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Author Archives: Kate McLaughlin

  1. CAT – How can we find greater agency in adaptive relational dynamics?

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    One of the therapeutic models that we regularly provide is Cognitive Analytic Therapy, often referred to as CAT or sometimes Relational Therapy. This is because the main goal of CAT, compared to other commonly used forms of therapy, is to recognise where there are repeating patterns in our relational dynamics. If these patterns are unwanted, and causing problems that we would prefer to change, these cycles can be broken by replacing them with an approach to relationships that is reciprocal, constructive and communicative.


    Why is CAT used?


    As you might expect, CAT is typically used to explore the difficulty that a client is having in forming and maintaining romantic relationships. However, the main issue that this process is designed to address is that the client doesn’t have the necessary relational skills that are applicable for the relationships that they’re struggling with. This could be due to a lack of experience in reciprocal relationships, but most often it is that there’s already a well-established set of beliefs, expectations and behaviours that isn’t an appropriate match for the relationships that the client is bringing it to.

    These internalised preconceptions that we have about ourselves and the other people in our lives is sometimes referred to as our internal working model for relationships. This isn’t something that we’re likely to notice or think about very often in day to day life, unless we’re actively, regularly trying to ask ourselves what we believe and why we act in the ways that we do. It is also not something that we’re likely to find very helpful or to keep doing for very long unless without being supported in the process.

    CAT is an opportunity for a client to receive that support from the therapist over a structured course of guided exploration and growth. This begins with a discussion about the problems that are currently happening and how they’ve happened in the past, so that the client and therapist can both recognise how and why these patterns first formed and what’s preventing them from going away on their own.

    The point of this is to help the client have a more intimate understanding of what their own internal working model for relationships is, and which parts of it is responsible for the cycles of behaviour that they want to change. This process may take as little as 6-8 sessions under the right circumstances, and is one of the main reasons why CAT was developed as a direct and accessible way to facilitate this process for patients of the NHS.


    What obstacles come with CAT?


    It is not uncommon for there to be obstacles in the process of CAT. Examining the history of our relational issues in this much detail is a very vulnerable thing to do, and can often be more painful, confusing or difficult than expected. This only becomes more true, the less of an understanding we have to begin with of the ways that we act and feel towards others. It is understood that the course of therapy might need to be extended to account for the extra support that’s needed, either by proceeding at a slower pace or pausing the examination to resolve these issues first.

    Once the client and the therapist have fully explored these blind spots, they then revise what they have discovered together to identify what needs to change to prevent the unwanted patterns from reoccurring.

    In a shorter course of CAT, this would be everything that the client believes they need in order to make these changes. However, CAT can also be extended from this point to support the client through a more challenging long-term process of making these adjustments to their internal working model.

    This will often involve finding new beliefs that will be more appropriate to the client’s relationships than the ones that they want to replace. These beliefs can then be practised and eventually internalised as part of an internal working model that isn’t going to cause the same sorts of unwanted conflicts, going forwards. Typically, if a course of CAT is extended for either of these reasons, it may instead last for as many as 24 sessions.

    It is important to note that CAT works in the same way when supporting other types of interpersonal issues as well, and isn’t just applied to romantic partnerships. Wherever there’s a problem that keeps happening in a client’s friendships, family life, workplace dynamics or any other kind of relationship that two or more people might share, the answer lies in addressing the beliefs and feelings that are causing these problems.

    It is for this reason that CAT is sometimes used as an alternative to, or supplement for, professional mediation. This might be the case if it is discovered that there are issues in the relational dynamics between the clients that are getting in the way of a constructive discussion. It is often found that by taking the time to recognise the nature of these obstacles, they can then be addressed first before continuing the process unobstructed.

    The perspective works with the same understanding that there are unmet access needs which are preventing the client from being able to engage with the process, as opposed to a lack of interest.


    two people arguing

    There are limits to the potential benefits of CAT in and of itself for other issues that a client may require support with, such as psychosis or chronic trauma recovery. As a form of talking therapy, it may also be inappropriate if the client is nonverbal, or has similar access needs that can’t be accommodated within the scope of the model. Additionally, like many other revision or reframing-based cognitive models, CAT relies upon the assumption that the client’s relational dynamics continue to be entirely maladaptive for current life. If the client is going to remain feeling unsafe without these protective patterns of thinking and behaviour, then they’re likely to return as a necessary part of their internal working mode after being removed or replaced.

    Despite this, CAT has remained popular as a model since first being introduced because of its clear and direct focus on relational issues, while also being a collaborative process between client and clinician. In particular, it is often recommended for supporting clients with personality disorders. This is one of the many instances which are benefited by CAT’s approach of clinical acceptance and absence of judgement.

    If you would like to learn more about CAT and the other therapeutic models that we are able to deliver, or how we can help support any of the issues mentioned in this article, please contact us on 01282 685345 or at office@jsapsychotherapy.com

  2. Why do more women attend therapy compared to men?

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    When conducting the State of Mind Survey with therapists from around the Northwest, we found that most clients attending therapy, were women.  

    So why are more women attending therapy compared to men? 

    Everyone has mental health and in recent years there has been an increase in mental health awareness and many people are now prioritising their health and wellbeing. The stigma surrounding mental health is also decreasing, slowly.  

    The rise in mental health problems in both adult females, adult males, and children and young people have increased recently.  It’s no surprise following a turbulent few years due to the pandemic that more people are searching for help, and sometimes, people get ordered through local authorities to seek psychotherapy services.  It’s worth noting that the amount of adolescent females and males that have come for therapy have been the same – it is highly likely this is due to an adult making the decision they need to attend therapy.


    Women’s Mental Health


    One in five women have a common mental health problem such as depression or anxiety and there are a number of social and economic factors that can put women at a greater risk of poor mental health compared with men. 

    One of these factors includes hormones and 8-15% of women experience postnatal depression after giving birth.  

    Women are also more likely to develop an eating disorder in comparison to men, especially younger women. This has severely increased with the rise of social media platforms and picture editing.  


    Men’s Mental Health 


    Three times as many men die by suicide compared to women, with men aged between 40-49 having the highest rates in the UK.  

    Men also report lower levels of life satisfaction than women according to the Government’s national wellbeing survey. However, they are less likely to access psychological therapies than women.  

    Men are more likely to act out their feelings through disruptive or anti-social behaviour and will often turn to alcohol and drug use, this can cause a vicious circle and worsen mental health problems.  They find coping mechanisms, that aren’t things like talking, before seeking help from others. 


    Why do more women attend therapy compared to men? 


    When talking about mental health and difficult feelings, both women and men will often internalise the feelings they are experiencing. The biggest difference between the two is the coping mechanisms they rely on – as stated before, men turn to outlets such a alcohol and drug use, while women prefer to talk about their feelings. 

    However, women tend to have better social networks and find it easier to confide in their family and friends. This makes women more likely to seek advice and attend therapy.  

    This can also stem back to the stereotypical divide between men and women and their societal roles. Men are expected to “get on with it”, which can make it difficult for them to feel as though they can talk freely without judgment.  

    These stereotypes, although now being challenged more, cause stigma around talking about mental health, which stops men from speaking out and seeking help, and possibly why they turn to these other outlets instead.


    At JSA Psychotherapy, we have a wide range of psychotherapists, both male and female, who specialise in a variety of different therapies to help clients feel at ease and accommodate to their preferences. You can find the different services we offer here.  

  3. Men’s Mental Health

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    The Burnley Express recently published an article around men’s mental health. The article, which described how ‘millions of men said they are not ok and feel down an average of three times a week was a devastating read but not a surprising one.

    Suicide is the leading killer of men aged under 50 whilst the number of men experiencing suicidal thoughts when feeling angry or low has doubled since 2009 and, on average, one man takes his life every two hours in the UK.


    Why are men struggling with their mental health?


    The natural question to want to ask is ‘why’. We want to analyse, to plan and to fix, and this is indeed a noble aim. But in doing so, we risk seeing statistics instead of people and symptoms instead of human experiences.

    As humans, we create meanings out of our experiences, and these have a profound impact on our wellbeing. For example, a pay rise is an objective event, the number written on our pay slip changes, but we embed it with significance. If we achieve one, we are successful, if we are passed over, we are a failure. We may then struggle to pay our bills, which are again objective numbers on a page that we fill with meaning. We may feel we have failed to provide and so our negative sense of self compounds and our distress mounts. Until, therefore, we understand the meanings that events hold for people and see the distress they cause, we put sticking plasters over long neglected wounds.


    How are men struggling with their mental health?


    The article in the Burnley Express describes several ways that men experience difficulties with their mental health, including anxiety around social situations and stress in the workplace. It was the comments on relationships, however, which give us the biggest insight into the inner tension that men often experience.

    According to the report, a third of men feel lonely and 60% feel unable to open up to a close friend or family member, meaning that there are a lot of men who are experiencing a massive sense of disconnect and isolation, as well as a stuckness about their ability to get out of the situation, being filled with worries about what might happen if they do try to open up. Indeed, when asked what their worries are about talking about their difficulties, 20% of respondents said that they don’t want to seem vulnerable and 20% said they want to handle it on their own. This is the centre of the tension. Men feel isolated but are anxious about the two central building blocks of connection and intimacy; vulnerability and reciprocity. Stuck between the pain and fear with limited encouragement or equipping to find a way through, is it any wonder that many men find their distress to be unbearable?


    What can we do?


    This study was completed in conjunction with Talk Club, who recommended a framework for checking in on your own and your friends wellbeing. This is an excellent start and, for many, may be the first steps on a journey to freedom.

    Allow us to recommend a next step, for those who are looking for something a little further. For example, the study reported that the most ‘off topic’ issue is that of fertility problems. This is not something which will be resolved by going to the gym more and it’s exactly here that our meanings are so important. If we try to apply action based techniques to an issue like this, it’s like trying to fix the boiler by tinkering with the radiators. We need to have our meanings heard, something Talk Club also stress as being important. To take the next step in the process, we can use the framework of ‘How, What, Why?’; How are you doing? What made you feel that way? Why did it make you feel like that? Obviously, this can be put into a style that is comfortable for each individual, but the three part framework can give us structure for stepping off into what, for many of us, feels like the unknown. Whether you are in a place to take that first step or have begun your journey and want to develop a real solidity, talking is central to building real connections and listening to each other’s meanings allows us to unlock the doors of our isolation and begin to feel truly ‘OK’.


    If you or someone you know is struggling and feel like you need some extra support, we might be able to help. Contact office@jsapsychotherapy.com or call 01282 685345 to find out how we could help.

  4. Touchstones – The Benefits of Painting

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    We have recently begun running Touchstone sessions at Church on the Street, in Burnley, which gives visitors the chance to take a moment out of their day to sit, paint stones, and chat about whatever is on their minds if they want to. 


    What is Touchstones?


    Touchstones is a new project that we are implementing at JSA Psychotherapy. It focuses on the therapeutic and cathartic benefits of painting stones and talking. 

    Although we also offer Creative Arts Therapy services, which have their own purpose and benefits, Touchstones is not so much a therapy, but a way to help relax and release anything on your mind while letting your creativity run wild.


    How is Painting Good for the Mind?


    Creative hobbies, such as painting, are an excellent way to improve your well-being.

    Life can often be stressful and we all experience high levels of stress in our lives at times. Painting and other creative hobbies can help release some of the stress that can build within ourselves. 

    The cathartic motion and creativity that comes from painting can help to relax your mind, allowing you to let go of all the stress you are holding in. It enables you to manage and regulate emotions, as well as handle psychological distress

    Painting can also help you express the emotions you are feeling without having to say a word – something that can seem daunting to some people. In fact, painting has been used as a method of communication for thousands of years, dating all the way back to 40,000 years ago. 

    Creative hobbies, like painting, also provides a community for those partaking in the activity. It can bring people together, create connections and provide a social activity – all of which prevents feelings of isolation.

    Art and painting are about expression – there’s no right or wrong answer, or way to do it when it comes to painting. This can take the anxiety factor away from the activity, and help provide a relaxing atmosphere for those letting their creativity flow.  


    If you would like to find out more about our Touchstones project, or get involved, contact us at office@jsapsycotherapy.com or call us on 01282 685345 – we are more than happy to have a chat!

  5. Care for Caregivers – What is it, and what are the benefits?

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    One of the key services besides psychotherapy and psychological assessment that we provide at JSA psychotherapy is clinical supervision.


    What are Clinical Supervisions?


    Clinical supervisions are monthly sessions in which practitioners themselves receive professional support, through an opportunity to discuss their caseload, address their emotions and reflect upon the challenges they are facing. Those of you who are familiar with the practice of psychotherapy and counselling may already be aware of clinical supervision as a mandatory requirement for anyone practicing under a registered regulatory body. 

    In addition to providing clinical supervision for counsellors and psychotherapists, we also provide this service to caregivers in other roles who are not covered by regulatory mandates but nonetheless benefit significantly from this support, which we refer to as Care for Caregivers. These caregivers include the ones employed by our sister company, residential care provider Life Change Care Limited. 

    In this way, Care for Caregivers forms the supervisory element of the TIER system, Life Change Care’s provisional framework that is used across the entire organisation. This incorporates the welfare and recovery of the children and families in their care, as well as – in this case – the wellbeing and development of the staff providing that care. We will be discussing the Care for Caregivers programme further and its possibilities further in an upcoming series of articles.  

    This article will cover an introductory summary into how we devised this element of our care delivery, and what outcomes it is designed to achieve. It is worth mentioning that JSA Psychotherapy have been providing Care for Caregiver supervision to Life Change Care’s homes for several years at the time of writing. As such, we have included a number of testimonials from carers who have received it to express their own experiences of how it has supported them in their roles. 


    What is Care for Caregivers?


    Care for Caregivers is a means of delivering periodic and consistent support for the caregivers’ emotional regulation and continued professional development through the process of reflective supervision. It is extremely well documented that clinical supervision is an inherently necessary form of support for other caring professions. Life Change Care was established as a sister company to JSA Psychotherapy given the perspective that we have gained of this with our mental health background. The purpose of developing this framework of care for residential care has been to demonstrate its importance, necessity and utility. 

    It is agreed that any practicing counsellor or psychotherapist needs this service every month in order to offload the stress that has accumulated while working with traumatised and vulnerable people with mental health issues and complex trauma. This is especially true when supporting them to process any distressing or traumatic events that may have occurred for them in providing this care, or that they have taken on as secondary trauma from supporting others to process their own. 

    The ability to provide grounded, affirming and supportive care for those needing help with these issues has to begin with a caregiver who is already themselves grounded with a stable foundation of emotional support. This is just as true for anyone working with vulnerable children and families in residential care as it is for those who are working with them as therapists. This is at least partly because a well supported carer is better able to recognise and manage their own levels of emotional regulation, and thus, recognise and manage other people’s feelings too. When we become dysregulated, we are unable to think clearly and instinctively fall back on our internal working models for how to behave in the stressful situation we are experiencing. 


    For children and young people who need support with symptoms of complex trauma, their internal working model is the source of their behavioural issues. This is because when they feel overwhelmed, they are falling back on survival skills that they have learned and internalised during adverse childhood experiences. skills that are harmful or inappropriate for adult life and relationships.  In addition to the support they need to meet their developmental milestones. Complex trauma recovery work is required to help them overcome, reframe and internalise new, less harmful core beliefs and coping skills.  

    Foundational to the TIER system, is the notion that the internal working model of the adult caregivers must also be considered when structuring this care plan. Many of the staff working to provide this trauma-informed care may be entirely new to the role, or may have extensive experience already, but from working in different care homes, with different behavioural management systems that are not trauma informed.  

    Obviously, workplace training in a trauma-informed framework is necessary, but upskilling in any new information requires repeated practical experiences and frequent opportunities to reflect upon that learning, in order to fully integrate it into the long-term memory and internal working model.  Ideally, with the grounding and regulation support provided through caring for carers supervision, there will be far fewer occasions where the carers will find themselves overwhelmed and emotionally dysregulated in the home. However, it’s unavoidable that there will always be circumstances that push the caregivers to rely up on their instinctive reactions to a crisis, without having the opportunity to think things through first.

    The function of Care for Caregivers with reflective supervision is that when they do so, those instincts are informed by an internal working model which has a fully integrated understanding of trauma-informed practices for behaviour management and de-escalation.  This is how we support the provisions we work with to ensure that their care is truly holistic in maintaining a trauma-informed approach.


    What are the Benefits of Care for Caregivers?


    In turn, the children and families receive the same benefits of this support. As touched on above, when the staff are supported this way, they are able to take what they have learned from their reflective process, and experience of actively working to integrate better practice into their internal working models, to then provide this same support through the therapeutic process of overcoming developmental trauma’s lingering effects. 

    There is no single outcome that the children’s homes we work with seek to achieve for the families and children in residence there that doesn’t directly benefit from and indeed require this underpinning to achieve properly. For example, it has shown particular utility within Life Change Care’s parent and child provision specifically, where these shared reflection techniques have been critical for caregivers to demonstrate and impart the parenting skills to vulnerable young families.  


    Be sure to keep your eyes peeled for further updates on this blog over the coming weeks and months, where we will be discussing this topic in greater depth! If you have any further questions about the services that we provide, or would like to inquire about sourcing them for your own care team, please get in touch on 01282686345 or at office@jsapsychotherapy.com.

  6. What are the Main Barriers to Engagement in Therapy?

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    When providing therapeutic intervention to a client, it isn’t uncommon to come across some barriers to engagement within therapy sessions.

    By understanding and pre-empting these barriers, therapists can plan how to overcome the barriers to prevent a disruption throughout the therapeutic intervention.

    We recently conducted a survey called “State of Mind” to get a deeper insight into the therapy sector, including the barriers to engagement therapists face from clients and how they overcome them.


    What are the Most Common Barriers to Engagement?

    From the survey, we found that the most common barriers to engagement included:

    • Professional improvement
    • Price
    • Parents availability to facilitate children attending sessions
    • Lack of understanding of reason for referral
    • Lack of trust
    • Hesitation and avoidance
    • Feel pressured into attending
    • Client being uncomfortable in a new environment with strangers
    • Client doesn’t believe that they need therapy
    • Availability
    • Attachment style of client

    Out of all these identified barriers to engagement, the most common, with 60% of therapists agreeing, was hesitation and avoidance from clients and that clients don’t believe that they need therapy.

    This isn’t surprising given the variety of circumstances that have brought people to therapy, and what expectations they have for the process. They might have sought it out for themselves because they are familiar or curious about the process and believe it can help them with issues that they know they are experiencing.

    However, it’s often because they’ve been recommended to seek the support by friends or loved ones or have been signposted by their GP. In this case, the client might not have a clear understanding of how therapy works or what they want out of it.

    It’s also very common for someone in their family to have insisted that they get therapy, rather than suggested. In this case, they might be fully dismissive of the process or keen to find a quick fix and then decide it’s helped as much as it’s going to. It’s worse still if the client has arrived at the therapy room because it’s been mandated by the courts or social services. This is, sadly, one of the more common circumstances for therapy to be commissioned.

    The therapeutic relationship relies on interpersonal trust, open communication, and emotional congruence. This is difficult to achieve under the best circumstances, and requires a period of building rapport and familiarity, no matter how eager both people are to engage. That’s because therapeutic work inherently involves engaging with deeply uncomfortable and disturbing feelings, something that we naturally avoid unless we’re making a deliberate effort to confront them.

    Making that effort to engage despite the discomfort, especially over a long period, often requires a deliberate, genuine desire to work through the issues the client is dealing with, and a willingness to receive the emotional support and guidance of the therapist.

    As such, it’s extremely difficult to achieve meaningful results if the client doesn’t have a clear understanding of what they want from therapy or is only complying to achieve somebody else’s intended outcomes for a change in their behaviour because they feel threatened or coerced to attend.


    What Techniques, Tools or Strategies are Used to Overcome These Barriers to Engagement?



    By identifying these barriers, we also wanted to understand how therapists overcome them. This is what we found:

    • Writing letters for regular non attendees
    • Rephrasing “therapy” to something else i.e., “special time”
    • Reflecting together on non-attendance
    • Planning sessions together
    • Offering early evening times and weekends
    • Offering different locations
    • Motivational interviewing style techniques
    • “Getting to know you” activities
    • Creating a bridge to trust and therapeutic alliance
    • Checking in pre and post session

    We found that the most common technique therapists use to overcome barriers of engagement within therapy sessions is by creating a bridge to trust and therapeutic alliance.

    This can be achieved through effective and reciprocal communication but will often require time and patience on both sides of the clinical relationship. For the therapist, their involvement in building this bridge can also look like addressing any disparities in power dynamic at play in the clinical relationship and affirming or asserting the client’s agency in the process where appropriate and necessary.

    Do you face these barriers and use the techniques mentioned, or face other barriers? Our dedicated State of Mindpage has more information and a link to the survey, where you can have an input into our findings.

  7. Kate McLaughlin: Our Digital Marketing Apprentice

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    In April 2021, we welcomed Kate McLaughlin as our digital marketing apprentice.  JSA brought Kate onboard with the intention of building up our online presence through our social media channels, blogs, monthly magazines and other marketing materials.  

    Kate is currently working towards her Level 3 Digital Marketing qualification with QA Apprenticeships. To celebrate National Apprenticeship Week 2022 (7th February – 13th February), we sat down with Kate to find out how she is getting on with her apprenticeship. 


    What do you enjoy the most about your apprenticeship? 


    “I really enjoy working with my team on various campaigns.  I manage all the social media, websites and marketing materials for JSA Psychotherapy and Life Change Care and work continuously with my colleagues to create and implement different campaigns for each company.” 


    What have you done over the past ten months on your apprenticeship? 


    “My apprenticeship has allowed me to understand a lot of different marketing aspects, which I’ve been able to implement into JSA Psychotherapy’s marketing efforts including social media and email marketing campaigns, specifically Group Equine Assisted Psychotherapy and State of Mind. I’ve also created monthly magazines for both JSA Psychotherapy and their sister company Life Change Care.  

    I’ve studied relationship marketing, some basic coding and web technologies which have all contributed to my role within the company.” 


    What are you hoping to achieve after your apprenticeship? 


    “I am hoping to continue with my learning and development within the marketing field. Marketing covers such a vast topic and there are many areas that I still want to explore – you never stop learning.” 


    Do apprenticeships give you clear guidance as to where it can take you in the future? 


    “I think they do. My apprenticeship has certainly allowed me to understand what I want to specialise in and has highlighted the opportunities that are there for me. It also allows you to see what other types of careers are needed to help run a business, which I don’t think you always learn in school.” 


    Do you feel that apprenticeships are beneficial? Would you recommend an apprenticeship to a young person? 


    “I would recommend an apprenticeship to everyone – it’s a great way for you to gain hands on experience. Especially in the marketing industry where no two days are the same. An apprenticeship allows you to gain valuable experience while learning and equips you with vital transferrable skills that you only get in a workplace.” 


    We are proud of how much Kate has achieved throughout her apprenticeship so far and we are excited to see what happens in the future. 


    As part of National Apprenticeship Week this week, we are also highlighting Alicia Barrett, who went from Apprentice to Group Administration Manager and recently celebrated her seventh year with the company.  

  8. Alicia Barrett: From Apprentice to Group Administration Manager

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    You might know Alicia Barrett as our Group Administration Manager, but did you know that she began her career with us at JSA Psychotherapy as an apprentice? 

    It’s National Apprenticeship Week (7th February – 13th February 2022) and we wanted to highlight our amazing apprenticeship success story. Alicia joined JSA Psychotherapy seven years ago, as an administration apprentice. We sat down with Alicia to look back at her time as an apprentice: 


    Why did you decide to do an apprenticeship? 


    “I decided to do an apprenticeship as I felt that I would learn more from on the job learning rather than learning from a college classroom setting.  When leaving school, I went to college to study Media Studies but after one year, I knew that this route wasn’t for me.  I knew I wanted to work in an office setting doing administration, I wasn’t aware of what field of work this would be in.  It just so happened that this was in Psychotherapy.” 


    What did you enjoy the most about your apprenticeship? 


    “I enjoyed learning new skills in the workplace setting which I wouldn’t have learnt from a classroom.  I enjoyed being able to complete my college coursework in my own time.” 


    How did completing an apprenticeship set you up for a successful career? 


    “When I completed my apprenticeship, I gained knowledge to set me up for my career ahead.  At the time, I didn’t realise that in 7 years’ time, I would be the Group Administration Manager.  I finished my apprenticeship and then went on to complete three additional qualifications to help me get to where I am today.  I feel like if I hadn’t have started off with my administration apprenticeship, I wouldn’t have been equipped with the skills I need for my role today.” 


    We are proud of how far Alicia has come in the past seven years and we are excited to see what happens in the future. 


    As part of National Apprenticeship Week this week, we are also highlighting Kate McLaughlin, who is currently completing a Digital Marketing Apprenticeship. 


  9. Personality Disorders: Changes in 2022

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    As of January 2022, the way personality disorders are identified and classified has changed. This blog delves into what personality disorders are and why the way they are being identified is changing. Keep reading to find out more.


    What is a Personality Disorder?


    According to the NHS website, “a person with a personality disorder thinks, feels, behaves, or relates to others very differently from the average person.”

    It is important to remember that we all have our own thoughts, feelings, and behaviours so just because you think something different to someone else, doesn’t automatically mean you have a personality disorder.


    What are the Different Types of Personality Disorders?


    Before 2022, psychiatrists used a system of diagnosis which identified ten types of personality disorder. These ten types were grouped into three categories:


    • Paranoid personality disorder
    • Schizoid personality disorder
    • Schizotypal personality disorder

    Emotional and impulsive:

    • Antisocial personality disorder (ASPD)
    • Borderline personality disorder (BPD)
    • Histrionic personality disorder
    • Narcissistic personality disorder


    • Avoidant personality disorder
    • Dependent personality disorder
    • Obsessive compulsive personality disorder (OCPD)

    From 2022, these categories will no longer be used to identify a personality disorder diagnosis.

    What Is Changing?


    The ICD-11 (International Classification of Diseases) is what is used to identify and classify the different types of personality disorders. In 2021, after being reviewed, “it was felt necessary because previous personality disorder classifications had major problems. These included unnecessary complexity, inconsistency with data on normal personality traits, and minimal consideration of severity despite this being shown to be the major predictor of outcome.”

    The new personality disorders classification doesn’t use the three categories as mentioned before. Instead, it uses a general description of personality disorder to diagnose patients. This diagnosis can be further specified as “mild,” “moderate,” or “severe”.

    Patient behaviour can further be described using one or more of five personality trait domains and clinicians may also specify a borderline pattern qualifier:

    • Negative affectivity (associated with neuroticism)
    • Detachment (associated with low extraversion)
    • Dissociality (associated with low agreeableness)
    • Anankastia (associated with high orderliness)
    • Disinhibition(associated with low orderliness)

    By changing the way personality disorders are identified and classified, it is hoped that it will lead to greater understanding of the concept of personality disorder and better clinical care. It also simplifies a complicated classification system, into a more evidence-based model.

    At JSA Psychotherapy, we offer a wide range of psychology and psychotherapy services, including for those struggling with a personality disorder. Find out more about the services we offer and how we could support you.


  10. What is Seasonal Affective Disorder?

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    It is not uncommon for people to begin to feel a little low as the nights begin to draw in earlier and the weather becomes cold and drizzly in the Autumn and Winter months, in fact, it could be something called Seasonal Affective Disorder. But what is Seasonal Affective Disorder?

    Seasonal Affective Disorder, or SAD, is a type of depression that comes in waves in certain seasons. It is also known as “winter depression” as people commonly experience SAD during the winter months, when it becomes a colder and darker. This doesn’t mean that people only experience SAD in the autumn/winter months, as they can experience symptoms during any season.

    Picture of girl in coffee shop (Image by ketut subiyanto)

    What are the signs of Seasonal Affective Disorder?


    Seasonal Affective Disorder is a type of depression. Depression is a low-mood that is persistent and affects your everyday life. However, people only experience these low moods during a certain season, rather than all year round – this is what makes it Seasonal Affective Disorder.

    As SAD is a type of depression, many of the symptoms are the same.

    • Having a persistent low mood.
    • Experiencing negative feelings such as sadness, hopelessness, worthlessness most of the time.
    • Not enjoying the activities you used to.
    • Being more irritable that usual.
    • Having low self-esteem

    Find out what other symptoms someone might show if they are experiencing SAD on the NHS website here.


    What causes SAD?


    Just like with depression and other mental health disorders, understanding the cause is not straight forward and often, there are many different reasons. However, it is thought that SAD is linked to the lack of sunlight we are exposed to in the autumn/winter months.

    The amount of sunlight we get during the day can affect things like:

    • the production of melatonin – melatonin is a hormone that makes you feel sleepy. For those experiencing SAD, the body may produce it in higher than normal levels of melatonin, making them more sleepy .
    • the production of serotonin – serotonin is a hormone that affects your mood, appetite and sleep. Not being exposed to sunlight can lead to lower serotonin levels. Low serotonin levels are linked to feelings of depression.
    • the body’s internal clock – Your body uses sunlight to time important functions throughout the day, for example, the time you wake up. Lower light levels during the winter may disrupt your body clock and lead to symptoms of SAD.

    It is important to remember that SAD can be caused by other factors too, such as genetics.


    Is there a treatment for SAD?


    There are things such as light therapy and CBT, that many use to treat their SAD. If you feel like you may need treatment, it is best going to see your GP. They will recommend the most suitable treatment option for you, based on the nature and severity of your symptoms.

    Here are some tips for dealing with SAD yourself:





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