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Isabel Clarke — Clinical Home Page

My work spans two areas: psychosis and spirituality, and clinical psychology. Both draw on the research based Interacting Cognitive Subsystems model of cognition, and both seek to bring spirituality into centre stage, founding it in cognitive and other research and theory, and regarding it as a central part of what it means to be human. My current role in the Hampshire and Isle of Wight Healthcare NHS Foundation Trust is lead for CCC, supporting its implementation across Acute, CMHT and Primary Care services.

  Comprehend, Cope and Connect (CCC - until recently known as Emotion Focused Formulation Approach, EFFA) in the diverse contexts of Acute, IAPT and Culture Free Adaptation. PCN and Transformation in Primary Care are also adopting it.
See  "ICS Underpinning 3rd Wave CBT"  and our   book for more details.
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:

MEETING MENTAL BREAKDOWN MINDFULLY: HOW TO HELP THE COMPREHEND, COPE AND CONNECT WAY.
Routledge -  Follow the link for a flyer with 20% discount.

 

 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.CCC 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.
 

CCC as a CULTURALLY ADAPTED - CULTURE FREE THERAPY

CCC has emerged as a promising avenue to pursue in the quest to adapt therapy to non Western cultures. It has been recognized as both suitable and relatively 'Culture Free' for the following reasons:
  • It follows the individual’s experience in an intuitively accessible way with a minimum of theoretical apparatus. It side-steps Western medical conceptualisations of mental distress and the more complex theoretical underpinnings of therapeutic modalities such as conventional CBT and psychodynamic therapies.
  • The emphasis on identifying and using only language and descriptors that are natural and comfortable for the individual in the formulation helps to ensure that alien concepts are not being imposed through the use of jargon.
  • It uses mindfulness in a targeted and practical manner that does not require extensive practice or commitment to the wider mindfulness tradition, which may not be familiar or acceptable to the individual.
  • It lends itself to the involvement of the wider family/social group. The straightforward formulation is easily communicated to important others who can then be recruited as supporters of change for the individual in therapy. The split between the formulation stage and application of new coping skills to the work of breaking the vicious circles identified in the formulation, creates the opportunity for the recruitment of available helpers, as we have seen in the case of mental health teams. In this instance, it can be utilized by natural supporters who will be readily available and will have an interest in helping their relative to recover.
  •  ICS theory that underpins CCC paves the way for a model of the human being that embraces both individual self-consciousness, and our embeddedness in the whole. Relationship is accorded a new, more central role. This opens the way to a more collectivist view, more in sympathy with many other cultures than our Western, individualistic, focus.
  • CCC incorporates the individual’s strengths and the role of wider, spiritual, connectivity in  task of finding solutions to immediate problems. Existing therapies have been criticised for being too pathologizing, too individualistic and excluding of religion and spirituality, to suit many other cultures.
 Research into this is at a pilot stage and has resulted in the following 2 publications:
 
Phiri, P., Clarke, I.,Baxter,L., Elliot,K. Rathod, S. and Naeem, F. ( 2021) Culture Free CBT for Diverse Groups.   DOI: 10.5772/intechopen.93904 Open access peer-reviewed chapter - ONLINE FIRST

Phiri, P., Clarke, I. Baxter, L., Yutain, Z. Shi, J. Yuan, X., Rathod, S., Soomro, M., Delanerolle, G. & Naeem, F. (2023) Evaluation of a culturally adapted cognitive behavior therapy-based, third-wave therapy manual. World Journal of Psychiatry 13 (1) 15-35