There are different approaches to psychological therapy but all, regardless of the particular philosophy, aim to help people overcome emotional (such as depression and anxiety), behavioural (such as "bad habits") and interpersonal (or relationship) problems.

At making changes, we concentrate on using proven and effective treatments such as Cognitive Behavioural Therapy (CBT).

The psychologists at Dr. Sharp & Associates are all highly trained and experienced in the delivery of cognitive behavioural therapy (CBT). Contemporary research suggests that CBT is the most effective treatment for the most common psychological problems such as depression, anxiety, panic, stress, insomnia, relationship difficulties and coping with chronic illness (such as pain). CBT is a relatively short-term, scientifically based therapeutic approach that is effective in achieving desired and meaningful changes.

CBT focuses mostly on the way people think about things (including their attitudes and beliefs) and the way they behave. CBT helps people identify where their thoughts and actions are self-defeating, and then to replace these "bad habits" with more helpful thoughts and responses.

CBT comprises both cognitive therapy and behaviour therapy. Cognitive therapy involves identifying and systematically evaluating the unhelpful thoughts (or cognitions) that lead to intense or frequent negative feelings (e.g. depression, anxiety) and result in unhelpful behaviours (e.g. avoiding friends). The treatment focuses on questioning thoughts and coming up with new more helpful ways to think about difficult situations.

Behaviour therapy is goal-oriented and aims to help people change unhealthy or unhelpful behaviours that cause them to suffer or lower their quality and enjoyment of life. For example, people who are depressed often enjoy fewer pleasurable activities and so your Psychologist would work with you to identify pleasurable activities and develop a plan to increase your participation in them.

Finally, CBT is focused on helping people like you to achieve your goals and to get more out of life. As well as helping you to change your unhelpful thinking and behaviour, CBT involves teaching you a range of useful and practical strategies to overcome the hurdles and obstacles in your life and to be happier and more productive.

Your Psychologist will ask you to sign a consent form indicating your understanding of the practice information and will explain the main issues associated with the privacy of your information. They will collect your questionnaires and score them after the assessment, giving you the results at your next session. The two main aims of the initial assessment session are to: discuss the issues that have brought you to the session, and to outline how we think we can help you. Each assessment session is individually tailored to suit your needs. Generally though, your Psychologist will ask you questions about your feelings, associated physical symptoms, thoughts that may have been bothering you, your family and medical history, your relationships, your activity level, and your goals and expectations for the program. At the end of the session there will be a brief discussion of the session plan and a chance for you to ask any questions of your Psychologist.

CBT is an active skills-based approach, so you will have to put work into learning new strategies and ways of dealing with difficult life issues. To get the most out of the sessions you will need to commit some time outside the sessions to working on tasks that you and your Psychologist agree upon. About 1 hour per day is usually enough - depending on the issues that you are working on – although it is often the case that the more time you put in between sessions, the more you will get out of the program and the faster you will achieve its benefits. Tasks you may be asked to complete between sessions may include: keeping a thoughts diary, practising relaxation techniques, completing an activity that you were working on in a session, or reading some relevant chapters from a book.

Ideally you will attend on either a weekly or fortnightly basis initially. At the start of treatment sessions tend to be more frequent so that you can quickly make some positive changes and start to feel better. As you progress through the session plan, you might discuss meeting less frequently so that you have more time to put in place longer term changes and work towards your goals. Please note that if you are feeling very anxious or depressed you would usually benefit from more frequent sessions initially.

The sessions are structured so that you get the most out of them. A typical agenda for a 50 minute session follows:

Brief review of progress since last session (discuss how you have been feeling and any major events)	5 minutes
Review of tasks assigned during the last session (troubleshooting any difficulties in applying the strategies)	10 minutes
Skills component (e.g. learn how to question thoughts or practice relaxation techniques)	25 minutes
Set tasks and goals to be completed for review next session and arrange next appointment	10 minutes

As you can see, most of the time in sessions is devoted to learning and practising new skills and there is limited time for just "chatting". We believe that clients get the most benefit out of sessions when they are active and learning a new skill, so just talking or ‘ventilating' isn't likely to be as beneficial. After all, if you want to just talk you can always talk to a friend or family member. Other therapeutic approaches such as counselling, don't seek to actively help an individual change but rather offer support and an opportunity to talk about feelings. In general, scientific evidence suggests that these approaches tend not achieve very significant results even after many sessions.

This varies according to the needs of the individual. However, most issues can be addressed in approximately 10 sessions. Some clients require fewer sessions as they want to focus on a very specific issue or area. However, if you are wanting to explore aspects of your personality and underlying beliefs about yourself and the world that have developed through your childhood and adolescence you will need to attend a greater number of sessions over a longer period of time. These sessions may be spread out so that you attend treatment once every 3-4 weeks if your Psychologist thinks this is appropriate.

From time to time you may not be able to attend a session due to unforeseeable circumstances. However, if you regularly cancel or reschedule appointments it can be very disruptive to your program and you may not achieve your goals if you are attending sessions infrequently or sporadically. Regular and consistent attendance ensures that you make the most of your program and reach your goals sooner. If you regularly cancel or re-schedule appointments your Psychologist will discuss this issue with you in your sessions so that you can work out a solution.

The formulation is a summary put together by your Psychologist of the main issues that were discussed in the initial assessment. It is important that you both have a shared understanding of what the issues are, how they have arisen, and what might be maintaining these difficulties, as well as identifying your strengths that will help you to overcome your difficulties. This is your chance to clarify any issues or add any information that you may think is relevant. It also allows your Psychologist to ask any further questions and fill in any gaps in their understanding of your situation. When you have finished treatment, it can be helpful to review the formulation and see how far you have progressed and how your situation has changed over time.

Your Psychologist will develop a draft session plan based on the formulation as well as the information gathered throughout the assessment process (including information from the first interview and the questionnaires that you completed). The plan is tailored to meet your specific needs and outlines in sequence the steps that your psychologist believes you will need to take to make positive life changes. This allows you both to have a clear plan and sense of direction for treatment. It is important that you work collaboratively with your psychologist and agree upon the skills and strategies that will be most beneficial to you and in which order you should proceed.

Sometimes it makes sense to learn certain new skills before others. For example, usually education about the psychological aspects of the issues that you face will come first. Also, the final session usually focuses on developing a setback plan, which involves reviewing all of the skills you have learnt in treatment and analysing the progress that you have made in order to maintain the gains in the future and to increase your confidence in dealing with future setbacks. However, the plan is not set in stone and you may decide with your Psychologist to change the order, add or eliminate items as treatment progresses according to your progress, individual needs, and changes in life circumstances.

As you progress through treatment, you will have some thoughts and feelings about how the sessions are progressing. Your Psychologist will ask you about how you are finding the sessions at regular intervals. It is very important that you feel free to raise any questions or concerns as soon as they arise. Your Psychologist will work with you to resolve any concerns you may have. As part of this process, you may need to consider your expectations of treatment. Problems that have been long standing will not disappear overnight and may take several months (or even years) to resolve. Also, no matter how hard you try, everyone will still experience some periods of sadness, anxiety or other negative feelings in their life and it would be unrealistic to aim to never feel sad or anxious again as these are normal emotions. However, if you feel you are not progressing as quickly as you would like, please discuss your concerns with your Psychologist so that you can work out a plan together to improve the situation.

In your second last session, your Psychologist will ask you to fill in the questionnaires that you completed at the start of the program and to bring them to your final session. At the final session you will be given feedback about the changes that you have made and the questionnaire results. Once you have achieved your goals and worked through the skills and strategies in your session plan, your Psychologist might discuss a follow-up program with you. This may involve a phone call one month after your last session or some follow-up appointments spaced out at 1, 2, or 3 months following your last session. The main aim of the follow-up program is to make sure that you continue to make positive life changes over time and that you don't slip back into unhelpful habits. After the follow-up program is finished, you can always re-contact Dr. Sharp & Associates for booster sessions or to get help with other issues that arise.

What We Treat

The exact nature of what we do depends on you and your needs. It also depends on the investment you wish to make in to your future and your happiness.

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