Emotion-Focused Psychotherapy 2011 Level One Training at Strathclyde

Entry for 28 January 2011:

Facilitated by Robert Elliott & Lorna Carrick

Tuesday 30th August – Friday 2nd September 2011, 9.00 – 16.30

University of Strathclyde, Jordanhill Campus, Glasgow

(Sponsored by HASS Research & Knowledge Exchange,

University of Strathclyde)

Emotion-Focused Therapy (EFT) – also known as Process-Experiential Therapy – is a humanistic, evidence-based form of psychotherapy/counselling that integrates person-centred and gestalt therapies, with particular relevance to working with depression, trauma, and anxiety difficulties. It has gained international recognition through the work of Les Greenberg, Robert Elliott, Jeanne Watson, Rhonda Goldman, Sandra Paivio and others. The Counselling Unit at the University of Strathclyde is again pleased to offer Level One professional training in this approach to qualified counsellors and psychotherapists (Diploma level or above).

Now in its sixth year at the University of Strathclyde, this successful, four-day Level One EFT training programme will provide participants with a solid grounding in the theory and skills required to work more directly with emotion in psychotherapy. Participants will receive an in-depth skills training through a combination of brief lectures, video demonstrations, live modelling, case discussions, and extensive supervised role-playing practice. The workshop will begin with an overview of EFT Emotion Theory, including basic principles and the role of emotion and emotional awareness in function and dysfunction; this will be illustrated by Focusing-oriented exercises. Differential intervention based on specific process markers will be demonstrated. Videotaped examples of evidence based methods for evoking and exploring emotion schemes, and for dealing with overwhelming emotions, puzzling emotional reactions, painful self-criticism, and emotional injuries from past relationships will be presented.

Participants will be trained in the skills of moment-by-moment attunement to affect, and the use of methods of dialoguing with parts or configurations of self and imagined significant others in an empty chair. This training will provide therapists from person-centred, psychodynamic, cognitive-behavioural and related backgrounds with an opportunity to develop their therapeutic skills and interests.

Educational Objectives: Participants on the training programme will learn:

1. To implement the basic principles of EFT

2. To identify different types of emotional response;

3. When to help clients contain and when to access emotion;

4. To help clients reprocess difficult emotions;

5. To facilitate emotional processing to resolve self-critical splits and unfinished business.

Programme Outline

Tuesday Morning: Foundations, Emotion, Empathy, & Alliance Formation

• Distinctive features of the EFT: neo-humanism & therapeutic principles

• Process-experiential emotion theory: emotion schemes

• Emotion response types & emotional change principles

Tuesday Afternoon: Therapeutic Tasks, Accessing and Managing Emotion

• Therapeutic tasks and process formulation

• Emotion regulation

• Focusing and Clearing a Space

• Skills practice

Wednesday Morning: Reprocessing Problematic Experiences

• Empathic exploration, evocative empathy, empathic conjecture

• Evocative unfolding, Narrative Retelling, and Meaning Creation

• Skills practice

Wednesday Afternoon: Accessing Primary Adaptive Emotions & Restructuring Emotion Schemes

• Empty chair dialogue and unfinished business

• Supporting the emergence of primary needs

• Helping clients use adaptive emotions to challenge core problematic emotion schemes

• Letting go of unmet needs

• Skills practice

Thursday Morning: Active Expression Processes - I

• Dialectical constructivist models of self

• Two chair dialogue and splits

• Accessing adaptive and problematic emotional responses

• Skills practice

Thursday Afternoon: Active Expression Processes – 2

• Accessing core problematic emotion schemes

• Varieties of splits

• Adapting two-chair work to different kinds of clients

• Skills practice

Friday Morning: Identifying Tasks; Empirical support,

• Review of tasks

• Strategies for identifying and selecting tasks

• Skills practice

Friday Afternoon: Personalized Applications

• Summary of Research evidence

• Practical parameters

• Depression, Post-traumatic stress difficulties

• Social anxiety, Borderline processes

• Question & answer period

About the Facilitators

Robert Elliott, PhD: Robert is professor in the Counselling Unit at the University of Strathclyde, where he teachers on the postgraduate diploma and MSc courses in Person-Centred Counselling. He taught at the University of Toledo 1978-2006, where he was Professor of Psychology, Director of Clinical Training and Director of the Center for the Study of Experiential Psychotherapy. He has also been a guest professor at Katholieke Universiteit Leuven, Belgium, University of Sheffield, UK, and La Trobe University, Australia. He is co-author of Facilitating Emotional Change (1993), Learning Emotion-focused Therapy (2004), and Research Methods for Clinical Psychology (2003), as well as more than 100 published scientific articles or book chapters. In 2008 he received both the Carl Rogers Award, Division of Humanistic Psychology of the American Psychological Association, and the Distinguished Research Career Award, Society for Psychotherapy Research. He is editor emeritus of the journal, Person-Centered Counseling and Psychotherapies and directs the Scottish Consortium for Psychotherapy and Counselling Research and the Strathclyde Centre for Psychotherapy and Counselling Research.

Lorna Carrick, MSc:
Lorna is a lecturer in the Counselling Unit at the University of Strathclyde. She is the course director for the Postgraduate Certificate in Counselling Skills and teaches on the Postgraduate Diploma in Counselling courses. Lorna’s background is in mental health and project development and as a founder member of the first Health Board-funded person-centred counselling service in Scotland, Lorna has over sixteen years experience in counselling, supervision and service development within the field of counselling and psychotherapy. Lorna is currently the director of the Glasgow Counselling in Schools Project and Chair of the Counselling Unit’s management group. Lorna’s research has focused on working with clients in crisis within the Person-Centred-Experiential approach and the use of counselling and Pre-therapy skills in the field of autism services. She has been practicing EFT within a broadly Person-Centred relational approach since 2006, and has also participated as an EFT therapist in the Social Anxiety research protocol of the Counselling Unit’s research clinic. She is committed to helping counsellors/therapists bridge the perceived gap between EFT and nondirective Person-Centred ways of working with clients.

Application Information: If you would like to reserve a place on this training course, please contact me or Jan Bissett for the application form. Places are strictly limited so book early to avoid disappointment.

The fee for this four-day event is has been set at £445. Please note that to keep costs to a minimum, catering is not included in this fee.

We are pleased to offer an Early Bird Discount of £50.00 to those who book before 1st July 2011. To take advantage of this offer, applications must be received by this date with no exceptions.

For further information on this event, please contact Jan Bissett, HASS Research & Knowledge Exchange (jan.bissett@strath.ac.uk, 0141 548 3418).

End of Year Update

Entry for 31 December 2010:

I had been feeling very impatient with the slow pace of my recovery when I saw my surgeon at the beginning of December. Amusingly, when I disclosed my fear that perhaps my progress was being slowed by scar tissue, he said pridefully, “Impossible! The anastomosis was perfect!” Then he told me that my progress was in fact good and was encouraged by my gradual but continuing progress. He told me to give myself at least 6 or 7 months post surgery, and had me schedule a follow-up visit for another 3 months on.

Then they tested my blood for PSA. After a couple of days of anxious waiting, the nurse phoned to say that my 3-month follow-up PSA was undetectable, essentially zero, which was really, really good news, and actually quite a relief for me. This is another sign that the surgery was successful in removing all the cancer, and that it hadn’t spread elsewhere. I now feel like I have my life mostly back.

It is of course still possible that there are undetectable micrometastases floating around my body somewhere, which means that it is now my job to make sure that I live my life to make it less likely that these potential tiny loose cancer cells might take hold somewhere. This means eating healthily, continuing my micronutrient regime, getting plenty of sleep (at least 8 hours a night), keeping the stress down, and restarting my running.

I asked my surgeon if I could start running again and he said yes, so the next day I went out for a run. I am pretty out of shape in terms of strength and aerobic capacity, from the aftereffects of the surgery and the results of the sedentary life I’ve been living for the past 3-plus months. I tried to take it easy the first day, running about half the time on my usual 5k course over Clevedon Hill to the Canal, then down the River Kelvin to the Botanic Garden and home, but it was still a bit too much, so I backed off a bit from that. Since then I’ve been able to work up to running 3 times a week a week, running about half the distance, sometimes under rather appallingly icy conditions in Glasgow. It has felt very good to get out and run again, but I’ve noticed that I’m more tired afterwards than before the surgery. So, I will continue to slowly build my capacity.

The incontinence is another matter: After more than 3 months, I am fine as long as I am laying down or sitting, and am OK if I stand for a few minutes (the latter is a recent development); however, I have problems whenever I have to walk for more than a couple of minutes. This is called stress incontinence, but it certainly doesn’t take much stress for this to happen. This doesn’t sound like much but is in fact progress and makes me hopeful.

So I have settled in for the long haul, the long game. Mostly, I am philosophical about this, put it into perspective: Compared to dealing with metastatic prostate cancer and death, this is a Wonder, a miracle that has given me literally a new lease on life. Living with incontinence is annoying and sometimes pretty frustrating, but it beats dying of cancer by a mile, and I feel very grateful.

Moreover, the lifestyle changes I am now making and continue to forge as I phase back into work are things that I should have done ages ago. My project now is to negotiate with myself and the University a slower, less intense pace of work. A few weeks ago I wrote to my head of school that it was now clear to me that I am going to be able to work 40 hours a week without difficulty, but that the 50- 60 hrs/wk that I’ve been working for the past 30 years is going to be out of the question. She wrote back to remind me that in fact our work week is 35 hrs and that no one is asking me to do more than that. I appreciate this, but it strikes me that the volume of work that we are asked to do exceeds what can be done within 35 hrs/wk, so the real issue is going to be reducing the amount of work in order to fit into the available time. It will be interesting to see how this plays out over the next couple of months.

In the meantime, I've enjoying my time in the US, first touching base in Toledo to finish Christmas shopping before going on to visit my oldest son, Brendan, his partner Mayumi, and our 7-month old granddaughter for Christmas. Mizuki has inspired me these past months with her attempts to crawl, which have recently met with success. We’ve now flown down to Northern California, where we enjoyed a peaceful post-Christmas period with Diane’s family. We then drove up into the Sierra Nevada foothills east of Sacramento to stay at my sister Louisa’s and to celebrate New Year’s Eve with my mom, siblings and their partners. No Murray Creek this year, but still, Happy New Year, everyone!

Empirically Supported Relationships Summaries Published Online

Entry for 13 November 2010:

Last year, Art Bohart, Jeanne Watson, Les Greenberg & I were asked to update our 2002 meta-analysis of research on the relationship between therapist empathy and therapy outcome, published in John Norcross’s Psychotherapy Relationships That Work. The revised version, in book chapter and journal article formats is still in press; however, a sneak preview version has just been published online, along with the rest of the reviews to appear on the second edition of John’s book.

SAMHSA, the Substance Abuse and Mental Health Services Administration, is a branch of the US government responsible for improving treatment of mental health and substance abuse issues by funding research and disseminating information about evidence-based practice. Somehow, the Powers That Be were persuaded to sanction summaries of the current set of meta-analytic reviews being published on their website.

SAMHSA have now published online a set of summaries of evidence supporting the importance of different aspects of the therapeutic relationship for promoting successful psychotherapy or counselling. We updated and replicated our previous analyses with somewhat larger data set and found a moderately strong and highly reliable relationship between therapist empathy and therapy outcome. In addition to empathy, the other Rogerian conditions of therapist warmth and genuineness also fare quite well.

The summary of our review can be found at: http://www.nrepp.samhsa.gov/Norcross.aspx#chapter6

The other reviews can be found in other parts of the same document/webpage.

Reference:

Elliott, R., Bohart, A.C., Watson, J.C., & Greenberg, L.S. (2010). Empathy. In J. C. Norcross (ed.), Evidence-Based Therapy Relationships. National Registry of Evidence-based Programs and Practices (NREPP). Online Resource, available at: http://174.140.153.165/Norcross.aspx#chapter6

Journey to Health: Eight Weeks Post Surgery

Entry for 31 October 2010:

It has now been 8 weeks since my surgery. I have spent that time off work, on medical leave, getting lots of sleep, spending an increasing amount of time on pelvic floor muscle (“Kegel”) exercises, walking 30 – 45 min/day, reading, doing email, writing & beginning to do phone consultations with my research students. It has been a time of healing, rest, recovery, but also frustration as I have had to deal with post-surgical complications (urinary incontinence) that were worse than I had anticipated (hence the exercises).

When the biopsy results came in, they indicated that the cancer was more advanced than anticipated (T1c => T2c), but that they had got it all (the prostate margins were clear of cancer). It’s a very good thing that I didn’t wait any longer to have the surgery!

I did a bunch of reading to try to understand what was happening to me, and what I learned struck me as deeply ironic and darkly humorous: While women have only one urinary sphincter, controlled by the pelvic floor muscles, men have three: one between the urethra and the bladder, the prostate itself, and the external sphincter, which is the same one women have. This is why women have more trouble with incontinence generally than men, and especially after giving birth vaginally, and why most women are familiar with Kegel exercises. I had apparently been relying heavily on my other two urinary sphincters, which now had been removed surgically along with my cancer and associated replumbing. This put me on an even footing with all the women in the world, including my new granddaughter Mizuki! There appears to me to be some sort of poetic justice to this. And while the adult women I know clearly now have a headstart on me, I am pretty much in the same camp as my granddaughter, trying to learn how to use a part of me that I wasn’t even sure I could sense, let alone control. I feel like I now have a new body, which I have to learn how to use.

From my research I learned that I was likely to have to practice these exercises for as long as six weeks before I would even begin to see any effect. I would have to do them on a sort of blind faith; I would have no basis for judging my trajectory of recovery. The research I read indicated that a systematic program of exercises of at least 6 weeks was likely to produce substantial positive results; however, I had no way of knowing if those average results would apply to me. To tell the truth, I found the whole situation scary, embarrassing, infuriating, and as I said ironic and darkly humorous.

I’ve now been doing my Kegel exercises for 5 weeks now, and am starting to see some results, but it’s slow, incremental progress. Over time, they’ve become a kind of prayer, for myself and friends who are going through a hard time.

All through this period, I gradually increased how much work I could do, to the point where I was easily doing 4 or 5 hours of email, writing and phone consultation a day. I managed to work my way through the enormous backlog of emails dating back to last January. I wrote a challenging book chapter on negative therapist reactions.

Last week, after having had my medical leave extended to near the end of October, I met with both my GP and the University’s occupational health physician. They both agreed with my assessment that although I am not currently able to work full time, I am fit enough to go back to work on a part time basis, on a “phased return to work”. The plan is for this process to continue for the next 6 weeks, between now and the Christmas holidays, with me gradually increasing the amount of work I’m able to do. This makes eminent good sense to me, although it is requiring some renegotiation of commitments for that time period. Tomorrow (Monday) I give my first lecture in months!

In the end, as much of a nuisance as the incontinence is, it is infinitely preferable to having a cancer that I now know was far more dangerous than I realized at the time. I am enormously grateful to have that burden removed and equally so for this time of rest and healing, which I so badly needed. This is clearly a much more healthy way of life. I am also deeply grateful to all those who brought by gifts (some quite creative) and cards or who sent positive thoughts, prayers, and wishes my way. Although I have spent most of the past 8 weeks in my flat, I haven't felt lonely with all of this caring around me. Thanks!

My current challenge continues to be, as one of my friends recently wrote to me, “master of my flow”. But after that, the even bigger challenge will be learning how to master the flow of my life so that it is no longer overwhelming and harmful. It is now clear to me that this will be a matter vital for the health of both my body and my soul.

Theories, Models or Approaches?

Entry for 21 October 2010:

I’m still at home, recovering from surgery, but sometimes I get questions out of the blue, little bits of grace like falling autumn leaves:

Dr. Elliott-

I first would like to apologize for the forward nature of this email as I am indeed a complete stranger to you. However, I have spent several days searching for an answer to my query and am at a loss as to who to turn to for assistance. I first emailed Dr. [Clara] Hill who promptly referred me to you (see her response below). Please know any information you can provide if your time allows will be warmly welcomed and greatly appreciated.

I am currently a graduate student at the University of __ in a counseling skills class where [Clara Hill’s] book Helping Skills: Facilitating Exploration, Insight, and Action is being used as our text. I was recently in discussion with a peer about different models that explain the concept of helping skills. I think the term 'model' is what has me blocked. My first response was simple...person-centered or a humanistic approach (the basis for the exploration stage), a behavioral model, and of course a psychodynamic model all came to mind as models used in the helping process. I realize after further thought that these concepts are theories and may not be considered 'models' within the realm of helping skills. The scope is certainly much broader than that. My friend argued for a more complex idea that 'models' include approaches such as motivational interviewing, solution-focused brief therapy, and the like. To me, these are methods or techniques used in counseling. Would you consider these approaches to fall under the category of helping skills are they 'models'?

It is quite possible this makes no sense to an outside expert, so please let me know if further clarification is needed. I just wanted a little guidance on what the term 'model' in reference to helping skills might mean to you. Dr. Hill labeled her approach as an integrated three-stage model; are there other models such as this with different theoretical foundations authored by other practitioners/researchers in the field?

Again, I appreciate your valuable time in offering any insight to this query. Have a wonderful day in the meantime; it is an honor to communicate with you.

Sincerely,

Carissa

Graduate Candidate in MHR

Dear Carissa,

You are engaged in philosophy! The questions of what is a theory and what is a model and how they are and are not similar; these are philosophical questions. Philosophy can be very useful for clarifying what we are talking about, and reducing the probability that we are talking nonsense! Of course, an awful lot of what we do when we talk about counselling and psychotherapy is, from a philosophical point of view, nonsense, because we usually don't stop to clarify our concepts.

To properly answer your question, we would have to look at how people (philosophers, scientists) have defined the words "theory" and "model". I'll leave that for you to do a bit of investigating into; you'll soon find that there are lots of different definitions and views, but in general we're talking about systematic representations of reality. Beyond that, it quickly gets very complicated. This means that whenever you or someone else uses a word like "theory" or "model", you or they need to be clear about what they mean by the word. What kind of systematic representation of reality? For what purpose? How systematic? Descriptive or prescriptive? Big or little bits of reality? etc.

What I generally say to people when they ask me a question like this is, "Isn't it fun how many words there are in English that mean roughly the same thing? And isn't it interesting how when there are a bunch of words meaning roughly the same thing, people start inventing distinctions and attaching them to the different words?" But if you were Winnie the Pooh, you'd laugh and say "It's the same thing!"...

"When you wake up in the morning, Pooh," said Piglet at last, "what's the first thing you say to yourself?"

"What's for breakfast?" said Pooh. "What do you say, Piglet?"

"I say, I wonder what's going to happen exciting today?" said Piglet.

Pooh nodded thoughtfully.

"It's the same thing," he said.

I hope haven't been too irreverent in addressing your question. The fact is, models, theories and approaches to counselling are very interesting and exciting and fun. It sounds like you are enjoying yourself and I hope you go on doing so!

Yours,

Robert Elliott

Footnote: I should also have added that underlying Carissa’s question is an ancient distinction that goes back to the Greeks: theoria vs. praxis: theory vs. practice; that is, how we represent the world vs. what we actually do. Theories, models and approaches are different ways of talking about representations; counselling skills (or help-intended speech acts) are what we actually do in practice.

“I Take My Waking Slow”

Entry for 19 Sept 2010:

I am not bored; there is plenty to do, and just the right level of visitors. My main frustration is with the catheter. This has gotten pretty old, especially over the past few days when, as I've gotten more active and find that it holds me back. I don't like this at all! However, it turns out that the catheter is my friend also, for one very important reason: It reminds me, forcefully at times, to go slow, to not try to rush things. This is critical for me at this point, because going slow is exactly what I need to be doing.

This going slow is such a contrast to my normal life, where I often have to rush around from meeting to meeting and sometimes end up being double-scheduled. Deadlines loom, and I feel forced to stay up late to meet them, cheating on my sleep, which isn't healthy. Email piles up, because ordinarily I don't have time to read it during the day. There were over 1000 messages in my inbox when I went into the hospital; it's less than that now, in spite of the time I've spent in hospital and resting at home. So ordinarily, I live under quite a bit of time pressure and feel like I have to do things quickly and not “waste time”.

But it does make me wonder: Was living at such a pressured, fast pace EVER a good idea? It now seems to me that this was one of the most unhealthy aspects of my old lifestyle, creating conditions for the cancer to develop -- or now for it to reoccur. Maybe the slow life I'm living now is actually closer to the way I should be living my life in general. Is there a way to go back to work in a healthy, less pressurised way? I don't have any answers about this, but it seems important to think about.

In the meantime, as Theodore Roethke writes, "I wake to sleep, and take my waking slow. I know by going where I have to go." I first encountered this line 40 years ago and now I try to take this as my motto to live by. I live in my old gray cotton bathrobe, reminding myself of some kind of celibate Hugh Heffner, but the love that surrounds me is not eros (or more accurately porneia, whence pornography), but rather philia and agape. This is calming; this is what I need; not striving (trishna, in Sanscrit), but letting go of striving, as the Buddha preached. It is a bit of heaven, as I've said before, a gift, a blessing.

2010 Emotion-Focused Therapy: Level 2 Workshop Series

Facilitated by Robert Elliott

Professor of Counselling, University of Strathclyde

Saturdays, 9.30-16.30, 20 November, 2010 – 14 May, 2011

Sir Henry Wood Building

Jordanhill Campus

(Sponsored by HASS Research & Knowledge Exchange,

University of Strathclyde)

The Counselling Unit at the University of Strathclyde is offering further training in Emotion-Focused Therapy (EFT) for counsellors and psychotherapists (Diploma level or above) who have completed Level One training in EFT or the equivalent. This series has been restructured from its previous evening format and will now meet on seven Saturdays throughout the 2010-11 academic year, beginning in November. The format will be a mixture of brief lectures, videos or demonstrations, experiential practice exercises in small groups, supervision of cases seen by course members, and discussion.

The specific topics to be covered will feature material not covered in the Level 1 course, including

· Therapist experiential response modes

· Client modes of engagement

· Narrative Retelling of difficult/traumatic experiences

· Relational Dialogue for Alliance difficulties

· Creation of Meaning for meaning protests

In addition, the Focusing and different forms of Chairwork will be particularly emphasized:

· Focusing with difficult or painful experiences

· Clearing a Space for overwhelming or chaotic experiences

· Two chair enactment for Self-interruption splits

· Two chair conflict split work for depression, anxiety and self-harm behaviour

· Compassionate Self-soothing for painful self states

· Empty chair work for unfinished business

This series is scheduled for the following dates:

Autumn 2010:

20 November

11 December

Winter-Spring 2011:

15 January

19 February

19 March

16 April

14 May

• Enrolment is set for a minimum of 10 and a maximum of 20.
• Course fee: Until 15 Oct: £395; after 15 Oct: £445
• The course could be taken for continuing professional education credit.

Please direct enquiries and requests for applications to HASS Research & Knowledge Exchange, Jan Bissett (jan.bissett@strath.ac.uk, 0141 950 3135), or alternatively Counselling Unit office (muriel.walker@strath.ac.uk or 0141 950 3165) or, after 1 October, Robert Elliott (Robert.Elliott@strath.ac.uk or fac0029@gmail.com).