Therapeutic interventions and assessment

At ReNEW, our therapists take a person-centred approach to each client, and are trained  in a variety of treatments. We will pull from various models and approaches in aiming to support you to the best of our availability, and if you feel an approach doesn't fit with you or isn't working - we will work together to identify something more helpful. 

Across all of our therapy approaches, we believe strongly in the importance of the therapeutic relationship, and the principles of treating our clients with warmth, empathy, and compassion. We look at the whole person, and aim to explore and celebrate the uniqueness of you as an individual. We assume that people have free will and are motivated to achieve their potential, and deserve to live a life free from trauma, cultures of abuse and disempowerment. 

Approaches we will draw from include Systemic Therapies (including Behavioural Family Therapy: BFT, and Brief Solution-Focused Therapy: BSFT); Psychoanalytical Approaches; Cognitive Analytical Therapy (CAT)-informed approaches; Acceptance and Commitment Therapy (ACT); and Structured Clinical Management (SCM). 

Below we have some further information on Eye Movement Desensitisation Reprocessing (EMDR),  Dialectical Behavioural Therapy (DBT)/Radically Open-Dialectical Behavioural Therapy (RO-DBT), Compassion Focused Therapy (CFT), and Cognitive Behavioural Therapy (CBT) - some of our most commonly used approaches at ReNEW. If you would like further information on any of the other approaches mentioned, please get in touch via the details on our contact page.

CAT looks at the way a person thinks, feels and acts, and the events and relationships that underlie these experiences (often from childhood or earlier in life). As its name suggests, it brings together understandings from cognitive psychotherapies (such as Cognitive Behavioural Therapy) and from psychoanalytic approaches into one integrated, user-friendly and effective therapy. It is a programme of therapy that is tailored to a person’s individual needs and to their own manageable goals for change. It is a time-limited therapy - between 4 and 24 weeks, but typically 16. 

CAT is an integrative model of human development and of psychotherapy. It is a fundamentally relational model, both in its view of human development and in its practice of psychotherapy. At its heart is an empathic, respectful and collaborative, meaning-making relationship between the client and therapist within the therapeutic boundaries.

CAT tries to focus on what a person brings to the therapy (‘target problems’) and the deeper patterns of relating that underlie them. It is less concerned with traditional psychiatric symptoms, syndromes or labels. CAT has been widely used to help people who have experienced childhood physical, emotional or sexual abuse, neglect and trauma, including people who self-harm. CAT is also used with people with eating disorders, addiction problems (like drugs and alcohol), obsessional problems, anxiety, depression, phobias, psychosis and bipolar illness. CAT therapists also work with adolescents, older people and people with learning difficulties, and in

forensic settings. CAT is mostly offered to individuals, but it can also be used effectively with couples, in groups.

EMDR (Eye Movement Desensitization Reprocessing) is a psychotherapy originally aimed at reducing distress associated with traumatic memories, but more recently has been used to alleviate psychological distress associated with a range of mental health difficulties. Within the therapy clients are asked to hold in mind an image associated with the distressing thought or memory, and back and forth eye movements (or other bi-lateral stimulation) are used to support the processing of the traumatic/distressing thoughts and memories. 

There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization, and the Department of Defense.  More than 30 positive controlled outcome studies have been done on EMDR therapy.  Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90-minute sessions.  In another study, 77% of combat veterans were free of PTSD in 12 sessions.   

EMDR therapy shows that the mind can in fact heal from psychological trauma, much as the body recovers from physical trauma.  When you cut your hand, your body works to close the wound.  If a foreign object or repeated injury irritates the wound, it festers and causes pain.  Once the block is removed, healing resumes.  EMDR therapy demonstrates that a similar sequence of events occurs with mental processes.  The brain’s information processing system naturally moves toward mental health.  If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering.  Once the block is removed, healing resumes.  As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. 

In successful EMDR therapy, the meaning of painful events is transformed on an emotional level.  For instance, a survivor of sexual assault shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.”   Unlike talking therapies, which rely heavily on therapist interpretations, healing within EMDR relies less on talking and more on the individual's natural healing processes in the mind and body. 

Schema Therapy (ST) has been found to be helpful for various mental health needs; both serious and long lasting, and those which have a significant impact on the individual’s daily life. It helps people make sense of their needs, with a particular focus on feelings and instinctive ways of coping with what the world throws at them. It also helps in developing a greater understanding of how challenges have come about, along with providing the consistent emotional support and security people need to be able make any desired changes in their lives. It is a flexible therapy that can be moulded to the needs of each individual.

The main concepts in Schema Therapy are: Core Needs, Early Maladaptive Schemas and Schema Modes. We all have core emotional and physical needs. When these needs are not met, maladaptive schemas develop that lead to unhelpful life patterns. These schemas lead to certain coping styles which are ultimately self-defeating and which can keep repeating and generating negative feelings, unless we address them. Schema modes are the moment-to moment emotional states, thoughts and responses that we all experience, reflecting our underlying schemas and coping styles. Maladaptive modes are triggered by situations that we are sensitive to (our "emotional buttons") and often lead us to over or under react, in ways that are ultimately unhelpful.

 Dialectical behaviour therapy (DBT) is a type of talking therapy. It's based on CBT (see below) but is specially adapted for people who feel emotions very intensely. The aim of DBT is to help you:

• Understand and accept your difficult feelings
• Learn skills to manage them
• Become able to make positive changes in your life

This is achieved through working on four key areas: 

• Mindfulness (being able to bring your mind back to the present moment and focus on one thing at a time, without allowing judgements to distract or deter you)
• Emotion Regulation
• Distress Tolerance 
• Interpersonal Effectiveness

‘Dialectical’ means trying to understand how two things that seem opposite could both be true. For example, accepting yourself and changing your behaviour might feel contradictory. But DBT teaches that it's possible for you to achieve both these goals together.

In contrast to traditional DBT, RO-DBT (Radically Open Dialectical Behaviour Therapy) targets individuals struggling with excessive self-control, also known as being "over controlled". The core targets for RO-DBT are social signalling deficits, low openness, and aloofness. Overcontrolled individuals, those who may benefit from RO-DBT, can still suffer from suicidal and self-harm behaviors, but unlike the under controlled population, these individuals tend to plan the behavior ahead of time and keep it secret from others. For this group, the aforementioned behaviors are rule-governed and not mood dependent. In RO-DBT, the therapeutic focus is external versus internal and includes increasing social signaling, openness, and social connectedness skills. The emphasis of the treatment is on self-discovery versus impulse control. 

CFT (Compassion Focused Therapy) is a therapeutic approach aimed at promoting mental and emotional healing by encouraging people in treatment to be compassionate toward themselves and other people. 

CFT is grounded in current understanding of basic emotion regulation systems: the threat and self-protection system, the drive and excitement system, and the contentment and social safeness system. Treatment sessions highlight the association between these systems and human thought and behaviour. The aim of CFT is to bring these three affect systems into balance. 

If a threatening situation occurs, a person may experience different feelings (such as fear, anxiety or anger), and as a result of these feelings, demonstrate certain response behaviours (fight, flight, freeze), as well as developing certain cognitive biases (jumping to conclusions, catastrophic thinking,  or assuming it is always better to be safe than sorry). The drive system aims to direct individuals toward important goals and resources while building feelings of anticipation and pleasure. People with an over-stimulated drive system may show riskier behaviours such as substance use or criminality. 

The contentment system is linked with feelings of peace and happiness. These feelings are not associated with pleasure seeking, nor are they only present due to an absence of threats. Rather, this state of positive calm is typically tied to an awareness of being socially connected, cared for, and safe. This soothing system acts as a regulator for both the threat and drive systems.

The primary therapeutic technique of CFT working together to help build a tolerance for experiencing compassion, and to build different aspects of compassion for the self and others. 

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.  CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle.

CBT aims to help you deal with overwhelming problems in a more helpful way by breaking them down into smaller parts.  During the sessions, you'll work with your therapist to break down your problems into their separate parts, such as your thoughts, physical feelings, and actions. You and your therapist will analyse these areas to work out if they're unrealistic or unhelpful, and to determine the effect they have on each other and on you. Your therapist will then be able to help you work out how to change unhelpful thoughts and behaviours.

The eventual aim of therapy is to teach you to apply the skills you have learnt during treatment to your daily life. This should help you manage your problems and stop them having a negative impact on your life, even after your course of treatment finishes.

Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past. It looks for practical ways to improve your state of mind on a daily basis.

*At the point of referral your therapist will work with you to discuss all of the treatment options, and formulate together which approach, or combination of approaches would be most appropriate for your individual needs and goals.  If you are interested in a specific therapy this can be noted on the enquiry form, or if you are unsure what would be most helpful you can discuss this within your initial consultation. It is important to us that each person is treat as an individual, and with this no two treatment plans will look the same. It is important for us to work together to agree an approach that feels comfortable and beneficial to you.