American Institute for Cognitive Therapy and Weill-Cornell Medical School, New York, USA

Many patients do not readily respond to standard cognitive-behavioural interventions, confronting the therapist with impasses that are difficult to resolve. In this workshop a multi-dimensional model of resistance will be presented. These dimensions include resistance due to validation demands, emotional processing, self-consistency, schematic processing, moralistic thinking, victim roles, risk-aversion, and self-handicapping. Validation resistance involves demands for empathy and agreement that may conflict with the change-model advocated in cognitive therapy. Emotional processing problems may occur when the individual either blocks the experience of an emotion, views emotions as incomprehensible to self or others, rejects the complexity of emotions, believes that emotions must be controlled, or misattributes emotions to other causes. Self-consistency needs are reflected in over-commitment to past decisions-or sunk-costs. Schematic processing may result in resistance due to the biasing effect of information search, retrieval and evaluation and to the impermeability of personal schemas. Moralistic thinking may result in resistance if the individual endorses overly rigid ideas of obligations for self and others. Victim roles often result in resistance if the patient believes that he or she is an innocent victim entitled to sympathy, self-pity, apologies from others or revenge. Risk-aversion may affect resistance to change if the patient views himself as needing complete certainty and control, as having limited current and future resources, and as likely to have a receding reference point for success and an early stop-out rule. Finally, individuals may utilise self-handicapping strategies in order to avoid direct evaluations of the self or perceived exposure to loss.

Teaching methods: A brief theoretical model will be reviewed for each dimension and case conceptualisations for specific examples of resistance will be presented.

Learning Objectives:
The participant will learn how:
• To evaluate and conceptualise different kinds of resistance in cognitive-behavioural therapy
• To utilise a variety of cognitive, behavioural and interpersonal strategies and techniques in dealing with resistance.
• To examine the therapist's response to the patient's resistance by reviewing counter-transference issues.
• To conceptualise in cognitive and behavioural terms rather than psychoanalytic terms. We will examine how the therapist may use the counter-transference as a window into the interpersonal world of the patient to modify the patient's schemas and resistance to change.
• Cognitive therapy interventions will be identified to reduce the negative emotional and therapeutic impact on the therapist of the counter-transference.

Robert Leahy, Ph.D., is the President-Elect of the International Association of Cognitive Psychotherapy, Director of the American Institute for Cognitive Therapy in New York City, Clinical Associate Professor in the Department of Psychiatry at Weill-Cornell Medical School, and author or editor of numerous books including Cognitive Therapy of Resistance, Practicing Cognitive Therapy: A Guide to Interventions, Treatment Plans and Interventions for Depression and Anxiety Disorders (with S. Holland),and Bipolar Disorder: A Cognitive Therapy Approach (with Newman, Beck, Reilly-Harrington, and Gyulai, L.).

Recommended Reading
Leahy, R.L. (2001) Overcoming resistance in cognitive therapy.. New York: Guilford.
Leahy, R.L. Decision-making and Mania. Journal of cognitive psychotherapy, 1999, 13, 1-23.
Leahy, R.L. Strategic Self-limitation. Journal of cognitive psychotherapy, 1999 13, 275-293
Leahy, R.L. Sunk-costs and resistance to change. Journal of cognitive psychotherapy, 2000, 14.
Leahy, R.L. (1996) Cognitive Therapy: Basic Principles and Applications. Northvale, NJ: Jason Aronson. Pp. 191-230.
Leahy, R.L. Emotional schemas and cognitive therapy. Cognitive and Behavioural Practice, in press.

Workshop 15

Cognitive Therapy and Resilience

Christine A. Padesky and Kathleen A. Mooney, Center for Cognitive Therapy, California, USA

Learning Objectives:
• Identify qualities that contribute to and build resilience in yourself and your clients Link resilience and emotional health
• Compare the usefulness of constructive and deconstructive questions in guided discovery
• Practice methods to evoke client use of symbolic syntheses to enhance resilience
• Observe how acceptance can either inhibit and enhance client development of resilience

Teaching method: This workshop emphasises experiential learning exercises followed by group discussion. In addition there will be brief didactic lectures and clinical demonstrations.

Who is the workshop aimed at: Intermediate and advanced cognitive therapists interested in fostering resilience in themselves and their clients.

Christine A. Padesky, Ph.D., Co-Founder of the Center for Cognitive Therapy, Huntington Beach, California, has dedicated her career to innovative practice and teaching of cognitive therapy. In addition to workshops, she has developed video/audiotape training programs for professionals (described on her website Her work contributes to our understanding of Socratic dialogue, schema change processes, levels of thought, the therapist-client relationship, therapist factors in CT, and supervision/consultation processes. Dr. Padesky is a Distinguished Founding Fellow of the Academy for Cognitive Therapy, a former President of the International Association for Cognitive Psychotherapy and co-author of four books (Mind Over Mood: Change How You Feel by Changing the Way You Think, Clinician's Guide to Mind Over Mood, Cognitive Therapy with Couples and Cognitive Therapy with Personality Disorders).
Kathleen A. Mooney, Ph.D., Co-Founder of the Center for Cognitive Therapy, Huntington Beach, is a Founding Fellow of the Academy of Cognitive Therapy. Her clinical specialties include cognitive therapy for anxiety disorders, psychophysiological problems, personality disorders, relationship problems, work stress, and lesbian/gay issues. Dr. Mooney has presented workshops at international meetings in Canada, Denmark, England, Ireland, Italy, the Netherlands, Northern Ireland, Scotland, and Switzerland. She is co-producer of cognitive therapy audio and videotape training materials, and designs and manages

Background Reading:
Mooney, K.A., & Padesky, C.A. (2000). Applying client creativity to recurrent problems: Constructing possibilities and tolerating doubt. Journal of Cognitive Psychotherapy: An International Quarterly, 14(2).
Pretzer, J. L., & Walsh, Chaille, A. (2001). Optimism, pessimism, and psychotherapy: Implications for clinical practice. In E. C. Chang (Ed), Optimism and pessimism: Implications for theory, research, and practice (pp. 321- 346). Washington, D.C.: American Psychological Association.
Scheier, M.F., Carver, C.S., & Bridges, M.W. (2001). Optimism, pessimism, and psychological well-being. In E. C. Chang (Ed), Optimism and pessimism: Implications for theory, research, and practice (pp. 189 - 216). Washington, D.C.: American Psychological Association.

Workshop 16

Clinical Management of the Suicidal Patient: Interventions and Safeguards

Corey Newman, Center for Cognitive Therapy, Philadelphia, USA

Who is the workshop aimed at: Some background in cognitive therapy is desirable, but not necessary.

Learning Objectives:This workshop focuses on helping practitioners to
• Understand the maladaptive thinking processes characteristic of suicidal individuals.
• Conceptualise the suicidal behaviour of patients.
• Devise an array of interventions in order to reduce the patients' sense of helplessness and hopelessness, and to increase their self-efficacy and capacity for joy,
• Compose anti-suicide "contracts" that will maximise patients' collaboration in therapy.
• Utilise self-help skills to cope with the demands of treating suicidal patients, and to maintain optimal perspective and judgment during times of duress.

Teaching methods: Lecture e.g. overheads. Video including clip of an actual session with a suicidal patient. Clinical problem-solving discussions with the audience.

Cory F. Newman, Ph.D., ABPP, is the Director of the Center for Cognitive Therapy in Philadelphia, Pennsylvania, USA, and an associate professor of psychology in the Department of Psychiatry at the University of Pennsylvania. He is extremely active as a therapist, supervisor, author of dozens of publications, international lecturer (having presented workshops in 14 countries), and protocol cognitive therapist and cognitive therapy supervisor in a number of multi-site clinical trials. He is the lead author of the recently published volume, Bipolar Disorder: A Cognitive Therapy Approach (2001, American Psychological Association).

Background Reading:
Beck, A.T., Brown, G.K., Steer, R.A., Dahlsgaard, K.K., & Grisham, J.R. (1999). Suicide ideation at its worst point: A predictor of eventual suicide in psychiatric outpatients. Suicide and Life-Threatening Behaviour, 29(1), 1-9.
Bongar, B., Berman, A., Maris, R., Silverman, M., Harris, E., & Packman, W. (Eds.), Risk Management with Suicidal Patients. New York: Guilford Press.
Ellis, T.E., & Newman, C.F. (1996). Choosing to Live: How to Defeat Suicide Through Cognitive Therapy. Oakland, CA: New Harbinger Publications.

Workshop 17

Cognitive Behavioural Therapy for Eating Disorders

Terry Wilson, Rutgers University,New Jersey, USA and Christopher Fairburn, University of Oxford

Who is the workshop aimed at: This workshop is aimed at novice and experienced clinicians interested in using an evidence-based approach to the treatment of bulimia nervosa and binge-eating disorder.

Learning Objectives:
• to summarise manual-based CBT for bulimia nervosa (BN) and Binge Eating Disorder (BED)
• to review specific behavioural and cognitive methods for treating core features of BN and BED. The focus will be on
strategies that are often implemented effectively.
• to describe an expanded range of procedures for addressing body shape and weight concerns and the role of negative affect in the maintenance of BN and BED
• to describe ways to increase individualisation of treatment within the framework of manual-based treatment and thereby enhance the efficacy of CBT
• to evaluate the use of different cost-effective versions of CBT within a stepped-care framework

Teaching methods: Interactive presentation. The core program will be presented using a series of integrated slides. Clinical case vignettes will be presented, and participants are encouraged to present their own cases for analysis.

Terry Wilson is Director of the Rutgers Eating Disorders Clinic and a practicing clinical psychologist. He co-adhered or co-edited a number of books, including Behaviour Therapy: Application and Outcome (with K. D. O'Leary), The Effects of Psychological Therapy (with S. Rachman), Annual Review of Behaviour Therapy: Theory and Practice (with C. M. Franks), and Binge Eating: Nature, Assessment and Treatment (with C.G. Fairburn). A Past-President of the AABT, he has many academic honors and has served as a member of the American Psychiatric Associations Eating Disorders Work Group, which developed the diagnostic criteria for eating disorders in DSM-IV, and is currently a member of the NIH's Task Force on the Prevention and Treatment of Obesity.

Professor Christopher Fairburn is Wellcome Principal Research Fellow and Professor of Psychiatry at the University of Oxford. He specialises in research on the nature and treatment of eating disorders. He has a particular interest in the development and evaluation of psychological treatments and is especially well known for his work evaluating the effectiveness of CBT, guided self-help and interpersonal psychotherapy in the treatment of eating disorders. Professor Fairburn has edited five books including The Science and Practice of Cognitive Behaviour Therapy (with DM Clark, OUP, (1997) and also written a cognitive behavioural self-help book for people with binge eating problems (Overcoming Binge Eating, Guilford Press, New York, 1995).

Background Reading
Fairburn, C. G., Marcus, M.D., & Wilson, G. T. (1993). Cognitive-behavioural therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In C. G. Fairburn & G. T. Wilson (Eds.), Binge eating: Nature, assessment and treatment, (pp. 361-404). New York: Guilford Press
Wilson, G.T. (1996). Acceptance and change in the treatment of eating disorders and obesity. Behaviour Therapy, 27, 417-439.
Wilson, G. T., Fairburn, C.G.& Agras, W.S. (1997). Cognitive-behavioural therapy for bulimia nervosa. In D.M. Garner & P. Garfinkel (Eds.), Handbook of treatment for eating disorders. (pp. 67-93). New York: Guilford Press

Workshop 18

Anger Assessment and Treatment

Raymond W. Novaco, University of California, Irvine, USA

Providing clinical services for people with recurrent anger problems is challenging. This turbulent emotion, ubiquitous in everyday life, is a feature of a wide range of clinical disorders. It is commonly observed in various personality, psychosomatic, and conduct disorders, in schizophrenia, in bipolar mood disorders, in organic brain disorders, in impulse control dysfunctions, and in a variety of conditions resulting from trauma. The central problematic characteristic of anger in the context of such clinical conditions is that it is "dysregulated" -- that is, its activation, expression, and experience occur without appropriate controls. Because anger is a common precursor of aggressive behaviour, it may be recognised as a salient clinical need, while at the same time be unsettling for mental health professionals to engage as a treatment focus. Anger assessment itself presents many challenges, because of reactivity to the testing situation and the multi-dimensionality of anger. Effectively targeting anger treatment, as well as ascertaining therapeutic gains hinges on assessment proficiency.

Learning Objectives: The workshop will present psychometric, interview, and staff-rated methods for assessing anger as a clinical problem. Issues of validity will be delineated, and recommendations for clinical strategy given. Among the assessment topics covered are assessing anger on intake at mental health facilities, children exposed to violence in the home, the relationship between anger and trauma, and the evaluation of treatment gains. Participants will be shown an interview method for assessing readiness for anger treatment and given opportunity for practice. Getting treatment engagement with chronically anger people presents multiple challenges, especially if they are seriously disordered and historically assaultive, but also if anger reactivity has become a coping style for dealing with the challenges of contemporary life and high pressure occupations. High anger patients are often avoided by clinicians because of their treatment-resistant characteristics and sometimes because of the safety risks faced by the clinician in seeking to treat them. Advances in cognitive-behavioural anger treatment will be presented, having demonstrated efficacy with patients in secure hospitals, patients with developmental disabilities, and a variety of community outpatients, including clients having severe posttraumatic stress disorder. Core themes arising in the treatment process and ways of obtaining leverage for change through a "preparatory phase" will be presented. Key components of the cognitive-behavioural approach to severe anger problems will be described, with some demonstration. Extensions from individual anger treatment to group-based anger management will be presented, along with assault risk reduction strategies for clinicians.

Teaching methods: The format for the workshop will be didactic and experiential.

Who is the workshop aimed at: It is an intermediate-level workshop aimed at mental health professionals with several years of CBT experience.

Professor Ray Novaco pioneered the cognitive-behavioural treatment of anger. His ongoing research includes studies being conducted in Scotland and England with patients in secure facilities and with psychotic patients in the community.

Background Reading:
Novaco, R. W. (1994). Anger as a risk factor for violence among the mentally disordered. In J. Monahan & H. Steadman (Eds.), Violence and mental disorder: Developments in risk assessment. Chicago: University of Chicago Press.
Novaco, R. W. and Chemtob, C. M (1998). Anger and trauma: Conceptualisation, assessment and treatment. In V. M. Follette, J. I. Ruzek, & F. R. Abueg (Eds.), Cognitive behavioural therapies for trauma. New York: Guilford.
Novaco, R. W., Ramm, M., & Black, L. (2000). Anger treatment with offenders. In C. R. Hollin (Ed.), Handbook of offender assessment and treatment. Chichester: John Wiley

Workshop 19

Individual and Family Cognitive Behavioural Intervention for Clients with Schizophrenia and Co-morbid Substance Misuse

Christine Barrowclough & Gillian Haddock University of Manchester

Many people with schizophrenia have problems with drug and/or alcohol use. This "dual diagnosis" is a risk factor for many illness complications and dual diagnosis clients may present many challenges for services. There has been limited evaluation of psychological treatments, and most work to date comes from the US.
Over the past 5 years we have been developing treatment approaches for working with these clients. A recent trial carried out at the University of Manchester has shown that an integrated family and individual CBT programme can produce significant clinical benefits for psychotic symptoms and substance use problems (Barrowclough et al, 2001).
The aim of this workshop is to show how family and individual CBT approaches can be modified to treat people who have co-existing schizophrenia and substance use problems.

Teaching methods: Theory and techniques will be illustrated with the use of video and case examples.

Learning Objectives:
• To provide participants with an overview of the current treatment literature pertaining to "dual diagnosis" clients, including the Manchester trial
• To provide a brief introduction to motivational interviewing techniques and how these can be used with clients with psychosis.
• To describe individual CBT approaches and show how they can integrated with motivational approaches and used with "dual diagnosis" clients
• To describe how family CBT approaches can be adapted for use with patients and carers with schizophrenia and co- morbid substance misuse

Who is the workshop aimed at: Participants with all levels of experience are welcome.

Christine Barrowclough is a Reader in Clinical Psychology, University of Manchester and Honorary Consultant Clinical Psychologist with Tameside and Glossop NHS Trust. She has over 20 years clinical and research experience in psychological treatments for psychosis, with a special interest in carer response to mental illness. She has published widely, and more recently has published work on the evaluation of specialised approaches for working with people with psychosis and co-morbid substance misuse.

Gillian Haddock is a Reader in Clinical Psychology, University of Manchester and Honorary Consultant Clinical Psychologist with Tameside and Glossop NHS trust. She has internationally acknowledged expertise in cognitive behavioural therapy for psychosis and has published widely and conducted many national and international workshops on this topic. She has a particular interest in psychosis and co-morbid disorders and has recently published work describing and evaluating psychological treatment for schizophrenia and co-morbid drug or alcohol misuse.

Background Reading:
Barrowclough, C., Haddock, G., Tarrier, N., Moring, J. and Lewis, S.(2000) Cognitive behavioural intervention for severely mentally ill clients who have a substance misuse problem, Psychiatric Rehabilitation Skills, 4, 216-233.
Barrowclough, C., Haddock, G., Tarrier, N., Lewis, S., Moring, J. et al (2001) Randomised controlled trial of motivational interviewing, CBT, and family intervention for patients with co-morbid schizophrenia and substance use disorders. Am J Psychiatry, 158, 1706-1713
Barrowclough, C and Tarrier, N (1992) Families of schizophrenic patients : a cognitive behavioural approach. London: Chapman and Hall.
Haddock, G. & Tarrier, N. (1998) Assessment and Formulation in the cognitive- behavioural treatment of psychosis. In Treating Complex Cases: The cognitive behavioural therapy approach Eds Tarrier, N., Wells, A. & Haddock, G. John Wiley & Sons: Chichester

Workshop 20

Formulation Based Cognitive Behavioural Psychotherapy for Psychosis

David Fowler, University of East Anglia

Aspects to be covered:
• The cognitive model of psychosis
• Review of clinical implications of data from outcome studies
• Establishment of a therapeutic relationship, therapeutic style
• Formulation of psychosis
• Overcoming problems in the process of CBT

Learning Objectives:
• To focus on the processes of implementing CBT with psychosis
• To develop understanding of the application of cognitive formulation
• To increase understanding of the critical change processes in CBT for psychosis
• To practice strategies of overcoming problems in the engagement process and developing
• a collaborative relationship with a paranoid person
• To practice sharing the formulation with patients
• To illustrate therapeutic strategies using video, role play and active discussion

Who is the workshop aimed at: People who have worked with a few psychosis cases using some form of CBT.

Teaching methods: A mixture of didactic and experiential learning will be used. Participants must be prepared to take an active role in the workshop and join in discussion and exercises. It must be appreciated that techniques and strategies can only begin to be demonstrated in this setting. Therapeutic interventions need to be supported by ongoing supervision in the long term.

David Fowler is a Senior Lecturer at the University of East Anglia. He has worked both as a clinician and research clinician in the area of CBT for psychosis for over 10 years. He has been highly involved in some of the key clinical trials of CBT for psychosis, and in the development of a formulation based CBT approach.

Background Reading:
Fowler D.G., Garety, P., Kuipers, L. Cognitive behaviour therapy for psychosis: Theory and Practice. John Wiley and Sons: Chichester. 1995.
Chadwick, P., Birchwood, M. and Trower, P. Cognitive therapy for delusions and voices. Wiley. 1996.
Birchwood, M., Fowler, D., Jackson, C. (eds.). 2000. Early intervention in psychosis: A guide to concepts, evidence and intervention. Wiley

Workshop 22

Cognitive Behaviour Therapy for Bipolar Affective Disorders

Dominic Lam, Institute of Psychiatry, London

Learning Objectives:
• to be familiar with the diagnosis and classify bipolar illness into subtypes;
• to be able to list briefly the outcome and course of illness and the effectiveness of prophylactic medication;
• to be able to define and elicit common prodromes;
• to list and describe the vulnerability issues;
• to be able to describe the common CBT techniques for bipolar illness

Teaching Methods: Didactic teaching, discussion, video tapes

Who is the workshop aimed at: Workshop is aimed at professionals who are familiar with basic CBT techniques

Dominic Lam received his clinical psychology training and his Ph.D at the Institute of Psychiatry, University of London. He has published in the psycho-social aspects of mental illness, particularly depression and manic depression. Currently he is a Senior Lecturer in Clinical Psychology at the Institute of Psychiatry and an Honorary Consultant Clinical Psychologist at the Bethlem and Maudsley NHS Trust. His clinical work is based in the Affective Disorders Unit at the Maudsley Hospital.

Background Reading:
Lam, D.H., Jones, S.H., Haywood, P. & Bright J.A. (1999). Cognitive Therapy for Bipolar Disorder: A therapist=s guide to concepts, methods and practices. Wiley & Son, London.
Lam, D. H., Bright, J., Jones,

Workshop 25

Using Stories In Cognitive Behaviour Therapy with Young Children

Joanna Grave and Lisa Walton, Child Psychology Services, Birmingham Children's Hospital

The quest to find an effective, developmentally-appropriate cognitive therapy has become apparent because of considerable evidence from outcome studies of CBT that children younger than adolescence, and particularly under 8 years of age do not benefit from therapeutic approaches based on logical analysis, disputation and abstract thinking (Dush, Hirt & Shroeder, 1989; Durlak, Fuhrman, & Lampman, 1991; Spence, 1994; Ronen, 1998). However, young children are not as limited in their abilities as they have been portrayed by traditional developmental theories, but are the active constructors of their realities based on the knowledge they have available to them. The leaders of this workshop have found that using stories is an effective and appealing means of working with younger children. The stories that children make up in therapy contain elements of their own experience and are a gateway to understanding children's thoughts and beliefs about their world as well as a vehicle for enhancing and changing their cognitions to make them more able to cope with their difficulties. The task of the cognitive behaviour therapist is to work collaboratively with the child to understand their story and then together to construct a new story that contains elements of the old story yet brings new meaning and new possibilities for coping. Participants in the workshop will have the opportunity to make up their own stories and then to consider how best to make sense of them without making interpretations and assumptions. They will be given strategies and guidelines that have been developed from clinical and research work done over the last few years. The workshop will also include a brief overview of therapeutic storytelling from different theoretical perspectives and an attempt at constructing a cognitive behavioural account of storytelling.

Learning Objectives:
• To gain an overview of the therapeutic use of storytelling from a psychodynamic; systemic and child-centred play therapy perspective;
• To understand the need and rationale for the use of stories as a tool in CBT with children;
• To construct a therapeutic story
• To extract meaning from the story

Teaching Methods: Predominantly experiential.

Dr. Joanna Grave is the Head of Child Psychology Services in East Birmingham. She has a particular interest in early intervention and the role of community engagement in the shaping and delivery of mental health services in primary care in the inner city. In her clinical work, Joanna Grave has developed a model of delivering CBT to young children through the use of stories, which she has evaluated for her doctoral research using a single case design. She is currently looking at other applications for stories as a vehicle for communicating meaning and changing behaviour.

Dr. Lisa Walton is a clinical psychologist working in early intervention community psychology services, Birmingham Children's Hospital Trust. She is currently involved in developing partnerships with professionals in primary care such as health visitors and school nurses, offering training, consultation and direct work with children with emotional and behavioural problems. She has particular responsibility for the delivery of a preventative universal social growth programme in schools. Lisa has a special interest in the creative use of cognitive therapy with young school-aged children.

Background Reading:
Friedberg, R.D. (1994). Storytelling and Cognitive Therapy with Children. Journal of Cognitive Psychotherapy, 8, 209 - 217.
Russell, R.L. & van den Broek, P. (1988). A Cognitive-Developmental Account of Storytelling in Child Psychotherapy. In S.R. Shirk (Ed.), Cognitive Development and Child Psychotherapy (pp. 19-52). New York: Plenum.
Mahoney, M.J. & Nezworski, M.T. (1985). Cognitive-Behavioural Approaches to Children's Problems. Journal of Abnormal Child Psychology, 13, 467-476.

Workshop 26

Improving Supervision Skills: A Cognitive Perspective

Gillian Butler, Department of Psychiatry, University of Oxford

Supervision is an essential element of professional practice, but few people have had the opportunity to learn about how to provide it, or about the various ways in which they could work as supervisors to facilitate the learning and professional development of others. This is a practical workshop that is intended to help practitioners reflect on their methods of supervision, and enhance their skills as supervisors. It will draw on the cognitive model as a starting point for identifying good (and bad) practices in supervision, and as a theoretical basis for structuring the work of supervision. It will also provide an opportunity to think about how to recognise, define and deal with some of the difficulties that arise during supervision.
The workshop will focus on issues of direct relevance to practising supervisors. It will make use of a variety of practical exercises, and participants will be expected to take part in discussions and other exercises including role-play, so as to think about how to apply what they learn to their own practice.

Learning Objectives
• To understand how the cognitive model and the methods used in cognitive therapy can inform the content and style of supervision.
• To identify assumptions about supervision and how they may hinder as well as help the individual supervisor.
• To increase the skill and the confidence of supervisors, so that they may make best use of their expertise, and be able to deal appropriately with problems when they arise.

Who is the workshop aimed at: those who already have experience of supervising as well as for experienced clinicians who wish to start supervising. It will probably be of most relevance to those who are familiar with and use a cognitive approach to treatment, but others may also find it useful.

Background Reading:
Campbell, J. M. 2000. Becoming an effective supervisor: A workbook for counsellors and psychotherapists. Taylor Francis Groups Books, Hove
Journal of Cognitive Psychotherapy 1998, vol 12. Special issue on supervision.

Workshop 27

Medically Unexplained Symptoms: A Generic Model and Cognitive Behavioural Approaches

Trudie Chalder, Guy's, Kings and St Thomas' School of Medicine, London

The essential features of medically unexplained symptoms are physical symptoms for which no demonstrable organic findings can be found. The symptoms are not feigned or intentionally produced. Work, social and private functioning are usually impaired and the extent of the disability is usually determined by the degree of belief in the physical nature of the symptoms and/or fearful cognitions about the consequences of them. Psychologists and other therapists find these patients particularly difficult to treat. This workshop will provide clinical insight into how these patients can be engaged in the therapeutic process. Various treatment techniques will be discussed. Participants will be expected to role play.

Who the workshop is aimed at: The workshop is aimed at qualified cognitive behaviour therapists. Some experience of working with this group of patients may be an advantage.

Learning Objectives: By the end of the session the therapist will be able to:
• describe a cognitive behavioural framework for understanding these disorders
• identify three issues than could disrupt the therapeutic relationship
• describe three interventions to prevent the above
• identify the components of a good rationale

Teaching Methods: Brainstorms, group work, role-play and feedback

Trudie Chalder is Reader in Psychology and Nursing in the Dept. of Psychological Medicine and Department of Psychiatric Nursing at Guy's, King's and St Thomas' School of Medicine (GKT) London. She is a cognitive behavioural psychotherapist and has a MSc in Health Psychology and a PhD in Psychology. She has worked as a clinician and a researcher in the area of medically unexplained symptoms and behavioural medicine for about 13 years.

Background Reading:
Chalder T. (1999) Somatisation and inappropriate illness behaviour. in: Mental Health Nursing-An Evidence Based Approach. Edited by Rob Newell and Kevin Gournay. Churchill Livingstone. 13; 225-242.
Whiting P, Bagnall AM, Sowden AJ, Cornell JE, Mulrow CD, Ramirez G. (2001) Interventions for the treatment and management of chronic fatigue syndrome. JAMA. 286, 1360-1368.
Sharpe M, Peveler R, Mayou R (1992). The psychological treatment of patients with functional somatic symptoms: a practical guide. Journal of Psychosomatic Research 36: 515-29.

Workshop 28

Coping with Adversity: Cognitive Therapy in Adverse Life Circumstances

Stirling Moorey, Maudsley Hospital, London

Helping patients who are facing realistically distressing circumstances presents a challenge for cognitive therapy. This workshop will consider the cognitive behavioural methods used in the treatment of patients coping with adversity. The methods covered are applicable to range of situations including trauma, loss and physical disability. These methods will be illustrated with particular reference to life threatening physical illness. Therapists can be daunted by the presence of apparently realistic negative thoughts in these circumstances.

Learning Objectives:
This workshop will demonstrate the power of the standard cognitive model as a tool for conceptualising and planning treatment with this group of patients. Adaptation of treatment for people facing adverse life circumstances will be described:
• Facilitating emotional processing.
• Enhancing a sense of personal control to combat helplessness.
• Dealing directly and indirectly with realistic negative automatic thoughts.

Teaching methods: Workshop participants will have the opportunity to practice conceptualisation and therapy skills in role play and group discussion. Participants should bring case details of a patient with a serious physical illness, disability or other relevant life problem.

Dr Moorey is Consultant Psychiatrist in Psychotherapy (CBT) at the Maudsley Hospital. He has been actively involved with cognitive therapy since 1979 and was co-founder of the Institute of Psychiatry Cognitive Therapy Course. From 1986-1991 he was a CRC research psychiatrist at the Royal Marsden Hospital, and worked with Dr Steven Greer to develop a cognitive based treatment for patients with cancer. He is author of the chapter "When Bad Things Happen to Rational People" in Frontiers of Cognitive Therapy and is co-author with Dr Steven Greer of "Cognitive Behaviour Therapy for People with Cancer" to be published by Oxford University Press in 2002. Dr Moorey regularly teaches on coping with adversity on the CBT courses at the Institute of Psychiatry, Newcastle, Salford and Dublin.