3-day CBT for Psychosis Spring School


DAY 1

 

1)    Counteracting Paranoia – Learning of Safety

Presentation outline:

Counteracting paranoia requires building new memories of safety.  Feared situations require being approached inquisitively, with defences lowered. Making new learning can be difficult when anxiety is high. But when a cognitive shift occurs to the realisation that a situation is safer than feared then this can be extremely freeing, allowing re-engagement in meaningful activities. It is one of the most powerful techniques in cognitive approaches to persecutory delusions. Methods, practicalities, and challenges in applying such behavioural experiments in paranoia will be presented.

Presenter:

Daniel Freeman is a Professor of Clinical Psychology, an NIHR Research Professor, and a British Psychological Society Fellow, in the Department of Psychiatry at the University of Oxford. He is also a consultant clinical psychologist in Oxford Health NHS Foundation Trust and a Fellow of University College Oxford.

Papers:

Freeman, D., Bradley, J., Antley, A., Bourke, E., DeWeever, N., Evans, N., Cernis, E., Sheaves, B., Waite, F., Dunn, G., Slater, M. & Clark, D.M. (2016). Virtual reality in the treatment of persecutory delusions: randomised controlled experimental study testing how to reduce delusional conviction. The British Journal of Psychiatry, 209(1), 62-67.

Freeman, D., Garety, P. A., Kuipers, E., Fowler, D., Bebbington, P. E., & Dunn, G. (2007). Acting on persecutory delusions: the importance of safety seeking. Behaviour research and therapy, 45(1), 89-99.

Freeman, D., Bradley, J., Waite, F., Sheaves, B., DeWeever, N., Bourke, E., McInerney, J., Evans, N., Černis, E., Lister, R., Garety, P. & Dunn, G. (2016).

Targeting recovery in persistent persecutory delusions: a proof of principle study of a new translational psychological treatment. Behavioural and Cognitive Psychotherapy, 44(5), 539-552.

2) Grandiose Delusions (Delusions of Exceptionality) – Developing a New Translational Treatment

Presentation outline:

Grandiose delusions are arguably the most neglected psychotic experience in research today.  Recent efforts to start to address this imbalance have yielded important insights however. This workshop will consider the evidence-base in relation to the lived experience of grandiose delusions, the harmful consequences that can occur, and possible psychological maintenance mechanisms. There will be an emphasis on the clinical implications that arise from this early research including potentially viable targets for intervention.

Presenter:

Louise Isham in a consultant clinical psychologist and NIHR clinical doctoral research fellow. Within the Oxford Cognitive Approaches to Psychosis (O-CAP) research group, she is currently undertaking a 5-year program aiming to develop the psychological understanding and treatment of delusions of exceptionality. She also works as a CBT trainer and supervisor for the Oxford Cognitive Therapy Centre and is the course lead for the PGCert in Enhanced CBT (Psychosis and Bipolar).

Papers:

Isham, L., Griffith, L. Boylan, A.M., Hicks, A., Wilson, N., Byrne, R., Sheaves, B., Bentall, R.P., & Freeman, D. (2019). “Understanding, treating, and renaming grandiose delusions: A qualitative study.”  Psychology and Psychotherapy: Theory, Research and Practice.

3)    A Cognitive Interpersonal model of fear of recurrence in people in psychosis

Presentation outline:

Fear of recurrence is linked to traumatic experiences of psychosis and is associated with greater worrying, stigma, depression, safety seeking and shorter time to relapse. The presentation will outline the phenomenology and empirical evidence for fear of recurrence in psychosis. Based on a Cognitive Interpersonal model the presentation will outline key intervention strategies.

Presenter:

Andrew Gumley is a Chartered Clinical Psychologist and Professor of Psychological Therapy in the University of Glasgow Institute of Health and Wellbeing. He is also Honorary Consultant Clinical Psychologist in NHS Greater Glasgow & Clyde. Andrew’s research encompasses biological, social and psychological mechanisms of transition to psychosis and relapse in those with established psychosis. His research includes development of psychological and digital therapies to promote recovery and wellbeing amongst people with experiences of psychosis.

Papers:

Gumley, A, Schwannauer M., Macbeth, A, Fisher R, Clark S, Wilcox L, Fraser G, McCabe R, Blair A, Davidson K, Birchwood M.  (2014) Insight, Duration of Untreated Psychosis and Attachment in First Episode Psychosis: a prospective study of psychiatric recovery over 12-month follow-up. British Journal of Psychiatry, 205(1):60-7. doi: 10.1192/bjp.bp.113.126722.

Gumley, A.I., Macbeth, A., Reilly, J.D., O’Grady, M., White, R.G., McLeod, H.J., Schwannauer, M., & Power, K. (2015) Fear of recurrence: Results of a randomized controlled trial of relapse detection in Schizophrenia. British Journal of Clinical Psychology, 54(1):49-62. doi: 10.1111/bjc.12060.

Allan, S, Bradstreet, S, McLeod, HJ, Gleeson, J, Farhall, J, Lambrou, M, Clark, A, Gumley, A (2019) Service users, carers and mental health staff understandings of early warning signs of relapse in psychosis: A qualitative investigation. BJPsych Open 6(1), E3. doi:10.1192/bjo.2019.88

4)    Learning from lived experience of CBTp to promote engagement and recovery

Presentation outline:

It is essential to consider the views and experiences of CBTp clients in order to maximise understanding of what works, when, and how. It’s also very important to consider the real challenges of CBTp, and the possibility of therapy causing distress or even harm. This talk will present client views of CBTp to help inform effective engagement, and to help recognise challenges and solutions.

Presenter:

Dr Rory Byrne received CBTp while considered to be at risk of developing psychosis, and later went on to work with one of the leading CBTp research teams in the UK, under Prof Tony Morrison in Manchester. Rory has concentrated on evaluating the lived experiences, views, and priorities of people with psychosis-spectrum difficulties, with a particular emphasis on experiences of CBTp.

Papers:

Brabban A, Byrne R, Longden E, Morrison AP. (2016) The importance of human relationships, ethics and recovery-orientated values in the delivery of CBT for people with psychosis. Psychosis, Dec. doi: 10.1080/17522439.2016.1259648

Kilbride M, Byrne R, Price J, Wood L, Barratt S, Welford M & Morrison AP (2013). Exploring service users’ perceptions of cognitive behavioural therapy for psychosis: a user led study. Behavioural and Cognitive Psychotherapy, 41(1):89-102.

Byrne RE, Morrison AP. (2013) Young people at risk of psychosis: Their subjective experiences of monitoring and cognitive behaviour therapy in the early detection and intervention evaluation 2 trial. Psychology and Psychotherapy, Sep;87(3):357-71. doi: 10.1111/papt.12013

 

DAY 2

1)         Dissociation in Non-Affective Psychosis

Presentation outline:

Dissociation is rapidly gaining recognition as an important phenomenon with links to risk for self-harm and suicidality, but it can be challenging to identify and treat. Evidence suggests that dissociative experiences may be highly prevalent in people with psychosis, and that dissociation may even drive key psychotic symptoms such as paranoia and auditory hallucinations.

In this presentation, Dr Emma Černis will outline some of her recent research into dissociation in the context of psychosis: including how it can be recognised, conceptualised, and measured, and common psychological factors underpinning the problem.

Presenter:

Emma Černis is a Wellcome Trust Clinical Doctoral Fellow and Clinical Psychologist working in the Oxford Cognitive Approaches to Psychosis (O-CAP) research group. Emma’s research focuses on improving clinical understanding of dissociative experiences arising in the context of non-affective psychosis. She has previously worked on several clinical trials of CBT for persecutory delusions, including the Worry Intervention Trial, SlowMo and Feeling Safe. Emma is an honorary clinical psychologist in the NHS Oxford Early Intervention for Psychosis team and an HCPC registered Clinical Psychologist.

Papers:

Cernis, E., Dunn, G., Startup, H., Kingdon, D., Wingham, G., Pugh, K., … & Freeman, D. (2014). Depersonalization in patients with persecutory delusions. The Journal of nervous and mental disease, 202(10), 752-758. DOI: 10.1097/NMD.0000000000000185

2)         Cognitive Behavioural Therapy for Nightmares for Patients Experiencing Psychosis

Presentation outline:

Problematic nightmares occur in around half of patients experiencing non-affective psychosis.  They can maintain psychotic symptoms by portraying paranoid fears and the threats made by voices in sensory rich detail.  However research shows that they are rarely assessed or treated.  A recent pilot randomised controlled trial led by Dr Sheaves indicated that brief cognitive behavioural therapy for nightmares might be highly efficacious for treating nightmares and co-occurring insomnia for patients experiencing psychosis.  This workshop will share the theoretical underpinnings and key elements of the treatment.  The key technique is imagery rehearsal training and novel potential causal factors for nightmares have been added to boost the efficacy of the treatment and reduce reliance on a single technique.  The CBT model and techniques will be shared using video, case examples and role play.

Presenter:

Bryony Sheaves is a Research Clinical Psychologist and NIHR clinical doctoral fellow working within the Oxford Cognitive Approaches to Psychosis research group at the University of Oxford.  She holds particular interests in sleep and voices and has conducted a programme of work investigating the problem of nightmares for patients experiencing psychosis.  This work has demonstrated that nightmares are common, associated with psychotic symptoms and might be highly amenable to treatment.  Bryony led the first randomised controlled trial of CBT for nightmares for patients experiencing persecutory delusions.

Papers:

Rek S, Sheaves B, Freeman D (2017). Nightmares in the general population: identifying potential causal factors. . Springer Berlin Heidelberg Social Psychiatry and Psychiatric Epidemiology 52, 1123-1133.

Sheaves B, Holmes EA, Rek S, Taylor KM, Nickless A, Waite F, Germain A, Espie CA, Harrison PJ, Foster R, Freeman D (2019). Cognitive Behavioural Therapy for Nightmares for Patients with Persecutory Delusions (Nites): An Assessor-Blind, Pilot Randomized Controlled Trial. Canadian Journal of Psychiatry

Sheaves B, Onwumere J, Keen N, Stahl D, Kuipers E (2015). Nightmares in patients with psychosis: the relation with sleep, psychotic, affective and cognitive symptoms. Canadian Journal of Psychiatry 60, 354–361.

3)         Body image concerns in psychosis: ‘the voices tell me that I am ugly’.

Presentation outline:

Given the high rates of obesity in patients with psychosis, body image concerns are a common clinical problem. They are distressing and may fuel other mental health problems. For example, persecutory delusions, and auditory hallucinations or voices, ‘thrive’ on feelings of vulnerability that arise from a negative self-concept. Body image may be one source of vulnerability. Yet they are often overlooked in clinical practice. In this session, we will learn from patient accounts, consider the interaction of body image concerns with psychotic experiences, and identify strategies for clinical practice.

Presenter:

Felicity Waite is the deputy lead of the Oxford Cognitive Approaches to Psychosis (O-CAP) clinical research group. She is the Lead Clinical Psychologist and Trial Coordinator of the Feeling Safe Study, a trial of a novel psychological intervention for overcoming persecutory delusions. Felicity has previously worked on a number of trials developing and evaluating Cognitive Behavioural Therapy (CBT) for distressing psychotic experiences. Key targets of treatment have included sleep disturbance and self-confidence.

Papers:

Waite, F., et al. (2019). The comments of voices on the appearance of patients with psychosis: ‘the voices tell me that I am ugly.’ BJPsych Open, 5(5), e86.

Marshall, E., Freeman, D., & Waite. F. (2019). The experience of body image concerns in patients with persecutory delusions: ‘People don’t want to sit next to me’. Psychology and Psychotherapy: Theory, Research and Practice.

Waite, F., & Freeman, D. (2017). Body image and  paranoia. Psychiatry Research. 258:136-140.

4)         Increasing physical activity for people who have experienced psychosis

Presentation outline:

The presentation will highlight the discrepancy in physical activity amongst people with psychosis and those in the general population. The importance of this discrepancy will be explored, primarily in the context of poor physical health and premature mortality. Previous attempts to address this will be presented, highlighting the need for new solutions. Potential solutions to tackle this problem will be presented, including the use of CBT techniques to increase physical activity. The presentation will include experiential elements and time for discussion around the issues arising, including how these may be applied to clinical practice by attendees.

Presenter:

Rowan Diamond trained as a Clinical Psychologist in Oxford. She specialises in working with people with distressing psychotic experiences and in addition to many years working within NHS settings,  has spent four years working on the Feeling Safe research study. This is a research trial of a novel psychological intervention for overcoming persecutory delusions within the Oxford Cognitive Approaches to Psychosis (OCAP) research group at the University of Oxford. Rowan has provided supervision and teaching to a wide range of professionals in both the NHS and the Third Sector, including supervising on the PG Cert in Enhanced CBT: Psychosis and Bipolar. Rowan’s research interest is in applying psychological techniques to address the poor health of people with severe mental health problems, particularly through increasing physical activity.

DAY 3

Formulation Skills in CBT for Psychosis

Presentation outline:

All cognitive therapists know the importance of developing a good formulation to inform treatment. Developing one in practice however may not feel quite so straightforward! This can be especially true in CBTp, where the array of CBTp models available and complexity of the presenting difficulties can leave therapists feeling overwhelmed and uncertain of what to do.

This workshop will enable participants to refine their skills in this field. We will  cover several key models of CBTp and develop the skill to “draw” on these models, but whilst developing a simple and useful formulation to guide treatment. We will consider the implications for assessment, and practice using assessment skills to elicit a collaborative formulation with a patient. There will be the opportunity to think about participant’s own cases and to practice developing formulation skills further with these in mind. The presenter will use role play, video examples, and case studies, and participants will observe and practice skills.

Presenter:

Dr Louise Isham is a consultant clinical psychologist and NIHR clinical doctoral research fellow. She works part time for the Oxford Cognitive Therapy Centre (OCTC) where she is the course lead for the PGCert in Enhanced CBT (Psychosis and Bipolar) and provides specialist supervision and training in CBTp. She also works within the Oxford Cognitive Approaches to Psychosis (OCAP) research group, lead by Professor Daniel Freeman at the University of Oxford. She has worked as a trial therapist on studies evaluating treatments of sleep and worry in patients with persecutory delusions, and is currently undertaking a 5 year program of research to develop the psychological understanding and treatment of harmful grandiose delusions.

Paper:

Johns, L., Isham, L., & Manser, R. (2020). Cognitive behavioural therapies for psychosis. In A Clinical Introduction to Psychosis (pp. 343-377). Academic Press.

Presenters

Andrew Gumley

Andrew is a Chartered Clinical Psychologist and Professor of Psychological Therapy in the University of Glasgow Institute of Health and Wellbeing. He is also Honorary Consultant Clinical Psychologist in NHS Greater Glasgow & Clyde. Andrew’s research encompasses biological, social and psychological mechanisms of transition to psychosis and relapse in those with established psychosis. His research includes development of psychological and digital therapies to promote recovery and wellbeing amongst people with experiences of psychosis.

Bryony Sheaves

Bryony Sheaves is a Research Clinical Psychologist working in the Oxford Cognitive Approaches to Psychosis research group and Oxford Sleep and Circadian Neuroscience Institute. She is currently co-ordinating a series of three trials aiming to gain a better understanding of the association between sleep and psychosis, and further the development of cognitive behavioural therapy (CBT) for sleep difficulties in this group.  Bryony is lead clinical psychologist for the Sleep Study, a pilot RCT of CBT for insomnia designed specifically for psychiatric inpatients.  She is the trial therapist for the Nightmare Intervention Study (NIteS), a pilot RCT of CBT targeting nightmares, for people experiencing persecutory delusions and also co-ordinates the OASIS study, a RCT recruiting over 3,000 university students to test the effects of CBT for insomnia on paranoid thoughts and hallucinatory experiences.  Bryony is an honorary clinical psychologist within Oxford Health NHS Foundation Trust and an HCPC registered Clinical Psychologist.

Daniel Freeman

Daniel Freeman is a Professor of Clinical Psychology, a Medical Research Council (MRC) Senior Clinical Fellow, and a British Psychological Society Fellow, in the Department of Psychiatry at the University of Oxford. He is also a consultant clinical psychologist in Oxford Health NHS Foundation Trust and a Fellow of University College Oxford. He has published extensively on the psychological understanding and treatment of persecutory delusions, and is the lead author of several books including Overcoming Paranoid and Suspicious Thoughts (2006), Paranoia: the 21st Century Fear (2008), Know Your Mind (2009), You Can Be Happy (2012), How to Keep Calm and Carry On (2013) and The Stressed Sex (2013).

Emma Černis

Emma Černis is a Wellcome Trust Clinical Doctoral Fellow and Clinical Psychologist working in the Oxford Cognitive Approaches to Psychosis (O-CAP) research group. Emma’s research focuses on improving clinical understanding of dissociative experiences arising in the context of non-affective psychosis. She has previously worked on several clinical trials of CBT for persecutory delusions, including the Worry Intervention Trial, SlowMo and Feeling Safe. Emma is an honorary clinical psychologist in the NHS Oxford Early Intervention for Psychosis team and an HCPC registered Clinical Psychologist.

Felicity Waite

Felicity Waite is the Lead Clinical Psychologist and Trial Coordinator of the Feeling Safe Study, within the Oxford Cognitive Approaches to Psychosis (O-CAP) clinical research group. The Feeling Safe Study is a trial of a novel psychological intervention for overcoming persecutory delusions. Felicity has previously worked on a number of trials developing and evaluating Cognitive Behavioural Therapy (CBT) for distressing psychotic experiences. Key targets of treatment have included sleep disturbance and self-confidence.

Louise Isham, Consultant Clinical Psychologist

Louise Isham is a consultant clinical psychologist and NIHR clinical doctoral research fellow. She works part time for the Oxford Cognitive Therapy Centre where she is the course lead for the PGCert in Enhanced CBT (Psychosis and Bipolar) and provides specialist supervision and training in CBTp. She also works within the Oxford Cognitive Approaches to Psychosis (OCAP) research group, lead by Professor Daniel Freeman. She has worked as a trial therapist on studies treating sleep and worry in patients with persecutory delusions, and is currently undertaking a 5 year program of research to develop the psychological understanding and treatment of harmful grandiose delusions.

Rory Byrne

Dr Rory Byrne received CBTp while considered to be at risk of developing psychosis, and later went on to work with one of the leading CBTp research teams in the UK, under Prof Tony Morrison in Manchester. Rory has concentrated on evaluating the lived experiences, views, and priorities of people with psychosis-spectrum difficulties, with a particular emphasis on experiences of CBTp.

Rowan Diamond

Rowan Diamond trained as a Clinical Psychologist in Oxford. She specialises in working with people with distressing psychotic experiences and in addition to many years working within NHS settings,  has spent four years working on the Feeling Safe research study. This is a research trial of a novel psychological intervention for overcoming persecutory delusions within the Oxford Cognitive Approaches to Psychosis (OCAP) research group at the University of Oxford. Rowan has provided supervision and teaching to a wide range of professionals in both the NHS and the Third Sector, including supervising on the PG Cert in Enhanced CBT: Psychosis and Bipolar. Rowan’s research interest is in applying psychological techniques to address the poor health of people with severe mental health problems, particularly through increasing physical activity.

Additional Information

Cancellation & changes policy

If you cancel more than 14 days prior to your booked event, we will refund your fee minus a charge of 15% to cover our administration costs. We regret that cancellations 14 days or less before the booked event cannot be refunded or changed/transferred.

If you wish to change/transfer your booking after confirmation we will do our best to accommodate you if you notify us 14 days prior to your booked event, and if there is space to do so. However there will be an administration charge of £15 per change/transfer.

Confidentiality

Workshops often contain clinical material. This is always anonymised as far as possible but delegates are none the less reminded to respect confidentiality.

All that is discussed in your therapy sessions will be treated as confidential, with the following exceptions.
We are required to seek supervision by our professional body (The British Psychological Society or equivalent) as a means of ensuring good practice. We will usually inform your referrer of your progress, but the details that we disclose will be discussed with you. We do have a statutory obligation to break confidentiality under rare circumstances, namely, if we believe that a client is of danger to themselves or to others (under the Mental Health Act, 2001) or if we believe that a child is at actual risk of physical or sexual abuse (The Children Act, Section 47, 1989).

If we felt that it would be helpful to request additional medical, social or legal information, we could only do this with your consent. Similarly, should another medical, social or legal professional request information from us, we would not release this without your consent.

Disclaimer

OCTC makes every effort to ensure that this programme is delivered as advertised. However, should a presenter have to cancel, we will endeavour to find another suitable presenter. We will inform attendees as soon as is reasonably practical and, if requested, will offer a refund. In the rare event that we are unable to substitute a presenter, we may cancel a workshop and refund payments already made by attendees. OCTC will not refund travel and accommodation costs that attendees may incur.
All the workshops in this programme are carried out by highly experienced therapists and trainers. The individual presenter is responsible for the content of the workshop and any views expressed do not necessarily represent those of OCTC.
Although highly informative, none of the open workshops or workshop series confer a formal qualification or assurance of competence in CBT (or a specialist area of CBT) since we are unable to assess attendee competency within the training event. However, credit and award-bearing courses that lead to formal qualifications are offered by OCTC in conjunction with the University of Oxford. More about these courses is available on our website www.octc.uk

Levels of competence

Before booking a place on a workshop, please ensure that it is pitched at the appropriate level of competence for you. The guide to levels is as follows:

Basic

Basic workshops are for people from a variety of backgrounds, who have at least one year’s clinical experience. Cognitive behavioural knowledge is not necessary for attendance at these workshops, though in practice, a number of attendees will have some skills in the area, and are refreshing/updating their knowledge.

Intermediate

Intermediate workshops are directed towards people who already have knowledge of CBT, and experience in using cognitive formulations and treatment methods – for instance, they are able to identify and test automatic thoughts, and design behavioural experiments. Most participants will be using CBT as part of their clinical practice, and may still be acquiring new CBT skills.

Advanced

Advanced courses are directed towards those professionals who use CBT routinely as part of their clinical practice. They have probably undertaken a significant number of training courses and/or workshops, and use a broad range of cognitive behavioural strategies to work with a range of presentations at varying levels of complexity.

Making reservations

Bookings can only be considered confirmed after we have received your online registration or application form and payment (or invoicing details, including an official purchase order document). Please note that registration to workshops closes 7 days prior to the event date.

If you are booking a workshop place for someone else, you must complete your own details in the billing field, but ENTER THE WORKSHOP PARTICIPANTS NAME/ADDRESS in the shipping field. If you wish to order items using a paper order form instead of online, you can view or download an order form in Adobe Acrobat (PDF) format. Once downloaded, print it out, fill it in, and send off with your payment [cheque made payable to OXFORD HEALTH NHS FOUNDATION TRUST] to the address on the form.

Refreshments

The cost of the workshops includes hot drinks on arrival, mid-morning and mid-afternoon, but not usually lunch unless stated. However, for workshops that do include lunch, if you have any special dietary requirements please let us know at the time of application.

Special needs

We welcome applications from diverse backgrounds. If you have any particular needs, please contact us
prior to booking.