Psychological Therapy Services, Manchester & Online

How I think about therapy

 

I don't think any one psychological therapy, or medical way we treat mental health can have all the answers. We should never be too wedded to one idea, just because it 'worked so well last time', or even 'because the evidence base says so'. What I'd rather inspire in my supervisees, is the confidence to have a looser grip around the therapies they prefer to use, and a willingness to adapt to the person sitting in front of them.

In my experience, this flexibility is what sets really good therapists apart. Across all the services I've worked in, the therapists who worked more flexibly were usually the ones getting the better recovery rates, and they were also the ones whose clients stayed in therapy rather than dropping out after a few sessions, and I don't think that's a coincidence.

For example, two people can have identical depressive symptoms and similar situations, but if what's driving it is different, and the past circumstances around it are different, then the treatment has to be different too. I think that's obvious when you say it out loud, but a lot of how we're trained pushes us to deliver therapy in quite a unformed way.

I've always worked this way, even in my early NHS days I was always looking for creative ways to approach things and rejecting the idea that there's a set way you're supposed to do it. I try to help all my supervisees gain trust in their instincts and creative abilities, so they can feel more able to spot the individual factors driving their clients distress. 

In practice that means I'll often bring in ACT, chairwork, or transdiagnostic ideas, depending on what would help. That's not me saying CBT isn't enough, because usually the CBT a supervisee is doing is perfectly sound and can work well. It's more that the formulation skills can be developed, and once you've done that, you sometimes need a different set of tools to work with what you've found.
 

What supervision with me is like

I'm fairly relaxed, and will trust you to know what you need. I'm a lot less structured than most CBT supervisors, and use more of a semi-structure. I do expect you to come in with questions, or for us to have agreed the general aims of what we're doing, but beyond that I'm comfortable with the fact that what you need changes week to week.

I also take the view that you're a person before you're a practitioner. If you're going through a difficult time yourself, I'll be sensitive to that, and sometimes we'll use the space to think about what's going on for you, or to look at how your own mental health is showing up in your work. I don't think enough supervisors do this, and in my experience, it tends to matter more to the quality of someone's clinical work than any amount of technique fine tuning.
 

Who I work with

 

Most of the therapists I supervise are qualified and reasonably experienced. Often they've worked in various mental health settings and they're solid at what they do. Chairwork, ACT integrated with CBT, EMDR, and complex or treatment-resistant presentations are the areas of improvement people often come to me for.
 

I also supervise CBT students and trainees each academic year, currently for the University of Birmingham, and I'm happy to hear from therapists earlier in their careers too. That said, if what you're after is help nailing down the protocols, you'd probably be better served by a supervisor who takes a more conventional approach to CBT supervision.
 

I often work with therapists from an NHS, IAPT or CBT background, but also have supervisees who were predominantly trained in counselling, psychology or more integrative approaches. 

​

A fair few of the therapists I supervise have come out of the NHS and are either setting up privately or building a caseload alongside a service job, which is a transition I've been through myself and am happy to think about with you.