Audience:

• Individual or 

• Couples

Types of Therapy:

 

Acceptance & Commitment Therapy (ACT)

Act explores psychological rigidity such as a focus on past or future, lack of direction, feeling stuck and being inactive, seeing oneself as part of the problem, letting one's thoughts and feelings govern one's life, and experiential avoidance –– to a more flexible view of the world. ACT was created by professor and clinical psychologist Steven Hayes and associates, it uses a model that challenges the psychological rigidity present in most of us to some degree. The issue is when these inflexible psychological states of mind affect our life in such a way that it gets in the way of what is important to us, and that is: what we value, and we end up with feelings of depression or anxiety. ACT teaches us skills that enhance psychological flexibility. These skills, being present in the moment, doing the things we value despite our thoughts and feelings, seeing ourselves in context (within a given situation) and not as the problem, acceptance of our thoughts and feelings, and letting go of unhelpful thoughts and feelings. The aim of ACT is to live a live worth living, one that is in line with what we value.

Helpful With:

• Daily stressors

• Excessive worry

• Depression & Anxiety

• Addiction

• Grief & Loss

• Trauma

Cognitive Behaviour Therapy (CBT)

The pioneers in the development of CBT were clinical psychologist Albert Ellis and psychiatrist Aaron Beck. In the early sixties Ellis started to focus on the role of thoughts  and beliefs in causing psychological problems. He believed that people often upset themselves by thinking negatively, and that a lot of psychological problems can be resolved by teaching people to think in a more realistic way. Aaron Beck also made contributions on the causes and treatment of depression. He noted that depressed people have a tendency towards distorted or sometimes considered irrational thinking patterns. These patterns are what he labelled schemas – core beliefs (also defined as life traps) that negatively affect our perceptions and interpretations of situations. Schemas are shortcuts used in order to make sense of experiences. Negative schemas like: ‘I am no good’, ‘people are untrustworthy’, ‘I will always be alone’ or ‘the world is unsafe’ can lead to thinking errors and contribute to depression and other mental health issues. Our thoughts can influence the way we feel and in turn, the way we behave. Our thoughts and beliefs can be helpful in inspiring us to do things that are important, such as visiting a friend, going to the gym and or reading a book we like. On the down side, thoughts/beliefs can lead to undesirable behaviours such as neglecting to attend to our activities of daily living, procrastination, and or aggression. To revise, thoughts and beliefs give rise to helpful or unhelpful behaviour. Therefore, CBT teaches us skills to be able to change these negative and sometimes irrational thoughts and beliefs to be more realistic which in turn will positively change our behaviour to be more in line with doing things that are important to us (things we value).

Helpful with:

 

• Depression & Anxiety

• Trauma

• Social Anxiety

• Specific Phobia

• Panic Disorder

 

Dialectical Behaviour Therapy (DBT)

DBT was created by psychologist Dr Marsha Linehan which teaches self regulation techniques for emotion regulation, distress tolerance and interpersonal conflict. DBT is divided into three main modules: emotion regulation, distress tolerance, and interpersonal effectiveness and one core module: mindfulness skills. Mindfulness skills are taught to increase awareness and pay attention in the present moment, using techniques derived from meditation. Emotional Regulation skills help reduce impulsive actions in response to the experience of negative emotions through the use of identification, awareness and acceptance of emotion. The Distress Tolerance module teaches skills to be able to tolerate distressing feelings in order to circumvent impulsive behaviour. Finally, the interpersonal effectiveness module teaches skills in interpersonal problem-solving and assertiveness. At Carol Manns Psychological Consulting, an abridged version of the DBT program is offered (as the DBT program involves intensive therapy 2 hours of group skills training and 1 hour of individual therapy per week) while waiting to join a group DBT program in the community. 

 

Helpful with:

• Personality Disorders

• Processing complex trauma

• Depression & Anxiety

• Emotion dysregulation 

• Interpersonal Conflict

 
 Schema Focused Therapy (SFT)
Schema Focused Therapy (a form of therapy that involves a combination of cognitive behavioural therapy and elements from other types of therapy) was created by Jeffrey Young and associates.  Schema therapy is not only targeted at resolving the current problems the individual is experiencing but also at assessing the individual’s past and the sources of these problems. Schemas emerge from unmet core emotional needs early in life. Because schemas maintain and perpetuate themselves, they continue to prevent the same needs from being met in adulthood. 18 early maladaptive schemas (Life traps) have been identified. They have been classified according to five domains of unmet core needs to which they are most strongly related. The domains aid in organising the unmet needs. Schema therapy increases awareness about which maladaptive schemas are triggered in certain situations, the different defences that are triggered as a result (counterattack, surrender, or avoidance), and how to reframe the thoughts and feelings associated to schema driven thought and behaviour.
 
Domain 1: Disconnection and Rejection.
The need for a safe, secure, nurturing and stable environment that is empathic and respectful of each others needs is not met. Early family environment is cold, rejecting, detached, or unpredictable and or abusive. Five schemas are tied to this domain:
1.  Abandonment, 2.  Mistrust/Abuse, 3.  Emotional Deprivation, 4.  Defectiveness/Shame, 5.  Social Isolation/Alienation
 Domain 2: Impaired Autonomy and Performance.
 The needs for autonomy and competence are not met. The lack of autonomy and competence in the early environment can lead to the perception that they can not live and or function independently. Schemas in this domain often result from a family environment that does not foster independent thought, where parents are too involved (overprotective) affecting the child’s confidence to act on their own.  Four schemas are tied to this domain:
 
6.   Dependence/Incompetence, 7.   Vulnerability, 8.  Enmeshment/Undeveloped Self, 9.   Failure
 
 
Domain 3: Impaired Limits. 

Internal limits affecting responsible behaviour towards self and others is impaired. Schemas developed from impaired limits can lead to difficulties in respecting the rights and or needs of others, interpersonal conflict, as well as lacking the ability to set realistic and or achievable personal goals. The early environment is characterised by a lack of direction or a sense of superiority, whereby there is a lack in discipline or boundary setting, or the child is overly protected from experiencing normal levels of discomfort and little guidance is given in regards to appropriate behaviour. Two schemas are tied to this domain:
 
10.   Entitlement/Grandiosity, 11.   Insufficient Self-Control/Self – discipline
 
 
Domain 4: Other - Directedness. 
The need for self-directness is not met. Therefore the individual tends to focus on the needs, feeling  and desires of others over their own. Often these schemas emerge from an early environment of conditional love and acceptance, where they had to hide aspects of themselves in order to gain attention, love or approval from a parent. The parent's emotional needs and desires or 'social acceptance and status' were considered more important than that of the Childs. Three schemas are tied to this domain:
 
12. Subjugation, 13.   Self-Sacrifice, 14. Approval seeking / Recognition seeking
 
 Domain 5: Overvigilence and Inhibition. 
The need for spontaneity and playfulness are not met. Therefore the expression of spontaneous feelings or impulses are shut down for fear of reprisal. The early environment was often critical, demanding and or punitive due to pessimism and worry that something would go wrong if not careful.  In these type of families certain rules and obligations  override the need for pleasure, relaxation, or playfulness. Whereby, children were expected to hide emotions, avoid mistakes, and strive for perfection. Four schemas are tied to this domain:

15.   Negativity/Pessimism, 16.  Emotional Inhibition, 17.   Unrelenting Standards, 18. Punitiveness

Helpful with:

 

• Processing Complex Trauma 

• Personality Disorders

Art Therapy

Using an eclectic approach utilising all the different cognitive behavioural approaches (mentioned above) and combining them with visual art therapy techniques help people with language or communication difficulties express their feelings and facilitate change in thinking and behaviour.

Helpful for:

• Individuals with Autism Spectrum Disorders

• Individuals with Intellectual Disabilities

• Individuals with Personality Disorders

• Individuals with Post Traumatic Stress Disorder or experiencing trauma

• Individuals with or without an artistic flair

 

Sleep Psychology

Sleep problems are an extremely common presentation in psychology and general medicine. Co-existing depression and anxiety are usually observed with sleep problems, but not always. CBT approaches help put your sleep patterns back on track without the need for medication. Also, if you notice that you have excessive sleepiness during the day, do not feel rested upon awakening or you have been diagnosed with Obstructive Sleep Apnea (OSA) and are having difficulties with using your CPAP machine, a thorough sleep assessment and CBT is recommended. 
 
As everyone is different, often an eclectic approach borrowing from all the different therapies is tailored to meet each individual's needs.

Helpful with:

• Insomnia

• Hypersomnia

• Sleep Apnea

• Sleep/Wake cycle disturbance