CBT at London South Bank University Transdiagnostic CBT using Method of Levels Therapy Wednesday 15 October 2014 Workshop overview The term ‘transdiagnostic’ was first coined in the context of CBT by Fairburn et al. (2003) to describe a form of therapy that could be applied across the range of eating disorders. In 2004, Allison Harvey, Ed Watkins, Warren Mansell and Roz Shafran published a comprehensive review of the literature on cognitive and behavioural processes in adult Axis I disorders that identified a range of maintenance processes that were shared across all disorders studied. A range of international groups are now developing transdiagnostic CBT (e.g. Barlow et al., 2004; MacManus et al., 2010) – a therapy that can be applied successfully without reference to the specific psychological disorder(s) a person experiences. There are solid historical, conceptual and philosophical foundations to the transdiagnostic approach (Mansell et al., 2009), alongside significant potential for improving the efficiency of the training and delivery of CBT (McHugh et al., 2009). Warren Mansell and his colleagues are contributing to two strands of developments in this field. First, he is working with frontline services to develop familiar forms of CBT that can be applied to a wide range of presenting problems (Mansell, 2012; Stott et al., 2010). Second, he is utilising a theoretical framework known as Perceptual Control Theory (PCT) to train, deliver and evaluate Method of Levels cognitive therapy (Carey, 2006; Mansell, 2009; Mansell, 2005; Higginson et al., 2011). This approach takes the view that the dozen or so cognitive behavioural processes known to be transdiagnostic are closely related, and they maintain distress because they prevent the deep, long-term goals driving goal conflict (e.g. ‘to be completely independent’ versus ‘to need other people near me for safety’) from being available, and sustained, within awareness. Therapy helps people to sustain attention on the present moment experiences (e.g. thoughts, images, metaphors, feelings, impulses) involved in this conflict between their personal goals to facilitate effective change (Higginson et al., 2011; Mansell, 2011). The workshop will involve small group discussions, workshop leader demonstrations, audio and video clips, and experiential learning exercises. Delegates will be expected to be willing to talk about their own problems and experiences within small group settings for training purposes. Pre-workshop reading Higginson, S., Mansell, W., & Wood, A. M. (2011). An integrative mechanistic account of psychological distress, therapeutic change and recovery: the Perceptual Control Theory Approach. Clinical Psychology Review, 31, 249-259. Carey, T. A. (2009). Dancing with distress: helping people transform psychological problems with the Method of Levels two-step. The Cognitive Behaviour Therapist, 2, 167-177. 1 Workshop Learning Objectives 1. To become aware of the evidence base for transdiagnostic cognitive and behavioural processes across adult Axis I psychological disorders. 2. To evaluate the pros and cons of taking a transdiagnostic approach in practice, and 3. To learn about a control theory approach to transdiagnostic approach that involves 4. To understand how existing tools & techniques in CBT (e.g. continuua; imagery; its context within existing services. a perceive - compare - act cycle of perceptual control, hierarchical goals, and arbitrary (inflexible) control as the cause of psychological distress via goal conflict. behavioural activation; pros and cons) can be applied from a control theory perspective to be more flexible across disorders. 5. To be introduced to the aims and process of Method of Levels Therapy & its 6. To consider how to incorporate control theory and Method of Levels into one’s empirical support and to learn the basic skills for practising the therapy. everyday practice and service organization. Workshop leader Dr Warren Mansell Reader in Clinical Psychology Warren Mansell has been involved in CBT research since 1994 when he began his DPhil on cognitive processes in social anxiety and social phobia at the University of Oxford with David M. Clark and Anke Ehlers. After completing his Clinical Psychology training at the Institute of Psychiatry, London, he focused his research and clinical work on CBT for bipolar disorder, transdiagnostic approaches to CBT, and the use of Perceptual Control Theory as an integrative theoretical framework. He has been closely involved in the annual conference of the British Association of Behavioural and Cognitive Psychotherapies (BABCP) since 2000, and co-chaired the scientific committee with Roz Shafran until from 2008 to 2013. In 2011 he received the May Davidson Award from the British Psychological Society for his outstanding contribution to the field of clinical psychology since qualifying as a clinical psychologist. Publications Warren Mansell is the author or co-author of over 100 publications, including the following books: Cognitive and Behavioural Processes Across Psychological Disorders (2004), The Bluffer’s Guide to Psychology (2006), Coping with Fears and Phobias: A Step-by-Step Guide to Understanding and Facing Your Anxieties (2007), The Oxford Guide to Metaphors in CBT (2010) and A Transdiagnostic Approach to CBT Using Method of Levels Therapy (2012). 2