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BABCP spring meeting: Nick Grey on memory-focused approaches in cognitive therapy for adults with PTSD - introduction (1st post)

I've just arrived from Scotland off the sleeper for the two days of the British Association for Behavioural and Cognitive Psychotherapies (BABCP) Spring Workshops and Conference. Today it's workshops and we have a choice of five. I'm going to Nick Grey's on "Memory-focused approaches in cognitive therapy for adults with PTSD" . The publicity reads:

"Guidelines from around the world for the treatment of PTSD in adults recommend trauma-focused CBT as a first line treatment. In essence ‘trauma-focused’ means placing an emphasis on discussing the details of the traumatic memories. This can be emotionally demanding for both patient and therapist. Despite the treatment guidelines many therapists still do not use ‘trauma-focused’, i.e. memory-focused, approaches.

This workshop demonstrates the range of memory-focused approaches used in Cognitive Therapy for PTSD, the treatment based on Ehlers and Clark’s (2000) cognitive model for PTSD. These memory-focused techniques include reliving/exposure, written narratives, stimulus discrimination, and site visits. The obstacles that both patients and therapists present to using these highly effective techniques will be addressed. The timing of such techniques within an overall treatment programme will be discussed.

Learning objectives:
To be aware of the range of memory-focused techniques including reliving/exposure, written narratives, stimulus discrimination, and site visits.
How to choose which approach to adopt at which time.
How to integrate memory-focused approaches in a course of treatment.

Implications for the science and practice of CBT:
Participants should be more confident in trying to use memory focused techniques in treatment of adults with PTSD. Patients will receive the treatment approaches with the best evidence for their effectiveness.

Nick Grey is a Consultant Clinical Psychologist at, and Joint Clinical Director of, the Centre for Anxiety Disorders and Trauma (CADAT), South London & Maudsley NHS Foundation Trust, and Institute of Psychiatry, King’s College London. His clinical work is providing outpatient cognitive therapy to people with a variety of anxiety disorders and PTSD, both within randomized controlled trials and in a more general NHS service. CADAT forms part of three local IAPT services and also offers a national service (www.national.slam.nhs.uk/cadat). He is a BABCP accredited practitioner, supervisor and trainer.

Ehlers, A. & Clark, D.M. (2000).  "A cognitive model of post-traumatic stress disorder."  Behaviour Research & Therapy, 38, 319-345.
Ehlers, A., Clark, D.M., Hackmann, A., McManus, F., & Fennell, M. (2005).  "Cognitive therapy for posttraumatic stress disorder: development and evaluation."  Behaviour Research and Therapy, 43, 413-431.
Grey, N. (Ed.) (2009).  "A casebook of cognitive therapy for traumatic stress reactions."  Hove: Routledge."

Now, I've been to workshops with Nick and his colleague Anke Ehlers in the past.  I'm pretty familiar with this particular treatment model for PTSD.  So what are my personal learning objectives for the day?  Primarily I'm here because working with traumatic memories is a significant slice of what I do and it can be a very worthwhile pleasure to get a refresher day with a world expert. 

And what about particular current areas of personal interest?  Well, I was attracted by the "memory-focused" emphasis in the workshop title.  Research on memory is moving forward all the time and I wonder if the Nick/Anke PTSD treatment model has evolved at all with these emerging understandings.  I'm also aware of the debate between Anke Ehlers and Bruce Wampold et al on whether trauma-focused CBT for PTSD is really such a front runner evidence-based choice as we have tended to think.  I'm interested too in how narrative therapy approaches overlap with and can inform & be informed by trauma-focused cognitive therapy.  What fun!  I'm looking forward to today's workshop.  For more on how it went, see tomorrow's post "BABCP spring meeting: Nick Grey on memory-focused approaches ... treatment structure (2nd post)".

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