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Snapshot: Karen Tepper

Thursday, September 30, 2010
Consultant Psychologist, Macquarie Psychology, Hobart, Tasmania, Australia

I am a Psychologist, working in private practice at Macquarie Psychology in Hobart, Tasmania. Macquarie Psychology specializes in the practice of MiCBT and is associated with the MiCBT Institute. I have not always lived in Hobart. My husband and I decided we wanted to make the move here after living in warmer climates for the past ten years or so. We decided this was the time for a “tree change”. Before moving here I was in Townsville completing the final practicum for my Masters in Clinical Psychology. Although only my husband had secured a job when we moved to Hobart, the leap of faith has paid off. I wanted to work in private practice and I wanted to specialize as a MiCBT practitioner.

I began my professional life as an intern Psychologist working for Centrelink in Darwin. This was an interesting and challenging job working with clients who had complex needs. A few years later, I transferred to the Sunshine Coast, where the job at Centrelink just wasn’t the same. The demographic was completely different and not so challenging. Consequently, I resigned and went on to work for various departments within Queensland Health, including Adult Mental Health and Child & Youth Forensic Mental Health. Over the years I had been using an “eclectic” approach to therapy that had mainly consisted of the “Sparkly Eye” technique! However at this time, my practice was not informed by the Mindfulness approach.

While on the Sunshine Coast, a colleague suggested we attend a 4-day workshop on Mindfulness integrated CBT, facilitated by Dr Bruno Cayoun. At the time I had not heard of Bruno but agreed to go with my colleague because of my interest in Mindfulness. I had meditated occasionally before attending this workshop. I learned a framework of psychological practice that made sense and the therapist in me was immediately intrigued. I learned to pay attention to my breath, and return to the present moment whenever I got caught up in my thoughts. At first, when I arose, I felt as anxious as I had before, but something else had shifted. I had stopped struggling with the anxiety and started accepting my feelings as my condition at that moment in time. Moreover, the mindfulness felt helpful to me in a larger sense, even though it did not remove my anxiety that day. I began seriously studying MiCBT and the knowledge base that had been built up over 2500 years by Buddhist practitioners watching their own mind experiences.

I have tried to go where my energy is. If something has been of interest to me, I have explored it. I also like this quote from the movie, “Men Who Stare at Goats”, "Bob, have you ever heard of optimum trajectory? Your life is like a river and if you are aiming for a goal that is not your destiny, you will always be swimming against the current. Young guy who wants to be a stock car driver -- it's not going to happen. Little Anne Frank wants to be a high school teacher -- tough titty Anne, it's not your destiny. But you will go on to move the hearts and minds of millions. Find out what your destiny is and the river will carry you”.

In accord with my need for authenticity and presence, my goal has been to work within a theoretical framework that resonates with my beliefs and values. My experience working with clients using MiCBT has been positive and extremely rewarding. Clients, who engage with the model and commit to practice, demonstrate quantifiable evidence that the model has been fundamental in symptom reduction and behaviour change. Inherent in this process is what I bring to the therapeutic relationship as a therapist. I continue to train in MiCBT, which involves a commitment to Mindfulness practice.

As well as working full-time in private practice I am also completing the final component of a Masters degree in Clinical Psychology. I am currently completing a thesis which aims to investigate emotion regulation and how this contribute to the difficulty individuals have in being able to maintain healthy lifestyle behaviours. I am in the process of collecting data for this research. Subsequently, I would welcome participation from anyone interested. This would involve volunteering 25-35 minutes of your time to complete questionnaires.

I accept referrals of clients and I can be contacted at Macquarie Psychology Monday to Thursday or by email: karen.tepper@macquariepsychology.net.au

Snapshot: Lyn Roubos

Monday, August 02, 2010
When Bruno asked me to write something for this edition, in January this year, I agreed willingly, as it seemed months away. When he reminded me by e-mail this past week that he needed my snapshot by this weekend, I find myself challenged by what to write.

My first exposure to MiCBT was in 2008 after a weekend seminar in Atherton, Far North Queensland with Bruno, which then led to an 8 week MiCBT training course the following year. I have been practicing as a psychologist since 1998; however my experience as a therapist began some years earlier in 1989. My attraction to MiCBT operates at several levels. As a therapist, I strive to be congruent in my life and work, and mindfulness meditation, as a personal practice, provides a very real and tangible way to maintain my connection to this strong value. In addition, the Eastern philosophies of acceptance and change, inherent in the model, feed a personal font of optimism around how I engage with my internal and external world and with the worlds of my clients. Nevertheless, one of the most exciting rewards for me is my own journey with this therapy has been the results that are achieved by clients that engage with MiCBT, and this on its own would be enough to keep me immersed in the model.

I live with my partner Colin and our 2 cats in Cairns, Far North Queensland, and work 2 days a week as a Psychologist in Sexual Health and 1 day in private practice, with the remaining time given over to my studies. In these working roles, I am inspired by the clinically significant behavioural and immunological changes in clients with significant health co-morbidities including HIV, Hepatitis C, Diabetes, and Cardiac Disease when they engage with MiCBT. I see so many opportunities to further expand our collective knowledge about the application of mindfulness to these problems. All in all, it is a very exciting time to be engaged in this work.

I have spent the last 6 months completely immersed in the practice of MiCBT. From January to March this year, I undertook a 3 month practicum at the MiCBT Institute in Hobart as part of my ongoing studies in a Masters of Clinical Psychology.  During this period, Bruno and I delivered a MiCBT group program for people in the community with mixed difficulties, with Bruno delivering the weekly group sessions and I meeting with participants individually for 10 weeks. I received ongoing supervision from Bruno throughout this period and administrative and organisational support from Karen in the Practice. For me, it was a unique opportunity to work within a single model framework and develop a depth of expertise, rarely accessible in ‘usual' practicum options.

Currently, I am working towards the completion of a thesis, which seeks to explore the differences between group and individual delivery of MiCBT utilising outcome measures including the Symptoms Checklist-90 (Revised Edition), the Depression Anxiety and Stress Scale, the Short Progress Assessment, the Mindfulness-based Self Efficacy Scale and the Satisfaction with Life Scale. Some of the hypotheses generated through this comparison relate to the effects of group dynamics on motivation to engage in formal practice, and whether the severity of symptoms influences outcomes in either delivery format. My hope is to complete this research this year and to this end, I have just completed my latest round of data collection in Hobart.

I would welcome opportunities to participate further in this dialogue with like minded colleagues and look forward to sharing anything useful that derives from my current research. I can be contacted on Lyn.Roubos@gmail.com. I also thank Bruno for this opportunity and his ongoing sensitive and elegant mentoring.

N.B. I have closed my books for the remainder of 2010 but would be delighted to receive new referrals from the beginning of 2011.

Snapshot: Clare Voss

Monday, May 31, 2010
I have worked for Carers Tasmania for the past three and a half years and I am now manager of the counselling program. We provide statewide support for carers. Carers are people who provide unpaid care and support to family members and friends who have a disability, mental illness, chronic condition, terminal illness or who are aged and frail.

Meeting carers in my new professional role and undertaking MiCBT training with Bruno three years ago was an interesting and synchronous experience. It led to the introduction of MiCBT to our clients at Carers Tasmania shortly thereafter and I am pleased to say this program has become an integral part of our work. Two of our counselling staff are currently facilitating an MiCBT group and we are now in the process of planning our seventh group training program. The assessment process begins next week. In addition, we provide individual training for some of our clients. I have particularly enjoyed co-facilitating the group program. The generosity of spirit that is apparent in each group is truly inspiring.

Our particular client group has responded well to the MiCBT training. This is substantiated by the evidence we have collected following the training, during the review process. Our client group, Carers, often present with high levels of stress, anxiety and depression. In many cases their caring roles are ongoing. It is heartening to see not only their quality of life improve, but those of their families and the person they care for and to know that they have the skills to manage the vicissitudes of life.

I have worked in a variety of counselling roles over the past seventeen years since completing my education and training in Melbourne. In my first position, I was fortunate to be employed in an accredited agency which trained people in relationship counselling. Reflective practice was emphasized within that learning environment and I continue to feel grateful for the foundation that it provided in those early stages of my development. There were a number of aspects that enhanced this model of learning. These included fortnightly Professional Development, guest speakers to provide fresh air and stimulation, case presentation and discussion, intra-agency seminars which were conducive to building collaborative relationships. In addition, counsellors were supervised in-house as well as externally, depending on their learning needs at the time. Some of my colleagues sought personal analysis, a course which I also chose to follow.

My intention is not to paint a utopian picture. It was far from that but I want to draw attention to the prevailing sense of openness that I experienced within that learning environment. I believe  this to be fundamental to healthy practice for all concerned. In a number of other roles, I have experienced  reticence towards talking about the work that is conducted in the very private setting of the counselling room, or worse, not even considered necessary.

This leads me back to MiCBT. For me, it is the experiential nature of the model that makes it shine. My personal experience of MiCBT, as well as ongoing supervision and continued practice, have prepared me to undertake the journey with my clients, with confidence and compassion.

I moved to Tasmania from Melbourne eight years ago to live a quieter life. My partner, John, and I had been in a caring role and we were looking for a change. Some time later, other family members joined us, including two adorable grandchildren, only three months old at that time. The quieter life looks vastly different to the one that I imagined ... but feels very rich to live.

Clare Voss, Manager–Counselling, Carers Tasmania clare@carerstas.org

Kicking the habit, against all odds

Monday, February 09, 2009

By TODAY, Singapore

 

An interview with Dr Cayoun after completion of a 3-day "Addressing Gambling Addiction with MiCBT" Workshop with the Institute of Mental Health, Singapore. 

From MCBT to MiCBT

Thursday, January 01, 2009
What's in a name? From Mindfulness-based Cognitve Behaviour Therapy (MCBT) to Mindfulness-integrated Cognitive Behaviour Therapy.

Important information about the change from MCBT to MiCBT

The four stage model of Mindfulness-based Cognitive Behaviour Therapy (MCBT) has been developed for crisis interventions by Bruno A. Cayoun between 1989 and 2001 and further piloted since then. Independently, the book "Mindfulness-based Cognitive Therapy: A new approach for preventing relapse in depression" (Segal, Teasdale & Williams, 2002) was published and has been a major influence in the proliferation of the use of mindfulness-integrated models in modern Western therapy. However, the similarity of acronyms between Cayoun's MCBT and Segal et al.'s MBCT created some confusion. Although there are inevitable overlaps between the two approaches, there are also important differences. However, therapists and researchers have often used these acronyms interchangeably.

Following a conversation between Bruno Cayoun and Mark Williams, it was decided to change the name of MCBT. The process took several months of brainstorming and deliberating among 211 members of the Mindfulness-based Therapy and Research Interest Group (MTRIG) worldwide. The new name "Mindfulness-integrated Cognitive Behaviour Therapy (MiCBT) was found to represent well the essence of this approach.

You can download the letters to the group communicating the need for change, a summary of the options proposed, and a decision for MiCBT below:

Need for Change Need for Change (30 KB)

Summary of Options Summary of Options (32 KB)

Decision and Conclusion Decision and Conclusion (36 KB)