Frequently asked questions
When people first contact me to enquire about whether I can help, I am often asked some of the following questions:
What happens when I first get in touch with you ?
One of my initial aims will be to ensure that I am the best person for you to see. Usually this is easiest over a brief, no-obligation telephone call, over which I can find out some key information about the problem, and let you know what I can offer. I also let people know at this stage about available NHS options, and how to access these. (See my "useful resources" section for information on NHS services.) The next step, should you wish to go ahead, will be to arrange an initial assessment session.
What happens at assessment?
The purpose of an initial assessment is to find out about the main problem(s) in greater detail - how long it has been happening, how it impacts you, what the patterns of thinking and behaviour are, and so on. We will also cover information such as previous treatments that you may have tried, and your expectations and goals for therapy. By the end of the assessment, my aim will be to give you my initial clinical opinion about the problem, and to talk you through a treatment plan. I will also encourage you to ask any questions that you may have before you decide whether to continue with therapy.
What forms of OCD have you worked with?
I am sometimes asked this question by people suffering with OCD when they first get in touch with me. Often this is because they have seen therapists previously who were not experienced in their form of OCD or did not understand it. As a specialist, the number of people with anxiety I have assessed and treated now numbers in the hundreds, most of which have suffered from OCD or related obsessional problems such as BDD, health anxiety, and so on. The underlying psychological structure of these problems (and therefore how to treat them) is often very similar, but I can also confidently say that I have worked with the full range of subtypes of OCD concerns, including contamination fears, checking, and so-called "pure O" types.
I’ve had experiences of CBT before that were (very) unsatisfactory, and I am therefore unsure if it's for me.
My response to this is usually to highlight that while there can be no dispute that Italian food is the finest on earth (!), we have all been served disappointing pasta at some point or other. Likewise, a poor experience of therapy of any kind should not necessarily be taken as a reflection of that type of therapy as a whole. (In much the same way, there are undoubtedly some very good psychoanalytic therapists out there – and some less helpful ones, too.) Often what is called “CBT” varies quite substantially between therapists, based on their levels of experience, training, and other factors.
I’m skeptical about CBT. Does this matter?
Skepticism is welcomed. The only thing that is key is that you are willing to fully commit to the therapy, and to work with me as a team to have a serious shot at working on the problem together. If you have questions, doubts or reservations along the way, I will encourage you to express these so that we can jointly understand and address them.
Do you offer other types of therapy, such as ACT, Mindfulness, etc.?
My professional opinion and ambition has always been that I wanted to practise one approach to the highest standard possible, rather than offer multiple different approaches less competently. This is why CBT is the only type of therapy that I practise and have formal training in. That's not to say that CBT is a panacea or the right approach for every type of problem or for every person - but for anxiety problems, the evidence is clear that it really is the only recommended approach.
How do I choose the right CBT therapist?
There is no set way to go about this, but there are some pointers you can follow. Make sure they are fully accredited with the BABCP. If you have a specific type of problem (e.g., OCD), ask about their level of experience in treating it, and if they have worked in specialist services. Ask for their initial clinical opinion about your problem, and for an overview of what the therapy will involve. If there are organisations available for your specific type of problem, check their websites to see if they offer any other guidance (see my useful resources page for OCD and BDD organisations). If you can, make an initial enquiry by telephone so you can get an impression of them as a person, and see whether they are someone you would feel able to trust and be comfortable with.
How long does therapy go on for?
Typically CBT consists of weekly sessions, and is short term. NICE typically recommends between 10 and 20 sessions for most types of anxiety, for example. My usual recommendation is to go up to 3 or 4 sessions initially, as this gives you an opportunity to try out the therapy and review how it is progressing before you continue further. As a short-term therapy, any good CBT therapist will pride themselves on (1) helping you overcome the problem and reach your goals as quickly as is possible, and (2) giving you the tools and knowledge that you need to "become your own therapist", and ultimately to no longer need therapy.
How likely is therapy to be effective?
While there are never any guarantees with any form of treatment, based on my clinical experience and the results of research trials I can usually provide an informed opinion. Some studies of CBT/exposure therapy for OCD, for example, suggest that around one third of patients make a full recovery, another third make what is known as a partial recovery, and a third do not respond to the treatment. There is likely to be a range of factors that can influence the treatment outcome, including the skill level of the therapist, and how much you can commit to the therapy.
Do you have a waiting list?
This varies, but I do sometimes have a short wait before I can see people. Please contact me and I will give you an idea of my current availability.
Are there any types of problems that you don't see?
Please see my "about me" page for a list of the types of problem that I specialise in. For very severe and disabling OCD, BDD and other types of anxiety, weekly outpatient therapy may not be the most appropriate treatment option, and in which case I may recommend that you look into alternative NHS options (e.g., residential or inpatient therapy) and will give you some guidance on how to do this. If I do not think that I can help you or that it is in your best interests to see me, it is basic professional decency that I be honest with you about this and tell you directly.