New cognitive behavioural therapy program tries to banish negative thoughts, positively
By KAREN GRAM, Vancouver Sun April 29, 2012

Successful U.K. cognitive behavioural therapy program now available in B.C.

As a new psychiatrist in Glasgow, Chris Williams felt frustrated by the limited time he had with patients. He wanted to find a way to make the few minutes he had more effective.

Familiar with a form of psychotherapy called CBT or Cognitive Behavioural Therapy, he began working out a method of delivery that allowed the patients to do much of the work on their own.

The short, bright series of booklets he wrote in 2007 titled Live Life to the Full, which combine with eight weeks of group classes, have become very popular in the U.K. and not just for those dealing with mental illness.

“So much CBT has this label of psychotherapy, which it is,” said Williams, adding it works for a wide range of mental health issues including moderate to severe depression, phobias, panic attacks, eating disorders, obsessions and anxiety. While it can replace medication, it can also work well with it.

“But another way to look at it is as an adult learning model. It is about helping people work out why they feel as they do. It’s about helping learn all those skills of identifying negative thoughts, challenging them, helping them become more active, building confidence. Those are all teachable skills that people can learn one-to-one or through group settings.”

With titles like Write all over the Bathroom Mirror, Why do I Feel So Bad?, Why Does Everything Go Wrong?, and How to Fix Almost Everything in Four Easy Steps, Williams has hit on an approach that is simple, engaging, direct and easy to apply.

Now the Canadian Mental Health Association is rolling out his program in Canada, training facilitators and scheduling classes throughout the country. They have also translated the booklets into Cantonese and have so far trained one Lower Mainland facilitator to offer the program in that language.

“I think this is suited to everybody, not just those experiencing mood problems,” says Bev Gutray, CEO of the CMHA, B.C. division. “The skills you learn are skills that help you through life. I am fundamentally blown away by it.”

CBT is extremely effective for day-to-day challenges like sleeplessness, inactivity, excessive worry or lack of confidence. It helps people identify five areas of their lives that can affect mental health: thoughts, feelings, physical symptoms, behaviours, activities and the environment in which we live. Then it helps effect change.

Williams, who is also a professor of psychiatry at the University of Glasgow, found it could be very effective in group settings but if necessary it also works as a self-help program for those who just can’t leave the house.

Living Life to the Full, has been subjected to four randomized, controlled studies all of which found it effective. One in Ireland involved 480 people. It found that the proportion of people who were depressed at the beginning dropped dramatically after the course. Eighty per cent of participants were identified as being depressed according to a standardized depression questionnaire at the start of the program. At the end, only 16.7 per cent remained depressed.

“And that was without my involvement,” says Williams, adding the benefits lasted through to the one year follow up.

A pilot program in Canada also proved very successful.

Of the 228 participants who completed evaluations, 85 per cent said the course was useful to very useful and 91 per cent said they would recommend the course to family and friends. This resulted in waiting lists at some organizations for additional courses.

“I tell people it is an awesome program, says Shaida Javer, a participant in a pilot within the Ismaili community in Vancouver. “I am a big advocate of it.”

Javer found the program really helped her deal with a grouchy co-worker.

“I was feeling he was attacking me maybe due to my race or colour or he had something against me from before,” she says, adding she didn’t always respond well.

But after taking the course she was able to step back from that negative thinking and problem solve it. She talked to her boss and to the co-worker and learned that his behaviour had nothing to do with her. “He said he was just having a bad day. Now we can work together.”

The program offers simple strategies such as recognizing negative thoughts, labelling them and then standing up to them. Williams calls it the Amazing Bad Thought Busting Program.

“It isn’t classic CBT language,” he says, adding he has made an effort to rid the program of professional jargon. “But it is classic CBT translated into everyday language that hopefully makes people smile a little.”

For example, some people frequently second guess what someone will say or do. The program teaches them to recognize that and label it mind-reading. Then they learn how to fight the thought like you would a bully.

“You might be invited out to a meal or a party and your thoughts will say things like: you will mess it up, you won’t enjoy it, people won’t talk to you. It is so easy to just not go.

“So we encourage people to face the bully. To go and see what happens.”

Very often, he says, they discover their fears were unjustified.

Each week, the program tackles a different topic and then participants make plans for how they will handle that situation in the coming week.

“It’s a small plan, it’s not running a marathon-type plan. It’s a small thing of what to do tomorrow.”

Each week in class the plans are reviewed: Students are told that if things have gone well, learn from that and put what was learned into practice. If it doesn’t go well, then try to look at what blocked a better result.

“It is a no-blame thing. Learn from it and put what you have learned into your next plan.”

The various branches of the CMHA are offering the program as they train facilitators. Some branches have found sponsors to subsidize the program, others charge for it. In the Lower Mainland, it will cost $150.

To find a program in your area or for more information, go to Living Life to the Full (LLTTF) helping you to help yourself / Canada.

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Canadian Mental Health Association Delta has a course starting next month to help people feel better.
dwillis@delta-optimist.com
April 29, 2012

Living Life to the Full is an eight-session weekly series for young adults and up that is based on cognitive behavioural therapy. It will be held in North Delta beginning March 2.

Cognitive behavioural therapy helps people understand they have control over a lot more than they think, said CMHA Delta executive director Judy Gray.

"It's not what happens to us in life, it's how we interpret it. This helps people look at how they're interpreting things and how to do it differently," she said.

The course could help people dealing with depression, low mood and anxiety or those that feel anxious.
"If you're not happy with how things are going we can help you with tips and tools to get you out of those ruts," Gray said.

Living Life to the Full was created by Dr. Chris Williams, a professor of psychosocial psychiatry at the University of Glasgow. The CMHA has the rights to present the course in Canada.

"This is a very practical application that will help people feel better immediately," said Carolyn Bell, who will be facilitating the course.

She noted the information will be given in a group setting and that individual learning styles will be taken into consideration and respected.

A small book is used each session. Participants get to practice whatever the lesson is in each session.

Living Life to the Full runs from 11 a.m. to 12: 30 p.m. on Saturdays starting March 2. It costs $150. The course will be held at 11715-72nd Ave., North Delta.

Gray said CHMA Delta is looking at holding the course in South Delta and noted if people are interested CMHA will keep a waitlist.

For more information, contact 604-943-1878, info. delta@cmha.bc.ca or visit www.LLTTF.ca.