Magical Beliefs About CBT…

abound.These beliefs are inculcated by initial training and maintained by sharing ‘best practices’. For example, low intensity CBT therapists operate, on beliefs such as  ‘if I go into the CBT superstore and choose a strategy it will be potent’, ‘my clinical judgement is sufficient to make the right choices’,  and ‘improvements in test scores are sufficient basis for believing the clients needs have been met ‘.  But these beliefs are not evidence-based.

 

For the past 50 years it has been taken as axiomatic that ‘arrested information processing plays a pivotal role in debility post-trauma and should be targetted’. In Personalising Trauma Treatment: Reframing and Reimagining Routledge’  (2022)https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwj2r8v8m_j2AhWxQEEAHQrjAGgQFnoECAUQAQ&url=https%3A%2F%2Fwww.taylorfrancis.com%2Fbooks%2Fmono%2F10.4324%2F9781003178132%2F I examined this issue in detail, dissented and concluded that it is the centrality accorded to the trauma that is the driving force for debility post trauma. To the extent that clients utilise the trauma as their window on themselves and their world they are likely to suffer impairment in functioning, both personally and interpersonally. It  is a magical belief that the problem lies with the traumatic memory, rather the issue is what the person takes the memory to mean for today (see youtube video https://youtu.be/3UeJ1Lux4pU) detailing how to help the client back to their old selves post trauma – Restorative CBT (RCBT).

Personalising Trauma Treatment : Reframing and Reimagining book cover

 ‘All disorders are maintained by a negative belief system, making CBT appropriate’, this belief underpins the extension of CBT to the treatment of long-term conditions. But it would not stand up in Court. It would be suggested that the idea is promulgated to satisfy the acquisition of power by service providers. A relatively newly emergent,  magical belief is that ‘if children are taught the elements of CBT model/adaptive coping it prevents the development disorder’ this may or may not be true but dogmatism here has no place. 

In the Middle AgesIn it was believed that the earth was the centre of the universe and planets such the sun  and moon orbited it in circles. This geocentric view of the universe persisted for a long time after it became evident that the earth was not at the centre  and that orbits were elliptical rather than circular. Unfortunately the power of the current Teflonocracy will likely lead to the persistence of these magical beliefs for some time to come.

Dr Mike Scott

Post Trauma, Quality Treatment Shouldn’t Be Traumatic – New Book

Personalising Trauma Treatment is about helping trauma victims back to their old selves and focuses on altering the perception of the centrality of the trauma.

In this book, clients are taught to rediscover their sense of self by reframing the trauma. Within this new framework the focus is on the client’s mental time travel from the trauma to today and reimagining their future. The therapeutic targets are the thoughts and images (cognitions) that interfere with day-to-day functioning. It does not assume that arrested information processing lies at the heart of the development of PTSD, with a consequent need for the client to re-live the trauma. For those clients who were abused in childhood, their experiences are viewed through a particular central window, but other ‘windows’ may make for more appropriate engagement with their personal world and a reimagining of their view of themselves. Treatment delivery options from telephone consultation, group work and videoconferencing are discussed. With illustrative examples, the author highlights the pathway to recovery for a wide range of clients with the comorbidity often found in real-world settings.

The book will be essential reading for therapists and other mental health professionals working with trauma survivors.

Michael Scott identifies the paradox, coolly critiques the evidence, and illustrates and emphasises the collaborative and crucial role of the creative, empathic, and restorative therapist in enabling the client’s natural resilience and preferences for today and tomorrow, without pathologizing normality, imposing supposed processing, and unconstrained by complacent diktat. — Greg Wilkinson Formerly: Editor, The British Journal of Psychiatry and Professor of Liaison Psychiatry, The University of Liverpool; Currently, Consultant Psychiatrist, Liverpool University Dental Hospital and Liverpool University Hospitals NHS Foundation Trust.

Dr Scott offers a unique and refreshing perspective on working with those affected by trauma, particularly when they don’t neatly fit into a PTSD ‘box’ but have nevertheless come to be defined by their experiences. Taking a critical eye to evidence-based practice, and at turns thought-provoking and light-hearted, he combines up-to-date theory and clinical pearls with a robust critique of the modern realities of service delivery. Full of rich clinical examples and dialogue that brings the reader into his therapy room, he takes you step-by-step through his clinical decision making and interventions.Highly recommended! — Sharif El-Leithy, Principal Clinical Psychologist, Traumatic Stress Service  

In Personalising Trauma Treatment: Reframing and Reimagining Dr Scott delivers an approach to treatment grounded in pragmatism and real-world functioning. After considering the pitfalls of poor assessment he guides the reader through the process of detailed and accurate diagnosis questioning whether treatments work for the supposed reasons they give. This book is a must for all IAPT & CBT therapists, counsellors and clinical psychologists involved in the care of individuals suffering with trauma. — Sundeep Sembi, Consultant Clinical Neuropsychologist, Psychology Chambers Ltd

https://www.routledge.com/Personalising-Trauma-Treatment-Reframing-and-Reimagining/Scott/p/book/9781032013121 utm_source=individuals&utm_medium=shared_link&utm_campaign=B021841_ca1_1au_7pp_d875

 

Who Arrested Information Processing?

Was it Freud, Horowitz, Foa, Resick, Shapiro, Brewin or Ehlers? Arrested information processing has long been held as pivotal in the development of PTSD, but in my Workshop, ‘CBT for PTSD and Beyond’ to be delivered at the Lakeside Centre, Crosby, Liverpool on October 4th 2018 under the auspices of Merseyside BABCP I question this.

 

There is also a paper ‘PTSD An Alternative Paradigm’ in submission.

Dr Mike Scott