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Therapies

I have studied many therapies. The therapies described below are the approaches I find to be consistently the most helpful (but often there are many points of overlap between them). Remember – all good therapies address your thoughts, feelings, physical sensations, and behaviours, and the relationship processes occurring between you and your therapist (or you and your partner). Precisely how each therapy does this is the main difference.

Good therapists not only have exceptional technical skills (which allow them to tailor their approach to best suit a client’s individual needs), but they also have exceptional interpersonal skills that allow them to work with you and the moment-to-moment processes that unfold during each session. This allows them to detect unworkable self-defeating patterns, unexpressed emotions, and unmet needs, so they can help you understand and resolve your struggles by teaching you new ways of responding to challenges. These are my aims and values as an evidenced-based therapist.

If you would like to discuss how therapy might be able to help you or if you are curious about working in a specific way that is not listed here, please contact me to discuss things further.

If you are interested in engaging in therapy, I recommend you read the article ‘How to Get the Most Out of Therapy‘. I believe this information will be relevant and useful whether or not you choose to work together.

Mindfulness

The Wisdom of Mindfulness is ancient. The state of being mindful has been a focus and a practice of ancient Traditions such as Yoga (over 5000 years old) and Buddhism (2500 years old). More recently (in the last 40-odd years), Science has established that the benefits of Mindfulness are immense for building psychological resilience, and for improving physical health and emotional well-being. However, contrary to popular belief, Mindfulness is not meditation, and Mindfulness skills are not unique to Buddhism.

Mindfulness involves actively paying attention to your own inner experience—in the present moment—from the vantage point of an observer who is non-judgementally aware, open, and curious.

Mindfulness skills are now being incorporated into all effective psychotherapies. Mindfulness skills can empower you because they can increase your awareness of all experiences (internal and external, pleasant and unpleasant) in ways that essentially strengthen your capacity to choose how you respond.

Applied to thoughts, Mindful awareness can help you stay focused in the present moment (what you’re doing) vs. becoming caught up in your thoughts (what your mind is doing). Rather than ‘stopping your thoughts’ or ‘sitting still, eyes closed and meditating’ mindful awareness can be applied to anything you are doing/experiencing—using any or all of your senses—anytime.

Although mindful awareness is important, it is not enough. You can read more about what Mindfulness is, how Mindfulness skills can help you, and the limitations of Mindfulness, here.

Eye Movement Desensitisation & Reprocessing (EMDR) Therapy

EMDR Therapy makes use for Mindfulness. It is a very unique and powerful approach to resolving painful memories originally developed over 30 years ago by Dr Francine Shapiro. EMDR Therapy views all emotional, psychological, and behavioural problems as being related to ‘stuck’ (unprocessed) memories. By identifying and processing these memories safely, a person’s emotional, psychological and behavioural problems also resolve.

EMDR Therapy is very unique because unlike most talking therapies, it does not require you to speak about what happened in very much detail. Instead of talking about the specific details, EMDR Therapy makes use of bi-lateral stimulation (i.e., both sides of the body). Eye movements are the most common bilateral stimulation used, and these movements are believed to mimic the eye movements of REM sleep (the stage of sleep responsible for memory processing and learning).

After identifying the specific unprocessed components of an event (which requires specialised training in EMDR Therapy), the therapist will ask you to recall specific aspects, with you performing left-to-right eye-movements which are often repeated quickly, in sets of 20-30 (several times), until the memory processing has completed. Often, this can happen quickly depending on the memory, and very little talking about what happened is required.

Although this may all sound absolutely unbelievable, you may be surprised to learn that EMDR therapy has over 30 years of research supporting its effectiveness, particularly for trauma, but also for many other emotional, psychological, and behavioural difficulties. In fact, EMDR therapy is useful whenever painful memories are causing an individual significant disturbance and/or a negative view about themselves.

Fast facts:

  • In 2013, EMDR Therapy was recognized by the World Health Organisation as a first-choice treatment for trauma.
  • In 2018, the Australian Psychological Society included EMDR therapy as a Level I evidence-based psychological intervention for posttraumatic stress disorder in adults.
  • In 2020 EMDR Therapy was included by Australia’s Medicare system as being the only one of two other therapies deemed an ‘acceptable strategy’. (This important because it is the first time any therapy has ever been added to this list by Medicare in the 10+ years the Better Access Scheme has been running).

Please visit the following page to read more about how EMDR Therapy works.

Cognitive Behaviour Therapy (CBT)

Cognitive Behaviour Therapy (CBT) is a term for a variety of therapies that create change by focusing on the connection between thoughts, feelings and behaviours. In other words: Thoughts can influence feelings and behaviours – likewise, feelings and behaviours can powerfully affect how we think.

The ‘cognitive’ interventions in CBT seek to identify, challenge, and replace unhelpful thinking with more helpful ways of thinking about things. Traditional cognitive interventions aim to change feelings via working with thoughts. For this reason, the cognitive interventions from traditional CBT are really only suited to simple issues, where there is very little distress involved.

Although CBT is not the only way to work with the mind, the ‘behavioural’ interventions in CBT are common across many other therapies. The most effective behavioural interventions involve exposure therapy and ‘reality testing’. Together, you and your therapist may work as both detectives and scientists: one minute you may be curiously exploring detailed thought-feeling-behaviour patterns; the next, you might experiment with new ways of behaving.

Although CBT has been the focus of much research attention, it is better suited to mild issues and it is certainly not ‘for everyone’.

Acceptance & Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT; pronounced ‘act’, as in ‘to take action’) is about both acceptance and change.  By practicing ACT, you become freer to choose how you want to respond: to notice rather than react to difficult thoughts, memories, predictions, emotions, urges, or situations. This allows you to focus on doing what is truly important.

Unlike traditional CBT (discussed above), which focuses on ‘logic’ and changing / challenging / replacing unhelpful thinking, the aim of ACT is to: Change the way you relate to your thoughts and inner experiences (i.e, thoughts, feelings, imagery, memories, ‘stories’, images, urges, & bodily sensations). When working while using ACT, it is not what you think, but how you relate to what you think that is the focus of therapy.

ACT sees thinking this way: a) thoughts are not always accurate or helpful, b) we can run into trouble when we act as if our thoughts are true, c) we do not need to change our thoughts – we need to change how we relate to our thoughts.

ACT incorporates many helpful processes including Mindfulness, Defusion, and Acceptance strategies (e.g., learning how to ‘look at’ thoughts as just another a bodily process (vs looking at the world through our thoughts) , let thoughts ‘come and go’ or ‘be’ rather than holding onto or struggling with trying to not have them), and distancing techniques (looking at your thoughts rather than seeing the world through the lens of your thoughts) to allow you to tolerate difficult thoughts, feelings, memories, and/or physical sensations that you have previously feared or avoided.

In this way, ACT helps you learn skills that will free you up to have ‘any’ internal experience, which will then allow you to break behavioural patterns that keep you struggling.

Another aim of ACT is to help you clarify what is most important and to connect with meaning and purpose. More and more research supports ACT and the usefulness of acceptance, mindfulness, clarifying your purpose and taking action in a wide range of difficulties – from depression, poor sleep, chronic pain, and rumination, to fear, anxiety, and chronic avoidance. ACT is also helpful for addictions, compulsions, and other problematic behaviours. ACT can also help with issues affecting relationships such as past trauma, anger and fear.

Compassion Focused Therapy (CFT)

Compassion focused therapy (CFT) was developed to deal with the universal human problems of shame, guilt and self-criticism. CFT is an evidenced-based system of psychotherapy developed by Paul Gilbert that integrates techniques from Cognitive Behavioural Therapy with concepts from evolutionary psychology, Attachment Psychology, Social psychology, Developmental Psychology, Buddhism/Mindfulness practices, and Affective Neuroscience.

Compassion is defined in CFT as a sensitivity to the suffering of self and others with a deep commitment to easing and preventing it. However, this requires great courage because, although most people are extremely eager to ‘alleviate’ their suffering, they are often insensitive to (or want to avoid) the causes. Basically, many of us want to get to the ‘fix’ without caring for the part of ourselves that is injured.

This is because of several understandable reasons, including developmental and societal factors.  For example, one of the most common barriers to developing self-compassion is our own “inner critic” which has origins in our early emotional learning (our developmental history). Similarly, in societies that encourage us to compete with each other, compassion is often seen as a weakness. For these reasons, striving to achieve and bullying ourselves self-criticism, shame, fear, and hostility all seem to come more naturally to us.

Research has found that developing kindness and compassion for ourselves (and others) builds our confidence, helps us create meaningful, caring relationships. Compassion can also lower anxiety and hostility and can promote physical and mental well-being. Again, this requires developing the sensitivity to the causes of suffering and the commitment to alleviate it.

In summary, CFT is particularly useful for developing self-compassion which is hugely helping when working with powerful emotions such as pain, anger, disappointment, fear, shame and self-criticism.

Emotionally Focused Therapy (EFT) for Couples

Emotionally Focused Therapy (EFT) for couples is a form of therapy that focuses on adult relationships and attachment/bonding. The therapist and clients look at patterns in the relationship and take steps to create a more secure bond and develop more trust to move the relationship in a healthier, more positive direction.

EFT focuses on the present, including focusing on patterns of communication as they are happening, to makes changes in the ‘here and now’. There are three stages of EFT. The first is to help couples to self-regulate and de-escalate the negative cycle of interactions, and to help them see and understand what is happening in their relationship. Generally problems relate to unintended consequences caused by insecurities and distancing. The next stage of EFT is to restructure interactions, wherein the therapist helps clients discuss their fears in the relationship, using language that doesn’t push the other away. Clients learn to turn toward each other and discuss their needs and they become more open and responsive to each other. In the third stage of EFT, the therapist helps clients see how they got stuck in their negative patterns and points out how they could change those patterns and can continue these types of conversations (themselves) in the future.

A lot of the important work in EFT draws from Attachment science which strongly influences how we function in relationships (and is the most well-researched area in psychology). Unsurprisingly, EFT is the Gold Standard approach for working with couples. There is over 30 years supporting its effectiveness and it is the most successful couples therapy approach in the world.

To learn more about Attachment, including how it affects how we function in relationships, I have prepared the following article.  

Exposure Therapy

Exposure Therapy is the most effective therapy for anxiety disorders and other problems that are typically being maintained by avoidance. When people are fearful of something, they often avoid the feared objects, activities, situations and/or engage in rituals to make themselves feel “safe.” Although avoidance and rituals may help you temporarily reduce your feelings of fear and anxiety, over the long-term it can lead to undesirable outcomes such as feeling trapped and hopeless and it can also make your feelings of anxiety become even worse. Exposure therapy was developed to help people confront and overpower their fears by breaking their fear-avoidance pattern.

Exposure therapy helps you gradually and strategically (i.e., in combination with skills from the therapies above) confront the very situations and objects you are avoiding. After helping you to build up a strong skill set of soothing and calming strategies, exposure therapy safely and gradually brings you in contact with previously avoided situations (while controlling rituals, compulsions, and other superstitious or safety behaviours). This leads you to important learning and re-evaluating regarding how likely the predicted / feared consequences would be to occur, how bad the consequence would be, and how you could cope differently should these consequences happen.

Exposure Therapy has been demonstrated to be a particularly effective treatment or treatment component for problems involving avoidance because of anxiety, including:

Because avoidance leads to so many psychological and emotional difficulties, Exposure therapy is not just for anxiety – it is also well-suited to any behaviour involving strong urges. This is often where strong emotions are also at play, such as: procrastination (the urge to ‘put things off until later’); the urge to call an ex-partner after a break up; or for compulsive or addictive behaviours such as gambling, substance use, or excessive technology use.

Functional Analytic Psychotherapy (FAP)

Functional Analytic Psychotherapy (FAP) is a behavioural approach to psychotherapy with a specific relationship emphasis in which problematic behaviours that show up live in the therapy session are identified and are shaped towards greater effectiveness. Although it may seem surprising, often these very same problematic behaviours show up outside of the therapy room.

FAP focuses on improving the interpersonal behaviours that are necessary for you to create and maintain close relationships and experience a more fulfilling interpersonal life. In FAP therapists provide you with honest feedback and reinforcement – in the moment – about identified adaptive behaviours.

Early in therapy, you will be asked to identify your treatment goals, dreams, and deepest desires, and what you feel compelled to move towards to in your life. From this discussion, behavioural targets are collaboratively determined. Specifically, which old problematic behaviours are maintaining your current “stuckness” in life and what new adaptive behaviours would move you towards the life you desire and the person you desire to be? FAP ties in well with ACT and CFT approaches.

Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy (DBT) is a highly effective treatment for a wide range of issues including anxiety, depression, addiction, impulsivity, relationship problems, post-traumatic stress disorder (PTSD), and eating disorders. It has its roots in Cognitive Behavioural Therapy (CBT) and Buddhism and focuses on helping you develop practical skills that help you self-regulate in times of high stress. DBT’s emotion regulation skills compliment many other therapies, such as ACT, CFT, and Exposure therapy.

Schema Therapy

Schema Therapy is an integrative approach to treatment that combines the best aspects of CBT, experiential, interpersonal and psychoanalytic therapies into a unified model. Schema  Therapy has shown good results in helping people to change negative patterns that they have lived with for a long time, even when other methods have been largely unsuccessful.

In contrast to traditional CBT which focuses on the current problem (e.g. current problematic thoughts / feelings), Schema Therapy is a more in depth in that takes into account a person’s developmental history and emotional learning. By identifying the core unmet needs from you childhood, Schema Therapy helps you uncover and work with the unhealthy beliefs that are biasing your current thoughts, feelings and reactions.

Motivational Interviewing

Motivational interviewing (MI) is a type of therapy that focuses on developing and strengthening the motivation in you to make behavioural changes. MI is useful with ACT, Mindfulness, and CFT and also anytime where you feel stuck, demotivated, or unclear in your direction.

If you would like to discuss how therapy might be able to help you or if you are curious about working in a specific way that is not listed here, please contact me to discuss things further. 

If you are interested in engaging in therapy, I recommend you read the article ‘How to Get the Most Out of Therapy‘. I am confident that this information will be relevant and useful regardless of whether or not you choose to work together. 

Locations

  • I am now available Australia-wide via Telehealth (telephone and video consultations).

  • Receive up to 20 Medicare rebates per year, no matter where you live in Australia.

  • To find out more about Telehealth, please visit the following page or contact me on the details below.

 

Dr Andreas Comninos 

PhD Clinical Psychologist & Board Approved Supervisor

I am a PhD Clinical Psychologist with over 10 years’ experience. My intentions are to help you to feel safe and respected, to collaborate with you to set clear treatment goals, and to facilitate an exploration of yourself and your situation in ways that regular conversations do not normally allow. Together, I hope we can discover constructive ways to improve your situation and your relationship with yourself and others.

My expertise and training draws from the latest evidenced-based ways to work with the mind, the body and all difficult emotions. My listening skills allow me to identify stuck patterns and unexpressed needs. I can help you to find new ways of responding to difficult situations, and I can help you to develop more resilience in the face of life’s challenges so you can act in ways that move you towards living with more meaning and purpose.

Medicare rebates are available for all Australians for up to 20 sessions each year with a GP referral and a mental health care plan. No matter where you live in Australia, Medicare rebates apply for all face-to-face and Telehealth consultations.

For immediate self-help, I have written practical articles containing tools to help you with a wide-range of topics. These articles are available here. If you are new to therapy, I recommend that you read this article to help you get the most out of therapy.

I look forward to hearing from you.

Therapies

Dr Andreas Comninos

Clinical Psychologist & Board Approved Supervisor
B.Psych (Hons), PhD (Clin Psych), ACBS, MAPS

Dr Andreas Comninos

Clinical Psychologist & Board Approved Supervisor
B.Psych (Hons), PhD (ClinPsych), ACBS, MAPS
Therapies

About me.

I am a PhD Clinical Psychologist with over 10 years’ experience. My intentions are to help you to feel safe and respected, to collaborate with you to set clear treatment goals, and to facilitate an exploration of yourself and your situation in ways that regular conversations do not normally allow. Together, I hope we can discover constructive ways to improve your situation and your relationship with yourself and others.

My expertise and training draws from the latest evidenced-based ways to work with the mind, the body and all difficult emotions. My listening skills allow me to identify stuck patterns and unexpressed needs. I can help you to find new ways of responding to difficult situations, and I can help you to develop more resilience in the face of life’s challenges so you can act in ways that move you towards living with more meaning and purpose.

Medicare rebates are available for all Australians for up to 20 sessions each year with a GP referral and a mental health care plan. No matter where you live in Australia, Medicare rebates apply for all face-to-face and Telehealth consultations.

For immediate self-help, I have written practical articles containing tools to help you with a wide-range of topics. These articles are available here. If you are new to therapy, I recommend that you read this article to help you get the most out of therapy.

I look forward to hearing from you.

Let’s Talk.

    Mindfulness & 

    Clinical Psychology Solutions

     

    admin@mi-psych.com.au
    Po Box 1028, Newtown NSW 2042