Dr Siobhan Blackwell
Experienced Clinical Psychologist in Guildford, Surrey
What does a clinical psychologist do?
A clinical psychologist is a mental health professional who specialises in assessing, diagnosing, and treating a wide range of psychological, emotional, and behavioural disorders. They use evidence-based psychological models with proven efficacy to help individuals improve their mental well-being and cope with various challenges.
Outlined below are the main psychological models we work in. In reality, they rarely work purely within one model, but rather will draw upon different models in a flexible way to tailor them to your unique situation.
Cognitive Behaviour Therapy (CBT)
We need skills to be connected to, but not controlled by, our emotions. In order master this we need to understand our emotions, what triggers them and how to make sense of them. We can learn how emotions drive our behaviour, both in ways that can be the source of all our potency and creativity as well as in ways that are destructive to us. Crucially, we can learn how to differentiate between these two paths so we can choose to behave effectively. Implicit in this is the importance of embracing our vulnerability, so we can function like a reed that bends in a passing storm rather than an oak tree that snaps. In so doing we will learn that pain is a part of the human condition, which if not acknowledged and accepted, simply transforms into ongoing suffering.
In CBT you will work collaboratively with your therapist to achieve the above by developing a range of skills and techniques. Once you have learnt to fluidly apply them in your everyday life they become life-long capacities that can greatly enhance your resilience. CBT has also been found to be effective in the treatment of a wide range of mental health difficulties including depression, anxiety, panic-attacks, addictions, eating disorders, obsessive compulsive disorders and post-traumatic stress disorder.
Schema-Focused Cognitive Behavioural Therapy (Schema-Focused CBT)
Sometimes we get recurrent patterns of thoughts and feelings in certain situations that are debilitating. For example, fear-based thoughts that hinder us socially, emotionally and/or professionally. When this happens, lurking beneath the surface are ingrained, tenacious beliefs that distort the way we view the world – rather like looking at ourselves (and life) through coloured lenses. The problem with these unhelpful beliefs is that they are rarely accurate, generate a great deal of unnecessary anxiety and pull us off-track. Schema focused therapy enables us understand how these beliefs operate and how to release ourselves from their iron-clad grip.
As well as uncovering unhelpful beliefs, schema focused therapy aims to replace them with helpful ones so that we can make healthier choices in life. In summary, schema-focused CBT goes beyond traditional CBT by targeting deep-seated emotional patterns and beliefs, which makes it suitable for individuals with long-standing psychological difficulties.
As well as just helping us to understand ourselves better, schema-focused CBT is particularly effective for personality disorders, chronic depression or anxiety, relationship difficulties, complex trauma and behavioural addictions.
Cognitive Analytic Therapy (CAT)
This is a hybrid model which aims to encompass the richness of psychodynamic models with the transparency of cognitive models. It is particularly effective for those of us with adverse early life experiences because it looks at how our formative years shape our development and the coping mechanisms we adopt, usually outside our conscious awareness as though they are the only choices available to us. These frequently hinder us as we move into adult life because they repeat in the form of self-sabotaging behavioural patterns, creating downward negative spirals in our lives. Insight and perspective allows us to develop a healthier relationship with ourselves as well as better boundaries with others. More importantly, it can enable us to let go negative emotions such as shame and the ‘not good enough’. With this, we can replace destructive patterns in our lives with positive, upward spirals. It differs from schema focused CBT in that it places a greater emphasis on exploring past events and the tenacious hold these have in the present.
Similar to CBT, CAT provides you with resources to to deal with your own psychological challenges in the future. It is proven to be highly effective at breaking long-standing reoccurring patterns of low mood, anxiety, chronic stress and relationship problems. It is time-limited treatment which usually lasts between 18 and 24 sessions.
Eye Movement Desensitization and Reprocessing (EMDR)
This is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. These can be very traumatic past experiences (large ‘T’ traumas) as well as current distressing situations (small ‘t’ traumas) such as panic attacks, or indeed any situations where the level of distress impacts on our ability to function effectively. The procedures and techniques that are used are specific to the EMDR model and its greatest strength is that it can be highly effective at processing emotionally distressing material far faster than traditional psychotherapy alone. It is often very effective combined with the other the other therapy models outlined in this section as it can greatly speed up the healing process.
EMDR has been proven to be effective for post-traumatic stress disorder, anxiety disorders, major depressive disorder, dissociative disorders, eating disorders, obsessional compulsive disorder, personality disorders and grief.
Dialectical Behaviour Therapy (DBT)
DBT is an evidence-based psychotherapy and a third wave version of cognitive behavioural therapy (CBT) and therefore can be viewed as CBT with some extra bells and whistles. What is unique to DBT is the concept of Wise Mind, which is that ability to handle situations effectively and make decisions that are right for us. As we settle more often into Wise Mind, we become more tolerant and more likely to accept ourselves and others, as well as less likely to judge, criticise, and reject ourselves and others. Or in Lao Tao’s words ‘To the mind that is still, the universe surrenders’.
Everyone has Wise Mind, even if we cannot access it at a particular point. When this happens, we can feel lost and out of control in our lives. DBT trains us to access Wise Mind by providing us with a variety of psychological tools that we can learn to implement fluidly in our daily lives to get us on course to where we want to be. It is a leading treatment for people who struggle with emotional instability but is an excellent model to build emotional resilience in general.
Motivational Interviewing (MI)
Effective therapy is also about timing and not everyone is ready to commit fully. MI an approach that aims to help us resolve ambivalent feelings about what we are struggling with in order to help us find the internal motivation we need to change unhelpful behaviours. It is a practical, compassionate and short-term process that takes into consideration how difficult it is to commit to and implement life changes.
MI is often used in the treatment of addiction and eating disorders. The therapy enables us to become motivated to make positive changes to the behaviours that may be preventing us from making healthier choices. It can also prepare individuals for further, more specific types of therapies.
