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CBT therapy in Dublin?

  • 15-03-2006 12:26pm
    #1
    Registered Users Posts: 10,846 ✭✭✭✭


    I am looking for a CBT therapist in Dublin - preferably in the city centre.
    Anyone here got any recommendations? Would rather go on a recommendation than pick someone out of the golden pages and end up with a pointless waste of time :-(

    Also, what sort of rates can I expect to pay?


Comments

  • Registered Users Posts: 10,846 ✭✭✭✭eth0_


    Never mind, the ones I spoke to in Dublin told me there's an 11 month waiting list, even as a private patient.

    Typical Ireland.


  • Registered Users Posts: 4,882 ✭✭✭JuliusCaesar


    did you try: www.babcp.com? Did you try the Irish Council for Psychotherapy website? Did you try the HSE?


  • Registered Users Posts: 5,856 ✭✭✭Valmont


    eth0_ wrote:
    Never mind, the ones I spoke to in Dublin told me there's an 11 month waiting list, even as a private patient.

    Typical Ireland.

    I remember reading in the paper a while back that there isn't enough psychology graduates pursuing careers in this area, thus the severe shortage of cognitive behavioural therapists.

    Mind you, I'm studying psychology and I don't quite know what a cognitive behavioural therapist does!
    :o


  • Registered Users Posts: 345 ✭✭Gibs


    I would be quite cautious about attending someone whose qualification is a "CBT therapist/counsellor". Depending on the type and severity of difficulty you need addressed, you should really seek out a fully qualified clinical or counselling psychologist. These are professionally trained people who will have completed usually between 6 and 9 years of training in psychology and who can draw on a variety of therapeutic intervention strategies and styles of working that are designed to meet the needs of their clients. CBT suits some people very well but there are many other therapeutic approaches that might be a better fit depending on the person and the difficulties being experienced.

    There are a lot of people out there who are working as counsellors and "CBT therapists" who have extremely limited training and expertise. They tend to use a cookbook approach and mistakenly believe that CBT is something you can deliver effectively by just atttending a CBT course that provides the basic format for this type of therapy. Unfortunately, there is minimal regulation at the moment to curb this kind of thing (although it is coming soon). In fact, you could open an office tomorrow and put a plate outside your door and call yourself a psychologist or a CBT therapist or a counsellor or basically any variation thereof and start seeing people and 'treating' them. There is absolutely no regulation of any of these titles at present. Anyone can be a psychologist ;)

    If you need to see someone reputable who can work effectively with you using a therapeutic modality that fits with you and can help you to resove your difficulties in a way that is respectful of your world view, a good place to start is with the PSI, (the psychology society of Ireland). They may be able to direct you to a qualified clincial or counselling psychologist who can help you. Their website is at:

    http://www.psihq.ie/

    You should also remember that CBT is the current a la mode therapy, primarily because it is amenable to being researched in a readily quantifiable way and can therefore be shown to be effective. However, there are many criticisms of CBT that appear to have some validity including its tendency to be simplistic/overly reductionistic and its lack of emphasis on context, environment and emotion. Other forms of therapy can offer different perspectives and ways of understanding one's difficulties. A 'CBT therapist' is basically a one-trick pony. A fully qualified clinical or counselling psychologist can draw on a variety of theoretical perspectives that fit with their clients' needs.

    If you find a clinical or counselling psychologist, make sure you ask them about their training and qualifications. Anyone appropriately qualified should be happy to explain their background and way of working and will not be offended in the slightest, as they will be glad that you are seeking the best and most suitable standard of care for your difficulties. Most if not all will probably be members of PSI or the BPS (British Psychological Society) and they should have:
    1. an undergraduate bachelor's degree in psychology AND
    2. either a master's/doctoral degree in counselling psychology OR
    a master's/doctoral degree in clinical psychology OR
    a PSI diploma in clinical psychology.

    The only other possibility is that if they have been practicing for many years, their qualification may predate the introduction of the master's and docatoral degree programmes. These people will usually have a H.Dip. Psych from either UCD, UCC or Trinity and will have been practicing for at least a decade if not more.

    Be carefull about attending people who tell you they have done lots of counselling/psychotherapy/CBT courses and who don't have post-graduate (or undergraduate) qualifications in psychology. As I said, the field is unregulated in Ireland and even when the regulation kicks in later this year, the word "psychologist" is not going to be protected the way that, say, "Doctor" is.

    If you do attend a counsellor, at least make sure that they are IACT accredited (NB - Full Members!), but I would recommend that you only do this if you can't find a clincial or counselling psychologist. There is a reason it takes the best part of a decade to become properly qualified and it would be unwise in my opinion to ignore the difference in expertise out there and go with an unqualified person who can 'do' CBT.

    Your first port of call should probably be your G.P. who will be aware of any psychological services in your area and who can refer you in for a consulatation. If you go via the HSE (i.e Health Board/Health Service Executive) depending on where you live, it won't cost you anything although you may have to wait a while.

    Best of luck with your search.


  • Registered Users Posts: 4,882 ✭✭✭JuliusCaesar


    Gibs wrote:
    I would be quite cautious about attending someone whose qualification is a "CBT therapist/counsellor". However, there are many criticisms of CBT that appear to have some validity including its tendency to be simplistic/overly reductionistic and its lack of emphasis on context, environment and emotion. Other forms of therapy can offer different perspectives and ways of understanding one's difficulties. A 'CBT therapist' is basically a one-trick pony. A fully qualified clinical or counselling psychologist can draw on a variety of theoretical perspectives that fit with their clients' needs.
    .

    Oh dear. An accredited CBT therapist, if you look at the BABCP website, can only be so if they have a specialised qualification in CBT beyond the basic professional qualification. Ie, they have completed training as a clinical/counselling psychologist or psychiatric or mental health nurse or occupational therapist and AFTER THAT do a couple of years training PLUS 2 years supervised practice.........

    Point taken that anyone can call themselves CBT therapists in the same way as the milkman living next door is legally entitled to put up a brass plate calling himself a counsellor or psychologist - that's why I gave the professional body's website. PLUS many DClinPsychs in Ireland have inadequate CBT training.

    As for being a "one-trick pony", maybe you don't know enough about it? Even the behaviourists gave more attention to environment and other contextual factors than the analysts. See the "myths about CBT" on the website.


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  • Registered Users Posts: 345 ✭✭Gibs


    I work in adult mental health last 20 (b@$%* h*ll, didn't realise it was so long) years. Cognitive behavioural orientation.

    Yikes!! - I think I touched a nerve. Given the above, it's no surprise why:D

    Before we get any further off on the wrong foot, I actually mostly agree with what you said Julius. Although, I'm not quite sure what you mean by this:
    As for being a "one-trick pony", maybe you don't know enough about it? Even the behaviourists gave more attention to environment and other contextual factors than the analysts. See the "myths about CBT" on the website.

    My intention was only to try to steer the original poster away from people who are unregistered, unregulated and under-qualified. I obviously fully accept the legitimacy of therapists registered with the BABCP. The difficulty with all of this stuff and the main reason I posted such a lengthy reply, is that while you are obviously extremely familiar with accrediting bodies both here and in the U.K., most people who don't work in the profession are not. (Also, perhaps I misunderstood you, but if you are implying form the above quote that I might have av affiliation with analysis, I can assure you that is not the case. I work as a clinical psychologist and am a fully paid-up member of the scientist-practitioner model:D )

    The typical person looking for a therapeutic intervention, who may have read about or heard about CBT, is unlikely to know that the BABCP is one of the best places to get information from regarding who might be a suitable therapist for them. In fairness, you yourself didn't give any more information other than a web address about why the BABCP is a good information source until you replied to my post. Perhaps the exchange here has thrown light on why one needs to be informed about making such an important decision as attending a therapist.

    As regards questioning whether I know enough about it, I think that was somewhat unjustified. Surely I can question the blanket application of CBT as a psychological panacea without having my understanding or knowledge of it called into question? After all, Its not a religion (is it?;) ) and every corpus of knowledge, no matter how well supported in the research, should have its tenets and theoretical framework as well as its measured outcomes questioned on an ongoing basis in order to maintain its scientific integrity.

    Also, I didn't actually say that there is anything wrong with CBT, I was referring to its use in isolation from a broader approach that views all theoretical persepectives as culturally, societally and temporally derived. Personally, I think therapy that is underpinned by both a strong therapeutic relationship and a reasonable formulation that fits with the client's worldview, rather than strict adherence to any specific therapeutic modality for its own sake, is much more defensible. The research also seems to support this notion, i.e. that therapeutic change is dependent, not so much on the particular method used, as the therapeutic relationship that exists between the client and therapist and, more importantly, on things happening outside of therapy in the person's immediate and wider environment. I can't find the article right now (its late and this is already too long!), but if memory serves, a recent metaanalysis suggested that only about 10-15% of therapuetic change is down to the therapeutic modality used. About 40% happens due to external factors and about 30% is due to the client-therapist relationship. I'll see if I can find the link another time.

    Finally, I would possibly accept that there are some clinical psychologists who may not be fully trained in the use of CBT or any of the derivatives that seem to be launched with ever-increasing regularity, but all of the ones I know are fully au fait with its use and most of them have done post doctoral qualifications to that end.

    Incidentally, the irony of all of this exchange is that I, like you, generally tend to use a Cognitive-Behavioral approach in my work with clients, so I am certainly not a major critic of its use, only its use in isolation from other, potentially helpful therapeutic approaches. We should fit ourselves and our models to the client, not the other way around. :)


  • Registered Users Posts: 5,856 ✭✭✭Valmont


    I think all undergraduate psychology students should ideally browse the psychology forum, it's full of quality information,mostly stuff that I couldn't find anywhere else!


  • Registered Users Posts: 345 ✭✭Gibs


    Here's a copy of that article that I mentioned in a previous post that details how much therapeutic change occurs as a result of the various elements involved in therapy. Makes for interesting reading;)


  • Registered Users Posts: 4,882 ✭✭✭JuliusCaesar


    Gibs wrote:
    Here's a copy of that article that I mentioned in a previous post that details how much therapeutic change occurs as a result of the various elements involved in therapy. Makes for interesting reading;)


    don't have the time or incliination to get into a debate about this, so, for anyone who's interested, some papers: have fun!

    the Dodo Hypothesis (everyone has won and all must have prizes!): http://www.srmhp.org/0101/psychotherapy-equivalence.html

    The Development of Evidence based therapies: http://www.cnsforum.com/magazine/nonpharmacological_treatment/psychotherapy/


  • Registered Users Posts: 345 ✭✭Gibs


    Thanks for the links to those articles Julius. Really interesting stuff, particularly the SRMHP article. Its a shame you don't have time to debate the issues because I think they are interesting and far from being resolved.

    Perhaps I have misunderstood you, but the fact that you suggested the 2 articles that you provided links for seems to imply that you think I see an equivalence among all forms of therapy, when that is not the case. I would respectfully point out that I didn't say in my earlier post that I thought all psychotherapies were equivalent, just that the particular method/philosophy/approach/modality that one uses may not be as important in effecting meaningful therapeutic change in distressed individuals as the other factors mentioned in the article I linked to above, such as external factors, therapeutic relationship and hope etc.

    Here is another point of view (not necessarily one I agree with, but something to stir the pot a bit more!) Its an article that was published in the Psychologist, the British Psychological Society's monthly magazine, a couple of years ago. I think it raises some interesting points, particularly about the contradiction between the messy reality of clinical practice and the rigour demanded by good quality outcome research. Maybe it's the mess that is the important thing, and not the clean bit measured in research :p.
    I don't know, but it's interesting to think about.....

    you'll have to download the article as it's in Adobe (pdf) format

    Also, here is another interesting article that looks at psychotherapy in terms of practice-based evidence, rather than evidence-based practice. Worth read, I think, even if you don't agree with it.


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  • Registered Users Posts: 4,882 ✭✭✭JuliusCaesar


    Good article in the Psychologist, thanks for bringing to my attention. Will read it properly later!

    Here's one for you: Westbrook D & Kirk J, 2005, The clinical effectiveness of CBT: outcome for a large sample of adults treated in routine practice. Behaviour Research & Therapy. 43, 10, Oct 2005, 1243-1261.

    As I work in an outpatient setting, the outcomes in routine practice tend to be what interest me more than research trials - after all my patients/clients come in with a lot of mixed problems that would exclude them from most trials. Despite my immersion in psychiatry, I do retain a great scepticism about the validity of psychiatric diagnoses - medics will be medics, but the fact is that mental problems and disorders are not analogous to physical ones where they can clearly identify the pathology. Also I do believe strongly that the therapy has to 'fit' the client; CBT is fairly adabtable but some clients are happier with a different approach, and indeed another approach may indeed be more suitable.

    There's an interesting article written by a psychoanalyst who decides to use CBT for a client with OCD: Bram A, Bjorgvinsson T. A psychodynamic clinician's foray into cBT utilizing ERP for OCD. American J of Psychotherapy 2004, 58 (3) 304-20. (Not making any point in particular! I just found it fascinating!)

    Time presses alas!


  • Registered Users Posts: 5 Paul M


    <temporarily edited, p.pete>


  • Registered Users Posts: 6 JoSoap


    <snip>. CBT is becoming an increasingly popular form of therapy as it is an empirically validated form of therapy - i.e. it's been proven to work. Good luck!


  • Registered Users Posts: 4,882 ✭✭✭JuliusCaesar


    A 4 year old thread suddenly revived? After all the advice given earlier? By a first-time poster?
    Could this possibly been an ad?? Therefore above thread edited.


  • Closed Accounts Posts: 1 A Realist


    The reality is Del Boy could create a website and call himself a CBT Therapist. And post a page of testimonials and spout forth on his expertise.

    I am a leading expert on anxiety, fully qualified, registered and insured.

    TESTIMONIALS
    Rodney -OCD/Anxiey

    Dear Del Boy, Thank you for giving me my life back with these wonderful techniqes that you thought me. I have now regained control of my life again. Thank you Del Boy

    Boycie - Low Self Esteem
    I visited so many therapists, but Del Boy you really helped me build my confidence. Thank you I will always be grateful for the wonderful CBT techniques that you thought me. Thank you Del Boy I now feel much more confident and happy.

    etc.................


  • Registered Users Posts: 6,754 ✭✭✭Odysseus


    I think the OPs issue was resolved, so I think thiss thread has run its course.


This discussion has been closed.
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