My name is Stephen Hillier-Davies.
I am an Accredited Psychotherapist and Clinical Supervisor in Cognitive Behavioural Therapy (CBT) with the British Association for Behavioural and Cognitive Psychotherapies (BABCP), with extensive clinical experience in the UK and USA.
I worked for more than 25 years within the National Health Service (NHS) within a wide variety of services - primary care, mental health, addictions, forensic psychotherapy and physical & sexual health - both as a clinician and supervisor.
For the last 17 years, I worked as a Forensic Psychotherapist within the South London & Maudsley NHS Foundation Trust (part of King’s Health Partners Academic Health Sciences Centre bringing together a world-leading, research-led university (King’s College London) and three successful NHS Foundation Trusts (Guy’s and St Thomas’, King’s College Hospital and the Maudsley), providing psychological therapy and specialist consultation in CBT for individuals with a wide range of mental health and emotional, behavioural difficulties including trauma, anxiety, depression, OCD, phobias, addictions, anger, abuse and personal, social and sexual relationship difficulties.
This experience has made me an extremely informed, clinically experienced practitioner and I have a reputation for compassion and an emphasis on the practicalities of offering help rather than just the theory of the client-based work. Having broad specialist mental health experience of treating a range of complex difficulties, I have extensive skill and ability which provides the knowledge experience to provide safe and structured treatment options.
I provide face-to-face CBT psychotherapy and counselling in Ashford, Kent - and nationally/internationally via Skype/FaceTime for individuals and couples.
Cognitive Behavioural Therapy (CBT) is an active, goal-orientated and time-limited approach to psychotherapy. It is guided by a shared understanding of the problems (formulation) you experience and helps you to develop and test out your individual set of tools which allow you to deal with and transform unhelpful thoughts and feelings.
The usefulness for CBT has been intensively investigated. For a large variety of conditions it has proven to be more or equally effective as other forms of psychotherapy.
Active - you will be involved in practical work during and outside the sessions to check some of your beliefs or new behaviours
Goal Orientated - you set your goals in the first sessions and we will regularly review them throughout the course of your therapy
Setting specific, measurable, achievable, realistic and time-framed (SMART) goals
Time-limited - a course of CBT usually lasts for about 6-12 sessions; the usual range is between 6 to 30 sessions
Collaborative - you and your therapist work together side by side, your experience, input and feedback being equally important
Evidence based - CBT is a scientifically-evaluated therapy approach
How does CBT work?
Cognitive Behavioural Therapy looks at the connection between thinking (cognitions), feelings (emotions), bodily sensations (physiology) and actions (behaviours). If these interact and form unhelpful feedback loops, one can get trapped in negative emotional states. This can lead to people feeling excessively anxious, depressed or angry.
In CBT, both client and therapist work together and develop a shared understanding of the current difficulties, their original cause, and in particular what keeps them in place now.
This is often put down on paper as a drawing or diagram (formulation) which will guide the work of the following session and introduces a variety of specific techniques or tools to address unhelpful thinking and less successful behaviours.
My approach involves guiding you to how use these tools in the session and, most importantly in your day to day life. This practical work will often result in an even more precise understanding and give you some effective tools to tackle difficulties.
Towards the end of the treatment, you will know a variety of techniques which work well for you. Finally, we will make a plan of when and how to use them should you be faced with similar difficulties in the future (relapse prevention). We can then review this in subsequent booster sessions.
How does CBT differ from other therapies?
Most therapies, including CBT, share many similarities, such as talking to a person you can trust openly, being respected and listened to or having a regular time and space dedicated to some work on changing oneself. Some researchers have argued that it is only these shared or general aspects which make change happen.
In CBT, we know that all these aspects are important and necessary to provide an effective treatment. However, we also know that for some conditions, like anxiety disorders, such as Obsessive Compulsive Disorder (OCD), these general factors on their own are not sufficient to help clients to overcome their problems. Indeed, research has shown that some specific ingredients (tools) are needed in addition to provide results.
Emphasis on Collaborative Working
CBT is primarily a collaborative venture. Both of us work side by side, with me bringing in my training and experiences and you being the expert in what works for you. It is important that what we discuss or put down on paper makes sense to you, and you understand what makes you stuck and what helps you to get going again.
As a therapist I will also bring into our meeting my own thoughts and personal experiences. I think, if some of this can help you to progress let us make use of it. If some of this gets in the way, let us speak about it. Feedback is important, and I am as keen as my clients to learn and make changes.
Main components of CBT
Formulation guided: the treatment is guided by a shared understanding of the difficulties (formulation) which is based on your lived experiences and the existing scientific knowledge of the specific condition. This can be drawn out in a diagram for easier understanding and helps in planning the therapy. Some of the formulation’s elements and their connections might be clear from the beginning; others might be checked out and added throughout the course of the therapy.
Time limited: a course of CBT does not usually last for years. For specific, isolated problems, treatments can be as short as 10 sessions or even less. Often, between 16 and 20 sessions are offered and a longer duration for the treatment can be negotiated with the therapist. With the exception of some longstanding personality related issues, CBT rarely lasts longer than a year.
Goal orientated: to help you to overcome current difficulties and to tackle successfully some of the challenges, we will be working towards your own personal goals. This focus helps to keep track of the success of the therapy and to experience a fuller life.
Active therapy: although most of the sessions are spent talking, therapy also includes more active parts. This may include testing out new behaviours, behavioural coaching, home study/reading psychoeducational resources and checking out your thoughts or assumptions in specific situations, for example, at work, with family or in social settings. This can initially feel a bit unusual, but it provides a highly effective way of learning.
Put into practice in your everyday life (work between sessions): one of the most important aspects of CBT is to help you to use your new skills in your day-to-day life. In order to get the most benefit from the therapy, you will be asked to do a certain amount of work between the sessions. We can talk about what would be acceptable and suitable for you and adapt homework assignments. However, it is a proven fact that clients who do engage in work between the sessions make faster progress.
Progress tracking: the success of a treatment is highly personal and only you, and sometimes the people who know you well, can decide if a treatment is effective for you. CBT therapy is specifically tailored to suit your own needs and goals and helps you to progress most successfully. Your regular feedback will guide us and help us to see if therapy is helping you to move in the right direction.
In addition, I suggest a progress review using, if available, an established questionnaire for the problems we are working on. With feedback from different sources, both of us can decide throughout the course of the therapy if it needs to be adapted further.
Evidence base for CBT:
The CBT philosophy is to provide treatment that works. From its conception in the 1970s, CBT was one of the first treatments to undergo rigorous evaluation of its effectiveness. Starting with Aaron Beck, the founder of CBT, many researchers have compared CBT with not having any therapy, CBT as opposed to psychiatric medication or in comparison with other psychotherapies. CBT has demonstrated again and again that it works better than a “wait and see approach”. Over the years, CBT has been shown to be as effective, if not even more effective, than psychiatric medication, such as antidepressants for mood and anxiety disorders.
Whereas a variety of psycho-therapeutic approaches work well for depression, CBT has been shown to be superior to other psychological therapies and is sometimes the only effective approach for many anxiety disorders.
What happens in CBT?
After exploring your background, your strengths and current struggles within the first one or two sessions, we will then discuss if and how CBT can help you.
Therapy will help you to understand how some of your difficulties relate to your thoughts, emotions and actions. Often, we will draw this in a diagram which will make sense to the two of us. In this way, you can become more attuned to recognise some of the existing connections. In a second step, you will learn to change previously unhelpful ways of thinking and less helpful behaviours. Over time, you will build your own set of tools which are most effective for the situations you encounter.
CBT is tailor-made for your purpose. In therapy, we will test drive these tools, optimise them for you, and practice so that they become second nature. For this, we work as a therapeutic team. Your feedback about the session, the techniques and the way I approach you is a very important part of the treatment, allowing us to get it right for you.
Over time, you will become more and more self-sufficient and, towards the end of the course of therapy, you will set your own session agenda, and have learned how to ‘become your own therapist’. In the last couple of sessions, we work on relapse prevention and summarise the treatment, the techniques you found particularly helpful, and a step by step approach of what you can do if things start to move in the wrong direction.