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Systemic behavioural couples treatment for depression: T e Exeter model

Presenter: Hannah Sherbersky This was a presentation from the AccEPT Clinic, Mood Disorders

Centre, Exeter University, where a model of couple therapy integrating systemic and behavioural techniques in the treatment of depression has been created. I was looking forward to it because couple therapy has been part of my work, supplementing family therapy in a CAMHS. It was a great presentation; Hannah Sherbersky gave a clear and energetic overview of the couple-therapy literature and the Exeter model. She included videotape of her work – hurray! These days, there aren’t so many people who let us see what they do in this way. In a workshop, it’s good to hear what the presenter thinks, but the doing of therapy adds an extra dimension. Hannah outlined the dilemmas of operationalising two

approaches to therapy within the overall aim of extending a behavioural model to treat depression. The dual approach is also refl ected in the data collection, as both the ‘Becks depression inventory’ and SCORE are used. A central question addressed by Hannah was: is this actually a manual of therapy identifying techniques to help reduce symptoms after a diagnosis of depression? She showed it could be more than this by describing how essential ideas from each model are fundamental to the therapeutic activity of this developing project. Genograms, reframing and attachment narratives (circular

questions and reframing) are from the ‘systemic-empathic model’. Creating new circularities, enactments and homework tasks come out of the ‘systemic-behavioural model’. Closely described techniques are included in each of these categories. In therapy, these are combined to help create behavioural change over 6-12 sessions. Hannah, in the video clips, gave as examples the enactment of new types of communication.

I have enjoyed thinking about how diff erent this workshop

was compared to other sessions at the conference. One of the expectations in my trust is that therapists of diff erent modalities fi nd the ways in which they overlap and that can be integrated for the benefi t of explaining to commissioners what we do. This approach to couple therapy demonstrates integration and is a good example of how the boxes of ‘strong evidence-base’ and ‘addresses presenting problems’ can be ticked. It will be interesting to follow the centre’s future reports on the curative factors in what they do.

David Secrett, family therapist, Sussex Partnership NHS Trust; couple therapist – private practice, Brighton

Refl ections on research presentations

Facilitator: Mark Rivet Saturday morning in the High Peak

Suite followed Friday’s format of a series of 20-minute presentations, this time on the theme of “systemic evidence, outcomes audit and research”. When the “last but not least”

presentation turned out to be ‘not there’, Mark grabbed the giſt and gave the room an opportunity to digest the fi ve presentations together.

Context February 2012 Connections were made to Kathryn

Blackshaw’s call for family therapists to develop and present business plans. Has this strand of presentations offered a way to respond to this? John Burnham threw up the challenge;

“Have we not been here, done this, felt and known this before? How did the energy around research die off?” and then, catching the challenge, asked if this connects to the well-trodden theoretical cul-de-sac about the nature

of knowledge and therefore research; the concept of “not knowing” morphing into a lack of willingness to explain what we are doing – not as a cure all (or know all) but as potentially helpful? A sobering conclusion from

contributors is that the battle for service and theoretical credibility is not now a competition for professional equality, it is one for survival. Perhaps the intent or conclusions of research will never satisfy the rigorous


Workshop reports

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