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"Therapeutic alliance ruptures": common, very challenging & a key area for increasing therapist (and personal) helpfulness

Originally added on 10th July 2013
Last updated on 12th October 2015

We had another of our small peer Emotion-Focused Therapy supervision/practice groups yesterday evening.  Half a dozen of us were able to make it.  We'd agreed we would look particularly at "therapeutic alliance ruptures" at this meeting.  As a doctor, I can't help finding the term "alliance rupture" rather giggle-inducing.  I have all kinds of pictures of unwanted extrusions, metaphorical trusses and possibly extreme interpersonal surgical cures. 

Achieving Clinical Excellence meeting in Amsterdam: second day (2nd post)

Originally added on 6th June 2013
Last updated on 30th June 2015

Yesterday was my second full day here in Amsterdam at the "Achieving Clinical Excellence" conference put on by the International Center for Clinical Excellence.  The first full day had been a workshop with Scott Miller on "Feedback informed treatment: pushing your clinical effectiveness to the next level".  This second day was the start of the conference proper and was entitled "Excellence: what do we know and what can we learn?".   I walked in from my hotel thinking that I'd be hard pushed to come up with a day of lectures that would interest me more than this exploration of what makes for clinical excellence.

Achieving Clinical Excellence meeting in Amsterdam: first day workshop (1st post)

Originally added on 5th June 2013
Last updated on 20th June 2013

On Wednesday evening I flew into Amsterdam Schiphol airport for three days of workshop & conference on feedback systems & the development of excellence in psychotherapy.  What a fascinating subject area to explore.  What a treat.  From the airport I caught a train to Amsterdam Zuid and then walked up through the sunny streets to my hotel.  They were short of rooms and upgraded me to the 6th floor ... two walls of windows and a view to die for.  A good start!

Emotion-focused and narrative therapies

Originally added on 3rd June 2013
Last updated on 5th June 2013

"Those who do not have the power over the story that dominates their lives - the power to retell it, reexperience it, deconstruct it, joke about it, and change it as times change - truly are powerless because they cannot think new thoughts."   Salman Rushdie 

Effective weight loss: a wake-up call and a personal story

Originally added on 31st May 2013
Last updated on 9th October 2017

I was talking to an old friend recently and I remarked on how well he was looking.  He said he had lost two stone in weight and his waist circumference had gone down from 42 to 34 inches.  Wow!  I was very interested to hear how he had done it and he very kindly agreed to write his story:  

A Wake-up Call 

Salman Rushdie "Those who do not have the power over the story that dominates their lives - the power to retell it, re-experience it, deconstruct it, joke about it, and change it as times change - truly are powerless because they cannot think new thoughts."

New NICE guidance on the recognition, assessment and treatment of social anxiety disorder (2nd post)

Originally added on 30th May 2013
Last updated on 14th June 2013

I wrote an initial blog post yesterday on this month's new NICE guideline on "Social anxiety disorder: recognition, assessment and treatment".  In today's post I would like to focus more on the guideline's very interesting treatment recommendations. 

Fascinatingly this NICE guidance comes down fair & square on the side of one-to-one cognitive therapy as the first line treatment for social anxiety disorder.  So the authors write:

1.3.2 Offer adults with social anxiety disorder individual cognitive behavioural therapy (CBT) that has been specifically developed to treat social anxiety disorder (based on the Clark and Wells model or the Heimberg model; see recommendations 1.3.13 and 1.3.14).

New NICE guidance on the recognition, assessment and treatment of social anxiety disorder (1st post)

Originally added on 29th May 2013
Last updated on 3rd June 2015

The National Institute for Health and Clinical Excellence (NICE) have just published their new evidence-based clinical guideline on "Social anxiety disorder: recognition, assessment and treatment".  They state: "This clinical guideline offers evidence-based advice on the recognition, assessment and treatment of social anxiety disorder in children and young people (from school age to 17 years) and adults (aged 18 years and older).

New NICE guidance on promoting physical activity using brief advice

Originally added on 15th May 2013
Last updated on 11th June 2013

This month the National Institute for Health and Clinical Excellence (NICE) published their new evidence-based clinical guideline on "Physical advice: brief advice for adults in primary care".  NICE state "The guidance is for ... anyone ... whose remit includes offering lifestyle advice. Examples include: exercise professionals, GPs, health trainers, health visitors, mental health professionals, midwives, pharmacists, practice nurses, physiotherapists.  It may also be of interest to others with a role in encouraging physical activity and members of the public."