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Posts Tagged ‘bristol’

Recently, a number of things have come together, and I feel myself undergoing a developmental leap in my practice and professional identity. I am manifesting that change through two decisions: leasing my own therapy room, and rebranding my practice.

It is unlikely to be a coincidence that Generation Rent is a political topic of the day. The transience and rootlessness of renting therapy rooms by the hour is something I have begun to find unbearable. The experience is interesting. Renting a space means more than just renting a space that belongs to someone else. After all, I haven’t bought my own building; my new therapy room is still on a lease. But there is a substantial difference between hiring a space, and a hire-space.

My new room is in The Ethical Property Company‘s centre on Colston Street. It is “my” space in so much that I contract with Ethical Property for use of that space to be exclusively mine for the period of the lease. Importantly, this means that the shaping of that space is down to me. I am free to create, not simply a therapy space, but my therapy space. Every decision about shaping this therapy space becomes a consideration of how this space can express the possibilities of my practice.

Contrast that with the nature of a hire-space, a room whose function is to be hired. The decoration may range from magnolia boxes, to beautifully themed rooms. But the spirit of the room, its very structure, is one of transience. The room is hired by many therapists, but belongs to none. It is no one’s “home room”. I tend to feel this as a sense of emptiness in the room; it is missing the many, tiny, background cues that suggest there is one specific person using this space on a regular basis.

In terms of figure/ground formation, the ground doesn’t support the figure of a tangible therapist. On the one hand, this means that it supports a kind of everytherapist, which certainly maximises the utility of the room as a hire-space. But this invites the therapist using the room into an everytherapist role. Just as any therapist could be using that room, so too could the clients who come to the room be seeing any therapist. The effect for me now is similar to every town having an identical high street; the unique element of soul that arises from place goes missing.

This has been ok so far. Gestalt therapy can be practised anywhere, with the only requirement being that the environment in which the therapy is situated be explicitly included in the therapy. There isn’t a correct set-up for the therapy, there is only the co-created experience of the therapy session, in awareness. If the therapy takes place in a soul-less box, then the experience of being in a soul-less box can be invited into the foreground for exploration. It is simply that my needs have changed, and now I feel constrained by hire-space in a way that I haven’t before.

Consequently, I am in the process of setting up my new room, and will practice from there as of the beginning of September.

A second need that arose as I made the decision to lease a room, was the need to attend to my professional identity. I feel like I have outgrown Silver Cat Psychotherapy, that this particular image no longer represents my practice. So, over the next few weeks, I will be transforming into the bristol therapist, a practice name that is more rooted in place, and reflects my sense of gestalt therapy as a particularly Bristol-ish approach. If psychotherapy was the UK, gestalt would definitely be Bristol!

And just to make that transformation process suitably challenging, I’ll be moving this blog to a new website, the very definition of growing pains!

I feel a mixture of excitement and trepidation. I wonder if my room will fulfil my expectations, or if I’ll discover that it’s no different to hire-space when it comes right down to it. I notice how applicable the cycle of gestalt formation and destruction is to specific projects like setting up a new therapy room and rebranding a practice.

Expect some updates. In the meantime, here is a work in progress shot of a painted corner of the room (first coat!):

therapy room work in progress

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I’m aiming this at Bristol’s many freshers (the fair city is home to both University of the West of England and the University of Bristol) but it’s just as applicable to returning students, and students at other Universities. It’s a really simple message: if you start struggling, ask for therapy.

As far as I’m aware, every University has a student counselling department these days. Better still, they tend to have websites too, so students in Bristol can check out the University of Bristol Student Counselling Service or the UWE Student Counselling Service as appropriate. These sites will have the information you need about what’s available and how to access the service.

If you can’t get what you need through your University, and you can afford private fees, then Counselling Directory is a good location-based directory. It’s also worth bearing in mind that counsellors and therapists often offer low-cost spaces, or know someone who does, or know local organisations who offer low-cost or free therapy. So ask!

Back to Bristol again, and Bristol Mind have a handy information page about local counselling/mental health services.

And if you do need to access counselling/therapy, remember to familiarise yourself with your University’s procedures around mitigating circumstances (your Students’ Union can advise you on this). Something that impacts negatively on your studies needs to be taken into account by your Board of Studies, but they need to be told about it before the academic assessment in question.

Aside from being a psychotherapist, I have personal experience of needing therapy at University. In my own case, I didn’t contact the counselling service. I didn’t have much of an understanding of what counselling or psychotherapy was. I feared that if I shared what I was experiencing with a professional, I would be required to take medication and/or sectioned. This was an expression of the kind of upbringing I’d had. My associations were that the police locked people up, social services took people’s kids away, mental health professionals put people in padded cells. This was not conducive to reaching out for support.

I also had a belief that seeking counselling was an admission of personal failure, and that I needed to pull myself together. I’ve flagged up the mitigating circumstances in particular because I specifically didn’t use this process. I had the notion that my results wouldn’t be real if they were adjusted to reflect anything I was struggling with. These ideas stemmed from a narrow idea of personal strength and weakness, and of what I was supposed to be able to achieve by myself.

The impact on my studies was pretty severe. I started having panic attacks in my second year, and stopped attending lectures and seminars. My Board of Studies noticed my poor attendance record and warned me I was at risk of disciplinary action; I could be failed on modules, or, in the extreme, kicked off the programme. That was a (partial) wake up call for me, and I forced myself to attend classes again. I discovered some breathing exercises that kept my anxiety low enough for me to stay in the room, and some concentration/meditation exercises that helped bring down my propensity to anxiety.

My grades improved dramatically. I was scraping 2:2s in my second year; in my third year I started getting solid 2:1s and 1s. Not because meditation gave me super powers, but just because addressing the blocks to my studies allowed me to start fulfilling some of my potential. Years later, in actual therapy, I exclaimed to my therapist, “if only I’d known back then that this is what therapy was!”.

Now, I share this experience because I think there are elements of what I experienced that are common in students generally. In people generally, in fact. The “I should be able to manage by myself” rule is something I hear often from people who come to see me for therapy. The experience of shame at seeking therapy in the first place because it means “there’s something wrong with me” or represents a personal failing is also a common theme. And, as a student, I often heard from friends/acquaintances that mitigating circumstances felt like asking for special treatment, and that if they got an improved grade as a result, it wouldn’t feel real.

Looking back, I feel a sense of remorse that I went through suffering that could have been alleviated if I’d felt able to seek counselling. I think there’s some good to be found in sharing that experience if it means someone can recognise themselves in my narrative and use that as a support for getting what they need now.

Maybe that’s you, or maybe that’s a friend of yours. Either way, whilst asking for help might feel hard, doing so might just save you a great deal of pain.

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My name is Simon Stafford-Townsend. I am a gestalt psychotherapist in private practice in Bristol and Cardiff. My private practice website is Silver Cat Psychotherapy.

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If you have an interest in alcohol-related issues, and/or the provision of long-term, low-cost therapy, and/or running a charity generally, then this may be an interesting opportunity for you.

I am a Trustee with The Swan Project; a small charity providing long-term, low-cost therapy for people wanting to work with alcohol related issues, primarily addiction. Its founder, Ronnie Aaronson, has written a book about her approach called Addiction: this being human. The charity also offers a general low-cost therapy service.

The Swan Project is small and only a few years old. Consequently, its structure and organisation is still very informal as it makes the transition from the founders’ labour of love to a fully functioning autonomous charity. Our board of Trustees is too small to provide stable leadership at this time, so we need more people.

The Board of Trustees’ collective duty is to ensure that the charity operates legally and in the spirit of its stated aims and objectives. Essentially, we make the strategic decisions, and the charity’s management implements them. We are responsible for ensuring that the charity’s accounts are done properly and reported to the Charity Commission and Companies House within the relevant timescales.

At this point, we need responsible and reliable people who are able to attend four meetings a year and make decisions in line with a set of stated objectives. There is a lot of scope for suggesting ideas for how The Swan Project develops, particularly in the direction of fundraising, which is a need area for us.

The Swan Project has grown a lot recently, and is currently sustaining itself financially, which is an exciting milestone. Our short-term focus is on consolidating this position so we can rely on remaining sustainable.

If you’re interested in finding out more, then please email me using simon@silvercatpsychotherapy.co.uk with any questions or to arrange a time to chat/meet.

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My name is Simon Stafford-Townsend. I am a gestalt psychotherapist in private practice in Bristol and Cardiff. My private practice website is Silver Cat Psychotherapy.

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A while back, I registered my private practice with the Bristol Pound. So Bristolians can now get support for themselves at the same time as supporting independent local trade by paying for therapy in Bristol Pounds. And by text message (how txt2pay works) no less.

I would like to see Bristol’s counsellors and psychotherapists adopt the Bristol Pound, as I think we generate an interesting economic microcosm. Every therapist has a supervisor; that supervisor has a supervisor; who in turn has a supervisor, ad infinitum. In fact, there’s a great therapy film waiting to happen about a therapist seeing a supervisor whose therapist is her supervisee’s client (Shakespeare would soil his/their pants).

Furthermore, the main counselling and psychotherapy professional bodies (BACP & UKCP respectively) require their members to attend to their Continuing Professional Development. Which is a bit like requiring cats to lick themselves, because CPD basically means attending trainings, workshops, writing articles, etc in all the interesting things to which counsellors and psychotherapists are already naturally drawn.

Consequently, if a client pays me in Bristol Pounds, it is highly likely that between my room hire, supervision, personal therapy, and CPD, I could probably hand over all that money to other therapists. Who will hand that money over to other therapists. And so on. And so on. Until someone finally buys a latte or a person centred scarf (sorry) from someone outside of Therapy World.

My point being, of course, that therapists end up handing over a significant proportion of their client fees to other therapists.

And the gestalt therapy angle on this is field theory. Gestalt therapy models a person as an organism in an environment. One dimension of my environment is the economic environment.

I’m thinking now of money as water, the economy as the water cycle, and the Bristol Pound as a dye trail showing how money flows around the local economic system.

Where does the money flow? Businesses that spend a high proportion of their income within Bristol are keeping money flowing around the local system. This is in contrast to businesses like, say, Starbucks and Vodafone, that spend a low proportion of their income within Bristol. If money is water, then the long-term prospects for a Bristol that loses more water than it takes in is economic dehydration.

Which is kind of the raison d’etre of the Bristol Pound: to increase local water retention. It has the potential to highlight who moves money around Bristol most effectively, and adds substance to an important discussion about what local economies are, and how they relate to regional, national, and international economies.

Perhaps most importantly, it connects the individual with the collective in a tangible way. And that’s the essence of field theory in gestalt: an individual is an organism, and an organism is both an expression and shaper of the environment from which it continuously emerges. A change in individual behaviour as simple as buying coffee (with Bristol pounds!) from an independent local coffee shop instead of Starbucks, scales up to a dramatic shift in how the local economy works.

Check out the directory of businesses accepting Bristol pounds to investigate how relevant to you this might be. And remember, the more a trader hears the question, “do you accept Bristol pounds?”, the more likely they are to get involved.

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Image scavenged from Positive Money’s “The Telegraph: Bristol Pound to Launch in September”.

~ ~ ~

My name is Simon Stafford-Townsend. I am a gestalt psychotherapist in private practice in Bristol and Cardiff. My private practice website is Silver Cat Psychotherapy.

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Today I have passed a new blogging milestone: my first guest post on someone else’s blog!

It’s actually something I put together on Storify, a site that encourages the telling of social (media) stories by pulling in twitter posts, facebook statuses etc into a blog post. I see lots of tweets that spark off gestalty thoughts in me, so this was a first attempt at putting those thoughts into writing.

So without further ado, I suggest you all make your way over to Reversal experiments: @suey2y vs the seasick as hosted on Diary of a Benefit Scrounger.

@suey2y is the twitter account of Sue Marsh, a campaigner for disabled rights who recently led multiple smackdowns on the Government by beating them over the head with the Spartacus Report.

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This is a brief check-in from me to draw attention to a new collaborative blog I’m involved with. It’s called Sex Positive Parenting. In a dramatic act of doing exactly what it says on the tin, the aim of the blog is to pull together bloggers who are parents trying to bring up their children in a sex positive way. Consequently, the writing so far has managed to be both amusing and provocative in a contactful way.

My first contribution to the project is “what are you having? A baby (boom, boom)…”, in which I start to explore the importance that gets placed on whether an unborn child is male or female.

I’m excited about the long-term possibilities for blogging with Sex Positive Parenting. I find blogging incredibly supportive for my development as a practitioner because the process of writing helps me focus otherwise quite fleeting thoughts into something solid and clear. I’ve been wanting to do something similar around my thoughts and feelings on parenting but don’t want le chat d’argent to become a parenting blog.

So Sex Positive Parenting will be a great focus for some of the trickier parenting stuff, at the same time as being a chance to experiment with a different writing tone. There will undoubtedly be overlap between what comes up for me there, and my work as a therapist, so I expect some of those thoughts will take a gestalt form here.

In the meantime, I recommend the blog not just for people with kids but for anyone wanting to cultivate a more sex positive attitude generally. For twitter updates, follow @SexPosParent.

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Recently, the Centre for Social Justice published the report “Commissioning Effective Talking Therapies” (pdf).

I find this interesting politically, as the CSJ was started by Iain Duncan-Smith, and so is broadly aligned with the Department for Work and Pensions. As the commissioning of talking therapies is the business of the Department of Health, this is an interesting intervention, about which I will have more to say in a future post.

The central message is fairly simple: to commission effective talking therapies, the service should be opened up to the private sector. Now, there’s not much in the way of hard stats on why that should be the case, which makes the report’s one key statistic a bit of a silver bullet to the head of the Improving Access to Psychological Therapies (IAPT) service.

Frankly, when what looks like a hatchet job in the name of free market economics rests its case on pretty much one damning statistic taken from one quarter of key performance indicators, I smell an undead gerbil. And so, inspired by the many, many smack downs delivered to the makers of suspect claims by Cathy Newman’s Fact Check blog, I thought I’d have a go at Fact Checking this core statistic for myself.

The claim:

“The Government has committed to spend an additional £400 million over the next four years on a limited range of National Institute for Health and Clinical Excellence (NICE) approved talking therapies, despite a recovery rate of only around 15% of all referrals” (p4)

The authors are unequivocal about this key fact: the IAPT service has a recovery rate of only around 15% of all referrals. Not only that, but the NHS is actually engaging in statistical skullduggery to disguise this alarmingly low figure:

“In the case of IAPT, it cites ‘recovery rates’ as a proportion of patients treated and also above ‘caseness’, rather than as a proportion of the baseline (patients referred), thus improving the outcome percentage. As described in more detail below, IAPT figures claim recovery as over 40 per cent… but from the point of view of commissioners and referring GPs, 86 per cent are not being helped by the IAPT service” (p37)

The background:

With the passing of the Health and Social Care Act 2012, NHS services are rapidly being opened up to tender by any qualified provider (AQP). The Act specifically opens up NHS services to tender from the private sector; de facto privatisation.

One of the areas open to AQP is adult psychological therapies. Currently, the vast majority of this service is delivered through IAPT. In order to prevent commissioning clusters from effectively defining AQP as an IAPT equivalent service, the CSJ’s report aims to demonstrate that IAPT is failing its users.

The analysis:

First, let’s get our terms clear. The IAPT service uses a peculiar language that aims to do what the majority of therapists tend to claim is not doable; quantify human suffering in statistically measurable terms. When someone is referred to IAPT, they are assessed for ‘caseness’. If someone has caseness, it means they meet the clinical definition for anxiety and/or depression as measured by a specific statistical tool. At the end of someone’s period of therapy, there is a final assessment; if the person’s scores have dropped below ‘caseness’ then they are deemed to have achieved recovery.

The report authors cite the IAPT key performance indicators for Quarter 1 2011/12 (April to June 2011). These figures claim a recovery rate (in England) of 42.5%. Step by step, we get there by:

Step 1. Taking the number of people who a) completed treatment in the quarter, and b) are moving to recovery (this is KPI 6a, and the number is 28,470)

Step 2. Taking the number of people who have completed treatment in the quarter (this is KPI 5, and the number is 75,697)

Step 3. Taking the number of people who a) completed recovery in the quarter, and b) were not at caseness at the start of treatment (this is KPI 6b, and the number is 8,725)

Step 4. Remove the people who didn’t have caseness to start with (step 3) from the total completed cases in the quarter (step 2) to get the number of people who a) completed recovery in the quarter, and b) had caseness at the start of treatment (the number is 66,972)

Step 5. Work out Step 1 as a proportion of Step 4 to get the percentage 42.5%

Phew! At least the stats add up in the way they’re supposed to; so far so gravy, though frankly, a 42.5% recovery rate is not exactly inspiring. But where has this 86% failure rate come from?

Well, the report authors’ claim is based on different stats. They work things out by:

Step 1. Taking the number of people who a) completed treatment in the quarter, and b) are moving to recovery (this is KPI 6a, and the number is 28,470)

Step 2. Taking the number of people who have been referred for psychological therapies in the quarter (this is KPI 3a, and the number is 206,918)

Step 3. Work out Step 1 as a proportion of Step 2 to get the percentage 13.8%

Now, pop-quiz, have you spotted the two sleights of hand that qualify the report authors’ calculations as bad science? Watch carefully:

Sleight of hand 1. The report authors use a suspicious tone of voice whilst pointing out that the NHS are using a smaller subset of the total available stats. This allows them to remove KPI 4 from view, an indicator that gives the number of people who have actually entered psychological therapies during the quarter. This is 123,792, meaning only 59.8% of referrals actually enter therapy. How can someone reach recovery when they’ve never even entered therapy? As a bonus, by the way, these figures contain a clear footnote stating that the number of people referred in a quarter don’t necessarily complete therapy in that same quarter; this is a totally unreliable figure to use as a baseline.

Sleight of hand 2. This one is the smarter move, and takes advantage of the ridiculous language IAPT is using. The very word ‘caseness’ presses the jargon button of all who hear it, making it a great primer for anti-IAPT sentiment from the outset. And so, because we all think we know what recovery means, but have only a vague idea of what caseness means, we are invited to stick with what we know and ignore a vital piece of causation: without caseness, there is no such thing as recovery. By definition, recovery means going from caseness to non-caseness; how can someone reach recovery when they didn’t have caseness in the first place?

The verdict:

It is incorrect to assert that IAPT has a recovery rate of only around 15%. Out of the total number of people referred into the IAPT service in the quarter examined, only 59.8% received therapy. Furthermore, people entering therapy in the quarter didn’t necessarily finish therapy in that quarter, making the figure unreliable for calculating recovery. Besides which, recovery in IAPT terminology means going from caseness to non-caseness using a specific measure. The inclusion of people who started therapy below the threshold for caseness invalidates the recovery rate because these people have nothing to recover from!

Let’s be frank, even if we’re convinced that recovery can be statistically measured (and whilst that’s an a priori assumption of the NHS, it is by no means a consensus in the wider professional field), a recovery rate of 42.5% is not inspiring. It’s enough to criticise IAPT using its own stats; the use of smoke and mirrors to make it look like a failing service is disingenuous at best, dishonest at worst.

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