Isabel Clarke: Clinical Pages
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Isabel Clarke — Clinical Home Page

The publications and therapeutic approaches that follow employ ICS as a way of approaching CBT across diagnoses – because: ICS provides a cognitive science based rationale for:

  • The disjunction between thought and emotion
  • The centrality of arousal in understanding mental health difficulties
  • Attachment and relationship as central to the self, and central to the therapeutic process
  • The role of mindfulness in providing a way into the process between thought and emotion and behaviour
  • Deconstructing diagnosis (see recent book chapter on coping mechanisms).
  • Involvement with the broader movement to shift mental health thinking beyond an illness conceptualisation - the New Paradigm Alliance.
Recent clinical developments revolve around EFFA - see below and on the "ICS Underpinning 3rd Wave CBT" page.


Psychosis and Spirituality
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 Comprehend, Cope and Connect (CCC)

Comprehend, Cope and Connect (CCC), formerly known as Emotion Focused Formulation Approach or EFFA, is a therapy approach that starts with collaborative, individual formulation – which can then inform the thinking of the wider system.Key: Where an individual’s experience of themselves feels unbearable, they will seek to cope with this – for instance by withdrawing, self harming,  drinking alcohol etc.
These strategies are understandable and work short term. Most of them are used by everyone at some time.
Past trauma and the way that the body picks up threat signals and gets ready for action combine to set up vicious circles that lock people into a trap.
Where vicious circles are identified – the individual can choose to break them – and support and skills can be offered to help with this.EFFA offers a compassionate understanding of peoples’ predicament, along with ways forward that lend themselves to support from the system – either other staff or natural supporters such as family and friends.
Skills can be taught individually or in groups.
It is being piloted and evaluated in a number of settings: Acute, IAPT and for Culturally Adapted therapy.