Helping to promote
16 January 2008
• Supported Self Help
• Role of Supporter
• Materials – How to use them?
The effectiveness of CBT in an educational
4 schools looking at effectiveness of self-help
What leads to change?
• Non Specific Factors:
Relationship with helper,
Commitment, Enthusiasm, Specifics
Non Specific Factors
relevance to individual.
• Specific Factors = Model Non Specific Factors
of intervention e.g.CBT
Cognitive Behaviour Therapy (CBT)
CBT is based on the idea that
how we think (cognitions),
how we feel (emotions) and
how we act (behaviour)
all interact and go together.
What is Cognitive Behaviour
An approach which can help to change
how you think – COGNITIVE
what you do – BEHAVIOUR
And therefore help you to feel better
It mainly focuses on the ‘here and now’
problems and difficulties.
How does CBT work
CBT can help individuals make sense of
overwhelming problems by breaking them down
into smaller parts e.g.
A problem event or difficult situation
From this can follow:
The Five Areas Assessment Model
Situation, relationship, family and practical problems
Altered Feelings Altered Physical
Supported Self- Help (1)
Using five-areas booklets
• Why CBT self-help?
• Clear structure of working
• Problem focused
• Build on a relationship – supported/guided
• Evidence based
• Equips people to help themselves – a
- Learn new skills
- Learn key knowledge
Supported Self Help (2)
• Time Limited
• CBT model but not using the language
• Can use with individual or group
• Need to focus on young person’s concept of the
issues – individualised materials
• Empowering young people
• Wide accessibility
What Sort of Support?
- therapy/treatment/being a therapist
• IT IS
-guiding, encouraging, supporting, regular
- building on young peoples’ skills and
- About developing emotional literacy
The Self-Help booklets
Dr Chris Williams
• Why Do I Feel So Bad
• I Can’t Be Bothered Doing Anything.
• How to Fix Almost Anything
• The Things You Do that Mess You Up
• Why Does Everything Always go Wrong
Why Do I Feel So Bad?
• Core booklet
• Introduces the idea that thoughts, feelings and
behaviour are interlinked.
• A vicious circle
– A bad event leads to altered thinking
– Altered thinking leads to altered feelings
– Altered feelings lead to altered physical symptoms
– Altered physical symptoms lead to altered behaviour
I can’t be bothered doing anything
• Particularly for mildly depressed young
people who may have lost enjoyment in
activities and have stopped doing things
• Encourages young person to identify one
activity and take small steps to enjoying it
How to Fix Almost Everything
In 4 Easy Steps
How to eat an elephant
a) Break elephant into small chunks
b) Eat one chunk at a time
Problems are like elephants
4 step plan to solve your problems
The Things You Do That Mess You Up
And how to stop doing them
• Taking control of unhelpful behaviour e.g.
self harm, taking risks, excessive drinking,
• 4 step plan
Why Does Everything Always Go Wrong?
And other bad thoughts you can beat.
• Unhelpful thinking styles
• The amazing (5 step) bad-thought-busting
Issues to consider
• How do we choose who can use self help?
• How do we introduce self help?
• How do we support someone using self
• How do we motivate someone to use it
Who to use the material with?
• Not primarily high tariff youngsters who are at
More appropriate for young people who are:
Stressed about exams
Displaying some anxiety about friendships /
Experiencing low mood/mildly depressed.
Students who are engaging in self defeating
How Do We Introduce self-help approaches
(Motivating young people to engage)
– Feeling distressed can make it seem difficult to
– Poor sleeping patterns/low energy can make it
difficult for people to focus their mind/enthusiasm
Re-labelling How the Material is
• Sometimes people talk themselves out of using the
- They may see reading/using the course as too hard, or in
some other way that makes them seem unattractive.
• Thinking about the material in a different way can be
- Reading or self-discovery of new life skills
- As a workout for the mind
- Development of new skills
• Consider using aspects of motivational
– Help the person identify the limitations that there
problems are imposing upon their lives
– Help the person to imagine ways in which life
would be different (better!) without these
– Maybe, with effort and support, self-help will work
Learning new things
• Can seem challenging: use examples of things
they have learned in the past that took some
getting used to e.g. swimming, riding a bike,
learning to drive
• Identify range of things they have learned in last
• Use metaphors of ‘putting your toe in the water’
and doing things ‘one step at a time’
Getting started: Assessment
• Joint summary/formulation of issues with
young person and supporter
• Aim: to increase their understanding of why
they feel as they do and hence increase
understanding of their behaviour
• Focussing in on an area to work on together
• Structured approach with one pupil, ie work
through one or more books together.
• Guided self-help, ie identify an area and
give pupil booklet to work on alone. Check
up on progress regularly.
• Small group
• Self help must use young person’s
language, their way of thinking and
understanding, based on their context and
background not ours.
• We are supporting them to make sense of
their feelings and behaviour, not to
understand our interpretation of them.
Other concerns and considerations
• Is it an appropriate time for this pupil?– assess this
(discussion with EP?)
• Don’t know if young person is using the material
- ask them how they are using it
• Young person may not know how to get the best out
of the materials
- teach them
• Young person might skim-read only
- encourage them to stop, think and reflect
• Consider a young person or young people who
you might use the material with
• Consider how you would use the material –
Guided self help or more structured approach?
• Consider how to timetable SHORT encouraging
contacts (Supportive monitoring)
– timetabled, negotiate with youngster, flexible
What support will you need?
• Informal support of colleagues?
• More formal support mechanism with colleagues?
• Informal support from EP?
• Formal support from EP?
– Guidance/SFL departmental meeting
– Colleague support group
– Support group with EP
– Individual support from EP
• Baseline questionnaire
• Training questionnaire
• Follow-up questionnaire March:
– have you used?
– How have you used?
– What’s worked well?
– What’s been difficult?
– Suggested changes?