ICS underpinning 3rd Wave CBT

The publications and therapeutic approaches that follow employ ICS as a way of approaching CBT across diagnoses – because: ICS provides a cognitive science based rationale for:

  • The disjunction between thought and emotion
  • The centrality of arousal in understanding mental health difficulties
  • Attachment and relationship as central to the self, and central to the therapeutic process
  • The role of mindfulness in providing a way into the process between thought and emotion and behaviour
  • Deconstructing diagnosis (see recent book chapter on coping mechanisms)

TRAINING WORKSHOPS

Details of CCC training workshops are also posted on the front page. These can be tailored to particular services – for instance teams, or NHS Talking Therapy services working in conjunction with CMHTs; groups composed mainly of therapists, or mainly of nurses and other staff groups.

I deliver a number of other workshops which are listed here. As you can see from the list, I have extensive clinical and teaching experience and can discuss other possible workshop topics as needed.

  • Self and Spirituality – A new course: among its aims: to present a holistic perspective on being human that is grounded in both cognitive science and lived experience that questions received notions of The Self, so called ‘Mental Illness’, and makes space for spirituality.
  • The Dynamics of Running Groups
  • Shaping Therapy
  • Managing Difficult conversations

COMPREHEND, COPE AND CONNECT (CCC)

Third Wave CBT Integration for Individuals and Teams: Comprehend Cope and Connect. Isabel Clarke and Hazel Nicholls. Routledge. January 2018.

CCC/EFFA is a therapy approach that starts with collaborative, individual formulation – which can then inform the thinking of the wider system.

  • Where an individual’s experience of themselves feels unbearable, they will seek to cope with this – for instance by withdrawing, self harming, drinking alcohol etc.
  • These strategies are understandable and work short term. Most of them are used by everyone at some time.
  • Past trauma and the way that the body picks up threat signals and gets ready for action combine to set up vicious circles that lock people into a trap.
  • Where vicious circles are identified – the individual can choose to break them – and support and skills can be offered to help with this.
  • Skills can be taught individually or in groups.

A Relational Approach

From this perspective, our very being is founded in relationship and we only make sense in the context of a web of relationships. Family and those close to us are clearly key to this, but it extends to the widest and deepest experience of relationship, the spiritual or religious. In emphasising the primacy of the emotional/relational aspect of the human being, CCC is in tune with non Western cultures. Experience and felt sense are at the heart of the approach and ‘symptoms’ are viewed as understandable, but ultimately self defeating, ways of coping with an intolerable internal state.

Theoretical Background

CCC represents an integration of third wave CBT approaches, on the theoretical foundation of the cognitive science based Interacting Cognitive Subsystems (ICS) model of cognitive architecture (Teasdale and Barnard 1993). This can be seen to underlie Dialectical Behaviour Therapy’s States of Mind diagram (Linehan 1993) of a separable Reasonable and Emotional Mind. Working at the level of felt sense is strongly indicated by ICS.

Applications of CCC

Acute services, inpatient and community acute (see CBT for the Acute Care Pathway)
Making Sense of Crisis. A one or two day training package to introduce this approach to a service.

Primary Care. Increasing Access to Psychological Therapies (IAPT). The italk Hampshire IAPT service used CCC/EFFA for patients who made limited recovery with existing interventions, identifying the target group as having problems exacerbated by complex trauma.

Culturally Adapted Therapy. A project to use CCC in a Culturally Blind form of therapy with a Mindfulness focus is in its early stages, linking three centres in Pakistan, Canada and Southampton.

Bridging the gap between Cognitive theory and therapy

ICS Symposium 2008. Talk: Visceral Impact Formulation; engaging heart as well as head using ICS.

The Construction of the Self