Posts Tagged ‘therapist Madrid’

How to Keep Good Employees in a Bad Economy

Thursday, March 25th, 2010

06:25 PM Friday February 26, 2010 – By Marshall Goldsmith

As we make our way through the challenges of the global economic crisis, high-impact performers are in demand. I’m speaking here of the indispensible workers who are willing to do what it takes to help the company succeed even in the most difficult of times. Those who pick up the slack when the organization is forced to cut back; those whose ideas save time, money, and effort; those with a positive outlook who help keep the organization moving forward.

How do you retain these people? The answer, simply put, is leaders must manage their human assets (i.e., employees), and they must do so with the same vigor that they devote to financial assets. In tough economic times, this may seem difficult; however, it is critical for the success of the organization.

Here are some steps that organizations can take that will help them keep today’s high-impact performers and tomorrow’s great leaders.

1. Show Respect: This may seem rote, but genuinely treating employees with kindness, respect, and dignity will elicit the continued loyalty of employees to both the leader and the organization. It is possible to lead people through fear and intimidation; however, the odds of retaining and developing people using this style are slim.
2. Focus on a Thriving Environment: Creating an environment in which high-impact performers want to stay and will put their all into an organization takes more than a gimmick or enrollment in the fad-of-the-month leadership development program. It takes an environment where people are learning, getting training, and developing their skills — where through inquiry and dialogue, the leader creates an environment that allows each individual to thrive.
3. Offer On-Going Training: High on the list for leaders who want to retain high-impact performers is training and on-going education, both of which ensure that people can 1) do their jobs properly, and 2) can improve on existing systems. Cross training — giving people the opportunity to experience and train in different aspects of the company — is a great way to cross-fertilize between departments and across regions. This is a great competitive advantage when organizations are required to cut back on manpower. Cross-trained employees are equipped to handle different functions in the organization far more easily than those confined in silos.
4. Provide Coaching (JM: and Counselling): By working one-on-one with employees in a coaching (JM: or Counselling) relationship, leaders can discover and tap the talents of individuals and direct their development, as well as align their behaviors and skills, thus becoming active as agents of change, enhancing the success of the organization.
5. Give Feedback: More than an annual review, leaders may give employees assistance in specific areas, such as developing networks, handling work/life balance, and attaining job and skills training. Providing feedback is more than an annual or semi-annual performance measure. It is a continual process which comes in the form of mentoring relationships, support groups, and action groups.
6. Money and Decision-Making: I haven’t yet mentioned compensation, which is an obvious employee retainer, but it’s not enough. In addition to compensation, people need to be involved in decision-making. The leader who asks people for their input on how the corporation can increase effectiveness is the leader who achieves buy-in from his or her employees. Not only does this help retain key talent, it also is a great way to generate ideas for organizational improvements.

Developing people is a strategic process that adds value to both the employees and the bottom line of the organization. Highly committed, highly competent people create financial rewards for the organization; organizations that develop their people and provide opportunities for growth are sought-after by high-impact performers. Great leaders know this simple formula. They understand it and strive to create an environment that supports it. And the result is success!

How to get the best out of your therapist

Friday, November 27th, 2009

Introduction
Professionals such as doctors and dentists are expected to provide patients with a quality service and we generally have some idea of what to expect when we seek their help. People receiving therapy are entitled to just as good a standard of care. However, many intending clients do not know what to expect or what is or is not normal in therapy. They are unlikely to know whether any concerns they may have are valid or not. In the first part, I will suggest ways of working with your therapist to make the most of the therapy, particularly when difficulties arise. In the second part I will deal with the situation when attempts to resolve the problem have failed. I will then explain the role of BACP in providing information and dealing with complaints against its members. When choosing a therapist, it is wise to select someone who belongs to a professional body with a complaints procedure. In this information sheet, the word ‘client’ refers to anyone receiving counselling or psychotherapy, irrespective of the setting. The words ‘therapist’ and ‘therapy’ include ‘counsellor/psychotherapist’ and ‘counselling/psychotherapy’. A ‘client’ may be an individual, a couple, a family or group receiving therapy. This is regardless of whether there is any payment by the client for those services.

PART 1
How to make the most of therapy
You can get the best results by:
- Being open
- Saying how you are really feeling
- Giving your therapist honest feedback on how you experience the therapy

Good therapy should feel safe and enable you to take risks with the issues you are prepared to work on. This includes saying how you think that you and your therapist are working together.

Working with your therapist when things go wrong
You may start out hoping for a good outcome from therapy or you may be ambivalent. Whatever your expectations may have been, something may happen that leaves you feeling uncomfortable or unsure. You may feel confused, or feel that what took place wasn’t helpful. It can be really hard to say ‘You are not helping me’ or ‘I felt bothered about x or y after our last session’ and to explain why you feel this way. The therapist may come across as a powerful person and you may worry about their reaction to critical comments. The therapy may have been useful until something happened which felt disturbing. You may be reluctant to talk about this for fear of spoiling what had been a good relationship. Uncomfortable feelings are normal and it can be hard to accept that therapy is not always a comfortable process. Therapists strive to deliver a good standard of care but sometimes, as in all human relationships, things can go wrong. The question is how to tell your therapist about your concerns. It is important to:

- Accept your uncomfortable feelings
- Think about what has caused them
- Discuss them with your therapist

Thinking about the problem
If you feel uncomfortable about any particular aspect of your therapy, it is important to spend time thinking about why. It might be something like:

- My therapist first agreed to see me for a reduced fee but now says she must increase her charges
and I can’t afford it
- My therapist keeps changing the time of my appointment at short notice
- I found out that my therapist is a trainee and I think she should have told me at the beginning. I worry about whether she is good enough
- My therapist often doesn’t say anything and waits for me to speak. The long silences make me feel uncomfortable
- My therapist used to give me a hug but now doesn’t
- I would feel better if my therapist would give me a hug sometimes, but she won’t
- My therapist often talks about herself in sessions.
- I feel annoyed because sometimes the session is more about her than me
- My therapist said I could ring her whenever I needed her but now she’s told me to stop and I don’t understand why
- My counsellor wants to tape some of my sessions. I don’t know if this is normal
- I feel very uncomfortable because my counsellor takes notes during sessions
- I met my therapist in a social setting and felt disturbed by some of the things she said about
herself. I can’t relate to her now in the same way that I did before
- My therapist suddenly told me that she can’t carry on working with me because she got a full
time job and next week will be my last session. I feel she’s dumping me and I’m very upset
- My therapist won’t give me any advice although I keep asking her what I should do. I expected to
be given more help in making decisions
- My therapist has suggested we meet at her home rather than my GP’s surgery where we started. Is that all right?

Talking to someone trustworthy or writing down what happened might help to clarify your thoughts and feelings. The aim is to be clear about what your concern is before talking to your therapist.

Telling the therapist what the issue is
Once you have thought about the issue, you should talk to the therapist. This is important if the therapy is to continue to be useful. You could choose to e-mail, telephone or write a letter. It can sometimes be easier to say difficult things about problems in a relationship when there is some distance between the individuals. It is best to tell your therapist what is wrong as soon as you can. Most people who start therapy do so because they want to feel better. It can be puzzling if you find that you feel worse. This is not unusual because therapy can be stressful and is uncomfortable at times. However, sometimes therapists can get things wrong. It is important to check out why your therapist behaved in the way that they did. Even a small thing such as the way the therapist spoke, the particular words used, the tone of voice or facial expression can be unsettling. A competent therapist will listen in an open way and work with you to understand what took place, and thereby achieve a better outcome.

Giving feedback
You should give regular feedback during sessions about what aspects of the therapy have been helpful and what have not. A good therapist will invite you to do this and will allow time for it. This should help issues to be dealt with when they arise.

When the therapeutic relationship is not working
You do not have to stay with a therapist with whom you cannot relate or feel safe, or whom you cannot trust. You may feel trapped and think you have to continue but this is not the case. You have the right to decide when to stop.

You have the right to look for another therapist.
If the service is being provided by an organisation with access to a number of therapists such as a GP practice or voluntary organisation, switching to a different therapist within the service may be possible. If you are working with a therapist in private practice then you can simply approach another therapist.

Key points
- Be open and give feedback about how you experience your therapy
- Say what is and is not helpful
- Raise concerns about practical matters such as increases in fees or changes to the time of sessions
- Give honest feedback. Therapists can often sense when clients have issues but they are not mind readers.

PART 2
What can you do if you are dissatisfied?
If you have tried to talk to the therapist and the response has been unhelpful, or you have serious issues about your therapist’s competence, you need to decide what to do. The first step is to ask yourself what you want. It may be that you want an apology, an acknowledgement of what happened and an undertaking that it won’t happen again. You may simply want an explanation about why something happened. In that case, it can be best to put your concern in writing, explaining the outcome that you would like, and allow the therapist time to respond. You may receive an explanation or an apology, either of which may satisfy you and enable therapy to continue. If you are not satisfied by the response, you can contact the Professional Conduct Department of BACP which deals with complaints against its members. If your therapy is provided by an organisation such as a GP practice or Employee Assistance Programme (EAP), you should first take your concerns to the person responsible for the service within the organisation. Such organisations are likely to have their own written complaints procedure, which may include an internal grievance or mediation route. Independent dispute resolution such as mediation or conciliation may be preferable to making a formal complaint to BACP. Taking a complaint to a formal hearing is often a very onerous and emotionally draining step for both parties, involving a substantial amount of time and energy. This should be weighed up when deciding how best to deal with unsatisfactory practice.

Exploitation – the power imbalance
Clients often feel very dependent on their counsellor. Most therapists are worthy of the trust placed in them but there are some therapists who may exploit that dependency, whether consciously or not. Clients who have been on the receiving end of malpractice or misconduct by therapists, or conduct that brings the profession into disrepute, are encouraged to use the Professional Conduct Procedure which can be found at the end of the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy (2007:9). You are not expected to seek to resolve such issues
with your therapist before taking this step.

Other sources of help from BACP
1. The Ethical Framework
If you are dissatisfied or worried about the quality of the service you have received from a BACP member, you can obtain a copy of the Ethical Framework. It gives guidance on the standard to be expected of a BACP member. The Ethical Framework covers a wide range of issues
including:

- The importance of trust
- What therapists and clients need to agree before counselling commences, such as payment, length of sessions, meeting times and areas to be covered in therapy (this agreement is often referred to as the contract)
- Record keeping
- The need for therapists to maintain competent standards of practice
- The importance of clear information about the services on offer
- The nature and limitations of client confidentiality
- The responsibility of therapists to respond promptly and appropriately to complaints.

2. The Information Department of BACP
For more information, you can contact the Information Department at BACP for help. They cannot tell you what to do but the staff will explore the issues and try to suggest some options. BACP will be able to confirm whether your therapist is a member of BACP. They can also give details of other professional bodies where you can check whether your therapist is a member. The Information Department may suggest that you contact the Professional Conduct Department of BACP.

About the author
Tessa Roxburgh is a retired solicitor who also trained as a counsellor. She currently lectures at Warwick University on the Open Studies programme and works with Relate.

References
BACP (2007) Ethical Framework for Good Practice in Counselling and Psychotherapy. Lutterworth: BACP.
Further reading
BACP professional conduct procedure, which can be accessed via: www.bacp.co.uk
Russell, J. (1993) Out of bounds: sexual exploitation incounselling and therapy. London: Sage Publications.

Additional observation: Joseph Maussen, a BACP member, is Head of Counselling Services and Intake Coordinator at Counselling Madrid, the counseling service for expats, international students and foreign professionals working and living in Madrid, Spain.

therapy results

therapy results

Behaviour link to lifelong health

Sunday, November 15th, 2009

People who behaved badly at school are more likely to suffer mental health and social difficulties as adults, a 40-year-study of Britons suggests. Canadian researchers writing in the Bristish Medical Journal examined data from 3,500 people from the age of 13 untill they reached their 40s or 50s. Those who had school behaviour problems were more likely to be depressed, divorced or have financial problems. The researchers from the University of Alberta wrote: “Given the long-term costs to society, and the distressing impact on the adolescents themselves, our results might have considerable implications for public health policy.” BBC. Source: Therapy Today – 2009
Counseling Madrid

British attitudes to emotional support

Monday, November 2nd, 2009

Although we are now relatively open to the idea that it is “good to talk”, most of our emotional support comes from informal sources rather than professionalsd in the “talk-based” therapies, according to the latest Bristish Social Attitudes report, published by NatCen.
The report finds a widespread view among the public that emotions are discussed more freely nowadays: 68 percent of people say it is important for them to be able to talk about their feelings. However, there is wariness about the idea of seeking psychotherapy or counselling: 43 percent would not want anyone to know if they had been to see a therapist, and 35 percent say they understand little about therapy.
There is also little evidence of reliabce on formal emotional support: four out of ten people have discussed their emotional lives at some point with a health professional. But the most common source of support is a GP: 31 percent of people have talked to their doctor about these issues, and 16 percent have used a professional “talk-based” therapist.People who have had serious mental health problems, or who have low levels of mental wellbeing, are particularly likely to have used formal emotional support. Poorer people, however, are likely to have used prescription medication at times of emotional difficulty.
Julie Brownlie, co-author of the report, comments:”Some have claimed that professional emotional support has come to occupy a dominant role in our lives. This appears premature. Informal social relationships continue to occupy a hugely important role in most people´s lives, while formal emotional support – and especially the use of talk-based therapies – remains relatively rare.”
NatCen. Source: Therapy Today

Counselling Madrid: dedicated to the expat community in Madrid, Spain.UK - culture

Poem: Good enough

Monday, August 31st, 2009

Body and mind
like birds and sky, intertwined
striving for the best
like horses on the racecourse, no time to rest!
Only the best seems good enough
although meeting high standards is tough
what else to expect from souls
living unknowingly, achieving third party goals.
Your body and your mind
isn´t it time to become more kind?
striving to be good enough
like wind touching trees, firmly sometimes, but not too tough.
You might be surprised to see the new responses coming in
when you are there you will be remembering
those days with relentless efforts pushing yourself
but here and now you uncovered a longer lasting verdict
good enough might just be perfect.

By Joseph Maussen – 2009

good enough often is good enough

good enough often is good enough

Relaxation techniques

Saturday, August 15th, 2009

This blog contribution by Joseph Maussen describes a way of helping with a common problem we are all likely to face – that of feeling tense or stressed. Sometimes this is related to difficulties in our personal lives or pressures at work or university, but, while the causes may be complex, it can be useful to think about how we carry tensions within ourselves and our bodies and how we can
actively develop ways of improving our sense of well being. Tension which continues over a long
period can end up affecting our health. How do we know if we are tense? Strangely, we can be so habitually tense that we accept our tense state as normal. (And it is true that a certain degree of tension can help motivate us to get on with a task.) The following are some of the symptoms which may identify undue tension:
● muscular tension, aches and pains
● difficulties with sleeping
● loss of appetite, stomach upsets
● persistent tiredness, exhaustion
● headaches, migraines
● hyperventilating, shallow breathing
● inability to concentrate or think straight
● a sense of things crowding in, feeling rushed and panicky.

To read more about relaxation techniques please visit www.counsellingmadrid.org/publications

Expat life & Counseling in Madrid

Monday, May 25th, 2009

At Counselling Madrid we welcome “blog contributions” from anyone wanting to share his/her experiences and views about life as an expat. Els Barkema-Sala has written an excellent article about the “ins and outs” and “ups and downs” while living the expat life.

(Els runs a private practice in The Netherlands helping expats with counselling, couple therapy and mediation.)

Article:
My life has been interesting with lots of traveling and living in different countries, including many years in Japan. Whenever I returned to Tokyo International Airport from a trip outside the country, the choice for lining up at passport control was always: ALIEN or NATIVE. It did not take long to absorb the fact that to Japanese this was a distinction of importance – not something to joke about. So I learnt to choose my place (as outsider, foreigner) and avoid hassle, but some other foreigners kept complaining about the airport signs.

Initially, life in a new country and culture can be a wonderful experience you just love to tell the folks back home about, but sooner or later the thrill gets mixed with frustration or anger, and you may miss home and all it stands for. This reaction is not so strange if we consider the definition of culture: ideas, customs and social behaviour of a particular people or society or the attitudes and behaviour characteristic of a particular social group that are
• based on learned human behaviour
• passed on from generation to generation
• a coherent, dynamic complex of norms, values and behavioural codes
• shared by a group of people.

When we try and settle in another country, we bring our own ways of being and thinking with us, and find they/we are different, which often comes across as ‘wrong’. Trouble is that when people from different cultural backgrounds interact, each takes things for granted that the other often finds unfamiliar (and sometimes appalling). The more that something is taken as ‘simply a fact of life’ by one, the harder it may be for the other to deal with it.

People miscommunicate for a number of reasons:
 It is hard to communicate in any language, more so in a second or third one. Little misunderstandings add up and stereotypical thinking or assumptions distort what is said or heard. Even body-language (non-verbal communication) differs subtly or majorly between cultures.
 How people use space differs: a good distance for one can be uncomfortably close to another. Private space is much more important in one culture than in another. Trouble is, there tend to be unspoken ‘rules’ about these things.
 How people regard time differs, for example: punctuality, dividing work and free time or private and family time. When people from different cultures live or work together, this can create chaos – consider for example what happens when a linear thinker (time is a line: one thing at a time) tries to interact with a person who likes to shift quickly from one thing to another or rather do several things at once…..
 Cultural values tell us what is seen as good, bad, important or trivial. They can differ hugely as to: how men/women/children should be treated, what food to eat, how to behave… Using your partner’s bathrobe may be a sign of pleasing intimacy to you, but to the other absolutely ‘not done’. Whenever people make judgements, values come into play. It needs awareness of one’s own values and a fairly strong sense of self to accept the fact that others have different values, without feeling threatened.
 Decisionmaking can vary from a high-context model (all opinions must be taken into account and ethics are situational) to low-context (strong demand for quick top-down decisions). Having to work things out with someone from another background can be much more difficult because of this difference in approach, however when you live anywhere long enough, there will be important decisions to make about: home, beliefs, lifestyle, childrearing, managing finances/ time/ vacations, family interaction, etcetera.
 Also the way in which information is shared, varies. An ‘outsider’ may be expected to know all about ‘the system’ (be it: social/ medical/ company/ family) without a need to explain. Trouble is, if someone expects you to know, but you don’t even know you ought to know, miscommunication is sure to happen.

People’s personality and character play a role too – in fact each individual carries her/his own culture, worldview and experiences from way-back that go beyond the mere fact of nationality and family of origin…… Even travelling to the other side of the world, we carry our own ‘bagage’ with us and that gives us that uniqueness, that can be fascinating as well as singularly difficult. Because wherever one lives, there is a need to create and maintain relationships and to find a niche to be comfortable in as an individual as well.

In close relationships, problems arise sometimes because there are too many unresolved issues (like family of origin or childhood difficulties). People think they get involved with a certain kind of person and then may find themselves plunged into situations they are unprepared for.
Having given up a career or satisfying job to be with this partner or spouse and thereby feeling fairly strongly dependent initially, this is bound to create difficult and painful situations. Another source of difficulties is that often signals are missed or misread as to: how a person feels, what is important or trivial, what really liked or disliked, what wanted or needed. How to communicate these things clearly? Too often we expect lover or friend to understand or be sensitive enough to know those things that are dearest/most personal to us.

People can behave differently when they are abroad as compared to back home in familiar settings, and this too can be confusing or upsetting – it may be useful to distinguish here between more group-based cultures (like many Asian, African or rural/traditional) and more urban, individualistic, Western societies. Interestingly though, intercultural interaction between people from a fairly similar background, that expect to have a lot in common, may actually be full of difficulties, probably because of those unspoken assumptions and high expectations. Of course our thinking about people and culture should not be rigid – sterotypes never promote understanding and neither do misconceptions, mistaken self-views or biases.

But if life in one’s own tried and trusted environment is hardly ever easy, international and intercultural living tends to be even more of a ‘mixed bag’. In fact, it can be said that living in another country is a life-altering experience, in ways that you never expected or could have foreseen. Of course, it makes a difference whether you chose to be there, or if fate has somehow thrown you there – and whether you plan to stay for a while only, or ‘for life’ because commitment or circumstances make leaving unlikely. When, for whatever reason, you feel you don’t have much choice, the experience is likely to be more stressful. Being part of a couple requires deeper commitment – when things do not go so well, there may be a greater sense of loss of ‘what was or could have been’. Short-term expatriates can take refuge in social interaction with people of their own nationality exclusively (a bit of Why bother?), but those who plan to stay feel a need to succeed, to get to know their new country and its people; there is likely to be more pressure to learn about and adapt to the culture and customs, and that may bring marvel or joy, but also frustration, irritation or tension. Support and understanding from partners or in-laws is not always there – it may be hard for them to be that empathic.

Occasionally things really go wrong. When you keep questioning yourself: What in the world am I doing here? and when you are feeling down all the time, you may be experiencing culture shock. That can be defined as: a condition of emotional upset and tension that becomes chronic for a period of varying duration and is experienced by persons who, exposed to life in an unfamiliar setting, react with anxiety, irritation and frustration. It can happen to anyone who has had to leave home, with its familiar and manageable routines and social patterns, and feels confronted with life in a different social setting with a language and mores/values that are unfamiliar (and that may be repugnant to the person with culture shock). No wonder this happens, because to feel lonely, isolated, uncertain about proper procedures, unable to control life, does give a lot of stress and wears a person down.
Culture shock has:
1. a honeymoon phase when all is terribly new, exciting, unknown but charming…
2. an angry, upset phase when you can’t help thinking Why don’t they do things properly?
3. a coping phase with more resignation, trying to adapt without losing your sense of self
4. a more integrated phase, when you are comfortable most of the time with where you are and how things are going.
Actually these phases may come and go and even after a long time any of those moods can become more dominant in certain circumstances. It helps to be aware of them, to know that what is happening is not uncommon, and to try and get help for the middle phases, such as an empathic listener, encouragement, good tips or support, if need be professional help. Don’t wait too long because getting timely professional help can save a lot of heartache!

Human beings are creatures of habit and maybe a nomadic existence is only good for those who can carry their ‘home’ with them, who feel at home whereever they are. That takes quite a bit of inner strength and considerable flexibility of mind. Those people have little trouble finding their feet in a new environment, they often have a talent for languages and a high degree of curiosity about other cultures or other ways of life. Experience learns though that even the most experienced expats can get some culture shock when they finally do go home and find it/themselves somehow changed, difficult to fit in again. It should be noted all of this goes for kids and especially adolescents as well – they may have been comfortable in a particular environment, but feel uprooted when they have to go and live in their ‘own’ country and feel ‘different’.

Of course in all of this there are many positives to consider, as the following statement expresses: The international and intercultural experience can be an unparallelled opportunity for learning and developing, for personal and professional growth and for sharing with others a sense of the uniqueness of the individual, whilst celebrating the diversity and similarity of human beings here, there and everywhere…..

About the author:
Els Barkema-Sala, MPhil, MBACP
www.counsellinginternational.com

Els, thanks again for your contribution!
Joseph Maussen
Head of Counselling
Counselling Madrid

The Differences between Counselling and Coaching

Monday, May 4th, 2009

As a Counsellor working in Madrid with the expat community I am often asked by clients about the differences between Counselling and Coaching. Although I have not researched this subject my explanation normally includes the argument that Counselling is for people who find themselves in a situation where they perform below what they consider to be their normal level of functioning. A Counselor is trained to assist clients getting back to their previous “normal” level of functioning. This explanation indirectly tells you what my view entails about Coaching: to get people, already functioning well, to perform even better.

From the above view you may deduct that some people receiving Coaching, actually might benefit more from Counselling. For example, when someone´s performance is temporarily affected by issues such as relationship problems or work related stress, Counselling seems a more approprioate way to get someone back on track again. I would add to this that Counsellors have more in-depth knowledge about the underlying triggers that lead to stress, and therefore are better equipped to look at the source of stress, rather then trying to make the symptoms go away through the use of relaxation techniques (also an important part of counselling). However, there are also people, currently receiving Counselling, that might actually benefit more from Coaching. Obviously there is no such thing as a clear line drawing the line between “will probably benefit most from Coaching” and “will probably benefit most from Counselling”.

Issues such as costs and availability also play a key role: the availability of one service – coaching or counselling – might increase the likelyhood of someone using one of the two services where actually the non-available service might benefit this client most. Let us also not forget the companies, schools and universities that are more or less inclined to be pro-active when it comes to offering Counselling and Coaching services to their most valued Human Capital: employees and students.

Therapists in Madrid, Spain

Sunday, April 5th, 2009

Counselling Madrid offers various types of therapy to clients in need of an English speaking therapist. In order to guide clients when making an informed choice, this week I wanted to write about the latest information released by NICE, The National Institute for Health and Clinical Excellence, based in the UK. (these guidelines have previously been published in the magazine for Counselling & Psychotherapy professionals “Therapy Today” – December 2008 issue). NICE have currently published 15 guidelines for the treatment of mental health and behavioural conditions. The following information is a brief summary of these guidelines.

Anxiety
Recommendations are made for both panic disorder and generalized anxiety disorder as follows:
Panic Disorder:
- CBT
- Self help in the form of bibliotherapy

Generalized Anxiety Disorder:
- CBT
- Self-help (bibliotherapy based on CBT principles

Attention deficit hyperactivity disorder (ADHD)
The ADHD guideline focuses on treatment for pre-schoolchildren, school-age children and adults:
- Group based parent-training/education programmes (CBT and/or social skills training)
- Individual based psrent training/education programmes
- Individual psychological interventions (CBT or social skills training)
- Group or individual CBT

Bipolar disorder
The guideline for bipolar disorder includes a number of recommendations for psychological therapies, including:
- Individual psychological therapy
- Structured psychological therapy
- Psychological treatment
- CBT
- Counselling (for women with unplanned pregnancy)
- Psychosocial intervention (psychoeducation and motivational enhancement)
- Self-help approaches (CCBT)
- Brief psychologival interventions
- Focused family interventions

Dementia
The guideline for dementia recommends:
- Psychological therapy (including CBT)
- Structured group cognitive stimulation programme
- Psychoeducation
- Genetic counselling

Depression
Psychological interventions feature in several of the key steps for the treatment of depression. Within step two, for the treatment of mild depression, the folowing treatments are recommended:
- Self-help based on CBT
- Brief psychological treatment – such as problem solving therapy, brief CBT and counselling.

In both mild and moderate depression, psychological treatment specifically focused on depression, such as problem-solving therapy, brief CBT and counselling, of six to eight sessions over ten to twelve weeks should be considered. Within step three, for moderate to severe depression, the folowing treatments are recommended:
- CBT (the guidelines states it should not be offered to patients with moderate or severe depression who do not take or who refuse antidepressant treatment)
- IPT if the patient expresses a preference for it or if, in the view of the healthcare professional, the patient may benefit from it. However, for moderate, severe and treatment-resistant depression, the treatment of coice is CBT
- Couple-focussed therapy for patients who have a regular partner and who have not benefited from a brief individual intervention
- Psychodynamic psychotherapy for the treatment of the complex comorbidities that may be present along with depression. In step four, CBT and mindfullness-based CBT are recommended.

Depression in children and young people

to be continued shortly

Note: looking for a therapist in Madrid? Counseling Madrid helps you choose the right therapy with the right therapist.

Counselling Madrid – Mindfulness, Meditation & Therapy

Saturday, February 28th, 2009

Mindfulness (often termed Right meditation) involves bringing one’s awareness into the present moment (from the past, the future, or some disconnected train of thought). By residing more frequently in the present moment, practitioners begin to see both inner and outer aspects of reality. Internally, one sees that the mind is continually chattering with commentary or judgement. By noticing that the mind is continually making commentary, one has the ability to carefully observe those thoughts, seeing them for what they are without aversion or judgment. Those practicing mindfulness realize that “thoughts are just thoughts.” One is free to release a thought (“let it go”) when one realizes that the thought may not be concrete reality or absolute truth. Thus, one is free to observe life without getting caught in the commentary. Many “voices” or messages may speak to one within the “vocal” (discursive) mind. It is important to be aware that the messages one hears during “thinking” may not be accurate or helpful, but rather may be translations of, or departures from truth. As one more closely observes inner reality, one finds that happiness is not exclusively a quality brought about by a change in outer circumstances, but rather that realizing happiness often starts with loosening and releasing attachment to thoughts, predispositions, and “scripts”; thereby releasing “automatic” reactions toward pleasant and unpleasant situations or feelings.

Meditation can be very helpful living a life more mindful. However, there are many misconceptions about meditation:

Misconception #1: Meditation is just a relaxation technique
The bugaboo here is the word ‘just’. Relaxation is a key component of meditation, but Vipassana-style meditation aims at a much loftier goal. Nevertheless, the statement is essentially true for many other systems of meditation. All meditation procedures stress concentration of the mind, bringing the mind to rest on one item or one area of thought. Do it strongly and thoroughly enough, and you achieve a deep and blissful relaxation which is called Jhana. It is a state of such supreme tranquility that it amounts to rapture. It is a form of pleasure which lies above and beyond anything that can be experienced in the normal state of consciousness. Most systems stop right there. That is the goal, and when you attain that, you simply repeat the experience for the rest of your life. Not so with Vipassana meditation. Vipassana seeks another goal–awareness. Concentration and relaxation are considered necessary concomitants to awareness. They are required precursors, handy tools, and beneficial byproducts. But they are not the goal. The goal is insight. Vipassana meditation is a profound religious practice aimed at nothing less that the purification and transformation of your everyday life.

Misconception #2: Meditation means going into a trance
Here again the statement could be applied accurately to certain systems of meditation, but not to Vipassana. Insight meditation is not a form of hypnosis. You are not trying to black out your mind so as to become unconscious. You are not trying to turn yourself into an emotionless vegetable. If anything, the reverse is true. You will become more and more attuned to your own emotional changes. You will learn to know yourself with ever- greater clarity and precision. In learning this technique, certain states do occur which may appear trance-like to the observer. But they are really quite the opposite. In hypnotic trance, the subject is susceptible to control by another party, whereas in deep concentration the meditator remains very much under his own control. The similarity is superficial, and in any case the occurrence of these phenomena is not the point of Vipassana. As we have said, the deep concentration of Jhana is a tool or stepping stone on the route to heightened awareness. Vipassana by definition is the cultivation of mindfulness or awareness. If you find that you are becoming unconscious in meditation, then you aren’t meditating, according to the definition of the word as used in the Vipassana system. It is that simple.

Misconception #3: Meditation is a mysterious practice which cannot be understood
Here again, this is almost true, but not quite. Meditation deals with levels of consciousness which lie deeper than symbolic thought. Therefore, some of the data about meditation just won’t fit into words. That does not mean, however, that it cannot be understood. There are deeper ways to understand things than words. You understand how to walk. You probably can’t describe the exact order in which your nerve fibers and your muscles contract during that process. But you can do it. Meditation needs to be understood that same way, by doing it. It is not something that you can learn in abstract terms. It is to be experienced. Meditation is not some mindless formula which gives automatic and predictable results. You can never really predict exactly what will come up in any particular session. It is an investigation and experiment and an adventure every time. In fact, this is so true that when you do reach a feeling of predictability and sameness in your practice, you use that as an indicator. It means that you have gotten off the track somewhere and you are headed for stagnation. Learning to look at each second as if it were the first and only second in the universe is most essential in Vipassana meditation.

Joseph Maussen: By demystifying meditation, clients can be motivated to start relaxing themselves. This is often a first and necessary step to become more aware, more mindful, of our thoughts and emotions and how these thoughts and emotions are the result of certain specific situations or events. Increased mindfulness opens the door to respond to situations instead of reacting or acting out. Clients often experience more freedom as a result and more fulfilling interactions with others, either at home or at work, with family members or friends.

Source: Mindfulness in Plain English, by Ven. Henepola Gunaratana
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