Therapy methods

Dr Sandra Darmanin offers high quality psychotherapy from different evidence based modalities based on the client’s history. In the first session a thorough clinical assessment is administered. This assessment than determines the modality and methods. one requires to reach the desired outcome.

Cognitive Therapy

Cognitive Behavioural Therapy (CBT) is a discussion-based treatment that is delivered in one-to-one situations with a psychotherapist over a number of sessions.

During CBT, individuals are encouraged to identify any patterns of thoughts, feelings and actions that reinforce negativity in their life. Clients learn strategies for breaking these patterns, and they practise these outside the therapy sessions, often keeping a diary of their experiences.

CBT deals mainly with the present, rather than the past, and has a logical approach to problem solving, with a client and their psychotherapist working in collaboration to find new solutions.

It has been shown to be very effective for depression and anxiety disorder treatment, stress management, sleep issues, and there is now good evidence that CBT tailored specifically for substance misuse can constitute effective treatment for both harmful use and drug or alcohol dependency.

Depression and anxiety problems very commonly co-exist with substance misuse, and in such cases a cognitive approach can be particularly valuable. It can also be used to help to treat eating disorders.

This type of therapy recognises that negative thoughts and emotions can result in an individual becoming trapped in a destructive cycle. This situation can feel very overwhelming, but CBT aims to overcome this by examining the various elements of a problem in manageable parts, in order to facilitate change and lead to greater well-being.

Schema therapy

Schema Therapy is an evidence-based and integrative psychotherapy developed by Dr Jeffrey young. Schema Therapy combines theories and techniques from other therapies such as cognitive behavioural therapy, attachment theory, psychoanalytic object relations theory and gestalt theory.

Schema Therapy is particularly useful for identifying and resolving the personality dynamics of individuals with chronic emotional and relationship problems. While therapies such as CBT and DBT are seen to be effective in reducing acute symptoms, schema therapy is effective in reducing chronic symptoms as well as pinpointing and treating negative life patterns and deeply ingrained emotional themes. It also seeks to build resilience and build on the individual’s key strengths.

What are Schemas?

Schemas, or what we refer to as Early Maladaptive Schemas, can form as a result of core basic needs being significantly unmet in childhood. When needs such as safety, predictability/consistency, love/nurturance/attention, acceptance/praise, empathy, guidance/protection, and validation are not provided for, Early Maladaptive Schemas can occur as a result. EMS can be otherwise be defined as deep unconditional beliefs about oneself, one’s relationship to others and one’s relationship to the wider environment.

There are five basic schema domains and organised within these five schema domains are 18 specific early maladaptive schemas (EMS).

Attachment-Based Therapy

Attachment-based therapy is a brief, process-oriented form of therapy. The client-therapist relationship is based on developing or rebuilding trust and centres on expressing emotions. An attachment-based approach to therapy looks at the connection between an infant’s early attachment experiences with primary caregivers, usually with parents, and the infant’s ability to develop normally and ultimately form healthy emotional and physical relationships as an adult. Attachment-based therapy aims to build or rebuild a trusting, supportive relationship that will help prevent or treat anxiety or depression. This form of therapy is used when a client wishes to make some of their unconscious processes more conscious as this will ‘untangle’ the barriers they are faced with. Attachment therapy is particularly helpful in relationship issues.

Solution-Focused Therapy?

Solution-Focused Brief Therapy (SFBT), also called Solution-Focused Therapy, Solution-Building Practice therapy was developed by Steve de Shazer (1940-2005), and Insoo Kim Berg (1934-2007) and their colleagues beginning in the late 1970’s in Milwaukee, Wisconsin. As the name suggests, SFBT is future-focused, goal-directed, and focuses on solutions, rather than on the problems that brought clients to seek therapy.

The entire solution-focused approach was developed inductively in an inner city outpatient mental health service setting in which clients were accepted without previous screening. The developers of SFBT spent hundreds of hours observing therapy sessions over the course several years, carefully noting the therapists’ questions, behaviours, and emotions that occurred during the session and how the various activities of the therapists affected the clients and the therapeutic outcome of the sessions. Questions and activities related to clients’ report of progress were preserved and incorporated into the SFBT approach.

Since that early development, SFBT has not only become one of the leading schools of brief therapy, it has become a major influence in such diverse fields as business, social policy, education, and criminal justice services, child welfare, domestic violence offenders treatment. Described as a practical, goal-driven model, a hallmark of SFBT is its emphasis on clear, concise, realistic goal negotiations. The SFBT approach assumes that all clients have some knowledge of what would make their life better, even though they may need some (at times, considerable) help describing the details of their better life and that everyone who seeks help already possesses at least the minimal skills necessary to create solutions.

Mindfulness

Cultivating awareness of one’s body, mind and present environment is a mindfulness technique that has therapeutic benefits in the treatment of a wide range of conditions and disorders. Mindfulness can help to:

Mindfulness work is an essential part of Buddhist practice and involves paying attention, moment-by-moment, without judgment and with acceptance, to everything that is happening both within and around us. The concept and practice of mindfulness has been around for thousands of years in Eastern cultures. However, it is only recently that Western medicine has started to research and discover the myriad of improvements to physical and psychological health associated with its practice.

The benefits of mindfulness

The medical benefits associated with mindfulness are thought to derive from enhancing one’s ability for attention regulation, body awareness and emotional regulation. Furthermore, it is thought to expand consciousness, leading to enhanced feelings of well-being.

By practising mindfulness, clients achieve more awareness of the present moment and learn to become more aware of the presence of negative, dysfunctional thoughts and destructive feelings. Only when an individual becomes aware of something can they begin to change.

Mindful awareness is often a big step in recognising where problems or difficulties exist, and how to address them. Such awareness is essential, since so many of us spend the majority of our lives on “automatic pilot” mode, completely unaware of who we are and why we behave the way we do.