Full Day Workshops

16th April, 2020

9.30 - 17.00

Download: Spring Workshops and Conference Programme [PDF]

These 4 workshops will consider challenges faced by those who find it hard to tolerate uncertainty as well as those whose lives are characterised by extremely high levels of uncertainty. Using active and interactive methods they will share with therapists up to date knowledge about how to understand the impact of these factors on service users and practical clinical tools and to help them to tolerate and even thrive in the context of the uncertainty they face.


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Workshop One

Living with Intolerance of Uncertainty and How to Make Friends with Uncertainty

Mark Freeston, University of Newcastle

Due to demand this workshop is now only available as a webcast

Intolerance of uncertainty (IU) is now recognized as a transdiagnostic factor that may contribute to the onset and maintenance of a range of mental health problems. The evidence is strongest for the anxiety disorders and OCD, but there is increasing evidence for a role in eating disorders, psychosis, body-dysmorphic disorder, body-focused repetitive behaviours, and perhaps externalizing behaviours. Likewise, there appears to be a clear role for IU in understanding anxiety among people with ASD and potentially ADHD. There is also a small but developing literature around IU in physical health problems. Research, mainly from the anxiety disorders, indicates that IU is modifiable.

The first part of this workshop considers the nature of IU, where it may come from, how it is experienced, and how it relates to familiar models of anxiety based on threat perception. The second part of the workshop considers how IU may be targeted in the context of anxiety disorders where anxiety and distress, by definition, is objectively excessive or disproportionate to the actual situation. The final part of the workshop considers IU in relation to situations where there may be high objective threat and high objective uncertainty. Although IU may still play an active role in distress, additional considerations come into play as to how and when it is approached. The workshop will use a range of approaches, including reflective exercises, work in pairs, developing IU interventions, plenary Q & A, etc.

Professor Mark Freeston is Professor of Clinical Psychology at the University of Newcastle. The basis of his work has been the understanding and treatment of anxiety disorders His particular interests are Obsessive Compulsive Disorder and Generalized Anxiety Disorder. Interestingly, his work has led to multidimensional models and multi-component treatments packages. With the emergence of transdiagnostic approaches and models, there is a natural extension of this work to separation anxiety disorder, psychosis, eating disorders, body-focused repetitive behaviours, and body-dysmorphic disorder. One such transdiagnostic process is intolerance of uncertainty (IU), a construct he was first working with in the early nineties at Université Laval in Quebec.

Specifically, he is interested how IU may operate within various populations to help explain some well-known shared and differential features of these disorders and, importantly, why some people find uncertainty so aversive. He is also testing single-strand treatments targeting IU in both individual and group settings.

From working within university and clinical settings Professor Freeston’s research is informed by clinical observation and has been developed and tested in collaboration with many collaborators.

Workshop Two

Persistent (Medically Unexplained) Physical Symptoms: A Scientist Practitioner Approach

Trudie Chalder, King’s College London and David McCormack, Queen’s University Belfast

Persistent (medically unexplained) physical symptoms is an umbrella term for a range of lasting symptoms and syndromes commonly seen in outpatient clinics (e.g. irritable bowel syndrome, non-cardiac chest pain, chronic fatigue, cough hypersensitivity, fibromyalgia, and tension-type headaches). Physical and psychological symptoms overlap across the various syndromes and anxiety depression and sleep disturbance are often experienced. It is common for patients with persistent physical symptoms (PPS) to report that their quality of life is adversely affected. Patients with PPS account for a considerable proportion of healthcare use and associated costs (Reid et al 2002). Therefore, management of PPS is one of the most important tasks facing health professionals.

The aims of this workshop are to; (1) describe a transdiagnostic approach to understanding and treating persistent unexplained physical symptoms, and (2) give therapists an opportunity to practice some key skills for intervening with patients experiencing such symptoms in primary and secondary care settings.

Trudie Chalder is Professor of Cognitive Behavioural Psychotherapy at King’s College London. She has worked as a clinician and a researcher in the area of long-term conditions and medically unexplained symptoms for 30 years. Trudie develops specific CBT models to understand and treat symptoms and distress in MUS and uses randomized controlled trials to evaluate the effects of treatment on quality of life in primary and secondary care. Trudie’s work includes treatment for adults and adolescents and she has published over 250 articles. She was the President of the British Association of Behavioural and Cognitive Psychotherapy and is a member of the IAPT advisory group for LTC and MUS.

David McCormack is a lecturer in clinical psychology at Queen’s University Belfast and a practising clinical psychologist at the Royal Belfast Hospital for Sick Children. He has an interest in psychological trauma and the impact that physical health problems have on psychological wellbeing and quality of life. From 2014 to 2019 he worked at the Maudsley Hospital, London where he was involved in randomised controlled trials of CBT for persistent physical symptoms.”

Young People with Complex Physical Health Conditions; Parenting in the Context of Medical Uncertainty

Anna Coughtrey and Sophie Bennett, UCL Great Ormond Street Institute of Child Health

Children with chronic physical illnesses are more likely to have anxiety, depression and behavioural problems than those without a chronic illness. Parenting a child in the context of mental health difficulties is challenging and chronic illness adds additional complexity to this, for example through fluctuating physical health, uncertainty about the future, and/ or the presence of developmental or intellectual disability. Over-protective parenting and parental beliefs about the vulnerability of their child have been linked to the development of mental health problems in children with physical illness even when the age of the child and objective severity of disease have been controlled for.

This workshop will consider how standard evidence-based interventions for mental health problems in children and young people can be used in the context of uncertainty related to childhood chronic illness. It will focus particularly on supporting parents to manage challenging behaviour and anxiety using examples of interventions for children with epilepsy and cancer.

Key learning objectives:

  1. To consider how uncertainty related to chronic physical illness may affect treatment for mental health disorders in children
  2. To explore how standard evidence-based interventions can be used flexibly to treat childhood mental health disorders in those with a chronic illness whilst maintaining fidelity to protocols
  3. To consider how to support parents of children with chronic illness

Dr Sophie Bennett and Dr Anna Coughtrey are clinical psychologists at the Institute of Child Health and at Great Ormond Street Hospital where they work. in the Psychological Medicine team. Sophie recently won the Discovery Award from at the fourth ‘Young Epilepsy’ Champions Awards for her work on mental health and well-being in children and young people with epilepsy. Her publications include the only review of psychological treatments of children with long-term medical conditions, including epilepsy. Anna is recognised as a digital pioneer for her project on guided online self-help for depression and cancer in adolescents, which is based on CBT. The treatment supports young cancer patients who are experiencing mild to low mood. The programme is run by Great Ormond Street Hospital in partnership with the Institute of Child Health, Macmillan Cancer Support, London Cancer, UCLPartners, and University College Hospital London.

Workshop Four

Working with PTSD in Asylum Seekers: What Can We Do to Help in Uncertain Circumstances?

Francesca Brady, Helen Bamber Foundation, Zoe Chessell and Amy Chisholm, Woodfield Trauma Service, Central and North West London Foundation Trust

This one-day workshop will give participants a theoretical and practical framework for the cognitive-behavioural assessment and treatment of complex/complicated PTSD in asylum seekers and refugees in uncertain circumstances.

Topics covered will be:

The workshop will involve formal presentations, case discussion and video role-play. We will also share and discuss helpful materials we have developed. A service user from the service will also attend and discuss her experiences.

The speakers are all Clinical Psychologists working in specialist refugee and asylum seeker services that provide psychological therapy and practical support. Dr Francesca Brady is Co-Head of Therapies at of Helen Bamber Foundation (HBF) and also works at the Woodfield Trauma Service (WTS) in London. Amy Chisholm also works at both HBF and WTS within the Grenfell Health and Wellbeing Service (GHWS). Dr Zoe Chessell also works at the Woodfield Trauma Service and within the Grenfell Health and Wellbeing Service. All three workshop leaders are involved in providing innovative, evidence-based CBT to refugees and asylum seekers suffering from PTSD, within a phased, multidisciplinary model of intervention. They write and lecture on this work nationally and internationally.