West Suffolk CBT Service Ltd

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Welcome to the West Suffolk CBT Service. We offer a dedicated out-patient clinic based in the centre of Bury St Edmunds. Within this clinic we offer the following services.

• Cognitive Behaviour Therapy
• Clinical Supervision
• Capacity assessments
• Cognitive assessments (IQ reports)
• Medico-legal work (court reports)
• Trauma-focussed CBT
• Eye Movement Desensitisation Reprocessing (EMDR)
• Parks Inner Child Therapy (for victims of sexual abuse)
• Child cognitive assessments
• Learning Disability Assessments for children and adults
• Therapy for individuals with high-functioning autism
• Workshops in CBT
• Mindfulness-based CBT
• CBT for children and adolescents

What is Cognitive Behaviour Therapy (CBT)?

Although the popular press describes CBT as a new powerful therapy is not a new approach. In fact, more accurately, it is a constellation/mixture of many ideas, some new and some others that have literally been around for centuries. CBT seeks to help you understand in a straight forward, logical way how your emotional problems have occurred and what you can do to reduce your emotional distress and suffering. For the interventions (coping strategies and other exercises) used in CBT to work successfully for you, you will need to become aware of key ideas used in a CBT approach.

Creating your own understanding (hypotheses) in CBT

A hypothesis is a prediction (or a guess) about what you think will occur based on what you think you know. Most of us create hypotheses all of the time in our daily interactions with others as we make predictions about how others may think or behave in response to what we do. For example, when I’m in my car in queuing traffic and I want to move into the next lane I know that if I put my indicator on and start edging out slightly into the next lane eventually there will be someone who is generous enough in spirit to let me move in front of them. For CBT to work effectively for you, you will be encouraged to make predictions about what makes you think, feel and behave in the way that you do.

After you have created an explanation that makes sense to you we will encourage you to put new coping strategies or psychological interventions (coping strategies that you are taught) in place. An idea behind encouraging you to try these new strategies is to help you find out if making little changes here and there produces different results for you. We can’t stress just how important it is that you give yourself the opportunity to try alternative strategies to assess what impact they have on the way that you feel. When this occurs you will have an opportunity to learn from your new experiences and have an opportunity to repeat or reuse more beneficial strategies in the future, maybe even for the rest of your life.

Scientific measurement in CBT

Strictly speaking, CBT is a scientific approach (an approach based on logical and reasoned thought) and as such it will have outcomes (results) that can be predicted and measured. It is only by measuring outcomes that we are able to ascertain (work out) if what we are doing is creating improvements for us. The number of outcome measurements can be considerable, however common measurements tend to be connected to how we feel, (e.g., the intensity of our anxiety), the rigidity of our thinking (e.g., how much we believe that something that we fear is true), and how long we spend engaging in particular mental processes, (e.g., worry). A selection of measurement tools are provided for your use within this website, within your sessions and within our books. At first sight, many interventions that we offer may appear counter-intuitive (go against what you might expect) or paradoxical. Equally, other ideas utilised may seem so obvious that you will end up kicking yourself for not working them out by yourself.

Self-observation in CBT

A fundamental aspect of CBT is self-observation. Standing back mentally and thinking about your own thinking processes will enable you to increase your awareness of your thoughts, feelings and behaviours, particularly when you are feeling distressed. Observation can assist you to become aware of the cycles that you engage in that may lead to you feeling anxious and to help you to take an exploratory approach to your problems and to your own thinking processes. When you are able to think about your thinking you will not need to be bound by the minds content and the minds automatic processes, (Ridgeway & Manning, 2008).

Relapse prevention in CBT

It could be suggested in CBT that reflecting on the processes that occur as you carry out the interventions that we offer you is fundamental. We suggest this because self-reflection (thinking about your own thinking) will improve your ability to learn, and you will continue to increase the number of neural connections (connections between brain cells that aid your thinking) in your brain. The more you use self-reflection processes and engage in new behaviours the less likely it will be that you relapse in the future.

Common types of problems that people find CBT useful for are

• Anxiety and panic attacks
• Depression
• Obsessional Compulsive Disorder
• Gereralised Anxiety Disorder
• Anger and relationship difficulties
• Personality Disorders
• Psychosis
• Trauma such as PTSD or sexual abuse
• Insomnia
• Eating Disorders
• Work related stress
• Health anxiety
• Social anxiety
• Phobias

West Suffolk CBT Service – Terms and Conditions.

Please retain a copy for your reference.

Payments to the West Suffolk CBT Service

Self funding referrals

For individuals who are self-funding, payment is usually expected directly after each session by cheque, credit or debit card. Cheques are to be made payable to the WSCBT Ltd. We do not accept payment by cash.

Self-funding fees (Dr James Manning & Dr Nicola Ridgeway) – £155.00 for an initial assessment followed by £130.00 per session thereafter.

Insurance company referrals

For individuals who have their treatment covered by a health insurance company such as BUPA and AXA PPP. Due to confidentiality issues insurance companies often do not tell us how many sessions your treatment is covered for. We therefore ask that you check first with your insurance company to see how many sessions you are funded for. This is very important, as you will be liable for any fees not paid by your insurance company. If you decide to have extra treatment sessions (i.e., more than you are covered for by your insurance company) then the same payment advice for individuals who self-fund applies.

Insurance and non-statutory fees – £155.00 for an initial assessment followed by £130.00 per session thereafter. We request a £250 deposit for those individuals whose treatment is covered by insurance. This deposit will be refunded at the end of treatment.

Statutory body referrals (e.g. the NHS)

For individuals who are referred by the NHS, the legal system, social services or rehabilitation companies you will not be involved in the administration of payments. You will not be liable for any payment withheld or not paid by your referrer. We will liaise directly with your referrer for payment.

Length of sessions

Initial assessment appointments usually take 1 hour. Sessions following this will take between 50 minutes and one hour. BUPA sessions are 1 hour for the initial assessment and 50 minutes for sessions thereafter.

Cancellations and fees

No fee will be charged if greater than 24 hours notice is given of a cancellation. We will charge you a full fee if less than 24 hours notice is given of a cancellation. (This fee can be waived at the discretion of your therapist). A full session fee will be charged if an appointment is not attended and no notice is given, as your therapist will need to be present and available to you at our offices throughout your appointment time.

Confidentiality at the West Suffolk CBT Service

Self-funding referrals

Your notes will be kept in lockable filing cabinets, within an alarmed building. No information about your treatment will be given to third parties without your prior permission (except in specific circumstances, see below). We will write to your GP to give information about your case, only if you request this. No information about your treatment will be held on NHS recording systems unless you specifically request this. The West Suffolk CBT Service follows advice as set out in the Data Protection Act. All reports or documents held on computers are password protected as are entry to computers themselves. The West Suffolk CBT Service use McAfee virus protection programs to protect data held on computers and in e-mail accounts. Generally, we make an assumption that e-mail communication is not secure, so if you wish to pass confidential information via e-mail to your therapist we suggest that you do this using a password protected document.

Circumstances where confidentiality may not apply

If it is the case that your therapist believes that the risk to yourself or others is significant in terms of a threat to your life or a threat to others life, then we may be obliged to break confidentiality and inform third parties from statutory organisations (e.g., your GP or the NHS). We will make attempts to contact you personally prior to any such information being shared.

Insurance company and statutory body referrals

For clients who are directly referred and have their treatment funded by the NHS, solicitors, social services, the American Military and rehabilitation companies’ written reports are usually expected. Your referrer will usually request your written permission for the West Suffolk CBT Service to disclose information to them. If there is any information that you wish to be kept confidential from your referrer this can be arranged via a discussion with your therapist.

Clinical supervision of therapists

All therapists within the West Suffolk CBT Service have clinical supervision. Clinical supervision is mandatory for all clinicians and your case may be discussed within clinical supervision. Any information discussed will be kept confidential and your real name will not be used. Notes from supervision consultations will be placed in your file. Therapists at the West Suffolk CBT Service meet for supervision on a bi-weekly basis. If you do not want any of your information being shared with other therapists at the West Suffolk CBT Service please let us know. We make an assumption that for husband and wife or partner/partner dyads who are receiving therapy simultaneously that information will not be shared unless this is explicitly requested by both parties.

Copies of your notes

You can request copies of your notes from sessions at any time. Photocopies of notes will be made available to you. Third party notes e.g., letters from Psychiatrists, G.P.’s or other bodies can be made available to you if you receive the consent of these third parties.

Homework and Symptom monitoring

We request that you access the three West Suffolk CBT Service websites to access psychological advice that is related to your sessions. Within this website you will find many homework tasks that we believe will benefit you between sessions (although you are under no obligation to complete homework tasks). We also request that you access symptom questionnaires related to your presenting condition and share your feedback about your symptoms at the beginning of each session with your therapist. Questionnaires can be completed on this website or we can e-mail or post you questionnaires on your request.

Parking at the West Suffolk CBT Service

Two parking spaces are available at the back of our building on Lower Baxter Street. These are offered on a first come, first served basis only. We ask that if you use the car park to attend your session that you move your car when you leave, as these spaces will be needed for other clients.

Child clients

We are happy to see children in therapy sessions accompanied by their parents, guardians, teachers or carers. On some occasions some children prefer to be seen alone. We are happy to offer children below the age of 16 sessions on their own, if parents or guardians agree to this verbally. We may not be able to share information disclosed within these sessions if a child particularly requests that we do not. This could occur in the circumstance where a therapist decides that a child has sufficient maturity and understanding to make specific decisions about whether he or she wants others to be given information about their sessions. Although children under the age of sixteen are not deemed as legally competent, rulings made in courts have determined that children can be deemed to be legally competent to make decisions about who has access to their information if they have ‘sufficient understanding and maturity to enable them to understand fully what is proposed’. This is based on a concept now known as ‘Gillick competency’ which initially arose in the case of Gillick v West Norfolk and Wisbech Health Authority in 1986. The term ‘Fraser competency’ is also used in this respect (Lord Fraser was the judge who ruled on the case). The West Suffolk CBT Service follows guidelines issued by the department of health which state that parents and guardians of children under the age of 16 should be involved about decisions about their children’s care unless there is a very good reason for them not doing so. Equally guidance suggests that if a competent child under the age of 16 is insistent that their family should not be involved in their treatment, their right to confidentiality must be respected, unless such an approach would put them at serious risk of harm. Risk of harm occurring by not sharing information will be determined by the child’s individual therapist.

We accept referrals from statutory organisations such as the NHS, Social Services, the Local Authority, and non-statutory organisations such as insurance companies (for example Bupa, Aviva, AXA PPP). We also accept direct referrals from individuals who would like to pay for an assessment and/or psychological treatment privately. If you would like an assessment with a Consultant Psychiatrist we can also arrange for assessment and treatment at our premises.

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