Jul 19, 2022
The British Association for Behavioural and Cognitive Psychotherapies, the lead organisation for cognitive behavioural therapy (CBT) in the UK and Ireland, is 50 years old this year. In this episode Dr Lucy Maddox explores how CBT has changed over the last 50 years. Lucy speaks to founding members Isaac Marks, Howard Lomas and Ivy Blackburn, previous President David Clark, outgoing President Andrew Beck and incoming President Saiqa Naz about changes through the years and possible future directions for CBT.
Dr Lucy Maddox: Hello, my name is Dr Lucy Maddox and this is Let’s Talk about CBT, the podcast brought to you by the British Association for Behavioural and Cognitive Psychotherapies or BABCP. This episode is a bit unusual, it’s the 50th anniversary of the British Association for Behavioural and Cognitive Psychotherapies this year. And I thought this would be a nice opportunity to explore some of the history of cognitive behavioural therapy, especially the last 50 years.
Some of the roots of CBT can actually be traced way back. Epictetus, an ancient Greek Stoic philosopher wrote that man is disturbed not by things, but by the views he takes of them. This is pretty close to one of the main ideas of cognitive behavioural therapy, that it’s the meaning that we give to events, rather than the events themselves which is important. But actually, cognitive behavioural therapy started off without the C. To find out more, I made a few phone calls.
Isaac Marks: Hello, Isaac Marks here.
Dr Lucy Maddox: Isaac Marks was one of the founding members of BABCP and a key figure in the development of behavioural therapy in Britain. I asked him if he could remember what CBT was like 50 years ago.
Isaac Marks: Originally it was just BT and a few years later the cognitive was added. At the time, the main psychotherapy was dynamic psychotherapy, sort of Freudian and Jungian. But just a handful of us in Groote Schuur Hospital psychiatric department, that’s in Cape Town, developed an interest in brief psychotherapy. And I was advised if I was really interested in it and I was thinking of taking it up as a sub profession, that I should come to the Maudsley in London.
Dr Lucy Maddox: Isaac and his wife moved to London from South Africa and Isaac studied psychiatry at the Maudsley Hospital in Camberwell.
What was it about CBT that had interested you so much?
Isaac Marks: Because it was a brief psychotherapy, much briefer than the analytic psychodynamic psychotherapy. We were short of therapists and there wasn’t that much money to pay for extended therapy, just a few sessions. Six or eight sessions something like that could achieve all what one needed to. They had quite a lot of article studies.
Dr Lucy Maddox: And I guess that’s still true today, that those are some of the real standout features of it, aren’t they? That it is a briefer intervention than some other longer-term therapies and that it’s got a really high quality evidence base.
Isaac Marks: I think that’s probably true, yes.
Howard Lomas: There was a group that met at the Middlesex Hospital every month. And that was set up by the likes of Vic Meyer, Isaac Marks, Derek Jayhugh.
Dr Lucy Maddox: That’s Howard Lomas, another founding member of BABCP remembering how the organisation got set up 50 years ago from lots of different interest groups coming together.
Howard Lomas: These various groups that got together and said, “Why don’t we have a national organisation?” So that was formed back in 1972.
Dr Lucy Maddox: Howard’s professional background was different to Isaac’s psychiatry training, but he found behaviour therapy just as useful.
Howard Lomas: I’d originally trained well in social work, but I was a childcare officer with Lancashire County Council.
Dr Lucy Maddox: And how were you using CBT or behaviour therapy in your practice?
Howard Lomas: Well, as a general approach to everything, thinking of everything in terms of learning theory. How do we learn to do what we do and maintain it with children? Things like non-attendance at school and other problems, behavioural problems with children and then later problems with adults.
But I suppose when I moved to Bury in 1973, I was very much involved in resettlement of people with learning disability from the huge hospitals that we had up here in the north. We’d three hospitals within sight of each other, each with more than 2,000 patients.
Dr Lucy Maddox: Wow.
Howard Lomas: They’re all closed now long since, but yeah, the start of that whole closure programme of trying to get people out into the community. You learn normal behaviour by being in a normal environment, which people in institutions clearly aren’t and weren’t. So it’s trying to create that ordinary valued environment for people. And simply doing that would teach them ordinary behaviours, valued behaviours. It was evidence-based, it was also very effective.
It looked at behaviour for what it was rather than what might be inferred. I suppose I saw psychology as more of a science (laughs). I’m still in touch with some of the people that are resettled from way back. People who had been completely written off as there’s no way they could ever live in their own home are now thriving, absolutely.
Dr Lucy Maddox: Now, Howard’s and Isaac’s memories of CBT 50 years ago highlight that an important route of CBT is behavioural learning theory. This includes ideas of classical conditioning, where in a famous experiment which you’ve probably heard of, Pavlov, taught his dogs to salivate in response to the bell that he rang for their dinner rather than the dinner itself. And operant conditioning, where animals and humans learn to do more or less of a behaviour based on the consequences which happen in response to that behaviour.
Howard Lomas: Half a dozen of us sitting with Skinner, chatting for three hours. So that was quite influential (laughs).
Dr Lucy Maddox: Skinner was another of the early behaviourists, and Howard has memories of being lectured by Skinner at Keele University. The formation of BABCP was important for therapists at the time because behavioural therapy back then was quite a niche field.
Howard Lomas: It was publicly very unpopular indeed. Behaviour therapy was known very much as behaviour modification, which has got an involuntary feel about it, even the name that it was being thrust upon people. And even at that time, aversion therapy was being used for trying to change homosexuality in people, aversion therapy then. Which is quite topical now with the whole debate on conversion therapy.
Dr Lucy Maddox: Absolutely. We’ve signed up to the memorandum of understanding against conversion therapy.
Howard Lomas: The aversive is horrible. And there was a big scandal at I think it was Napsbury Hospital about their clinical programme, which was allegedly based on behaviour modification, more aversive techniques. So there was a big scandal and that led to a major government inquiry, and they asked for anyone to offer, submit evidence on the whole question of behaviour modification, which BABP did. And that then formed the basis of our guidelines for good practice.
Dr Lucy Maddox: Just a note, if you’re listening to this as a cognitive behavioural therapist, please do read the memorandum of understanding against conversion therapy online at www.babcp.com. It makes it clear why we’re opposed to conversion therapy in any form. I’ll put the link in the show notes, too. Like Isaac, Howard remembered that shift from behaviour therapy to cognitive behavioural therapy.
Howard Lomas: Well, I was always against adding the C. I was always taught that behaviour has three components to it: motor behaviour, cognitive behaviour, and affective behaviour. So behaviour included cognitive, so why did you have to have it as a separate thing? Although in those early days I used to get told off if I spoke about thoughts and feelings.
Dr Lucy Maddox: Did you?
Howard Lomas: Yeah, because you can’t see them. You can’t measure them.
Dr Lucy Maddox: Yeah, interesting, although there’s still a lot of measurement, isn’t there? But maybe it’s like you say what we think we can measure has maybe changed.
Howard Lomas: That’s right, yeah. Yeah, I think the measurement and the evidence is so important.
Ivy Blackburn: We actually changed the name when we started it was called the British Association for Behaviour Psychotherapy. So at one of the conferences we passed a motion and added the C.
Dr Lucy Maddox: That’s Ivy Blackburn, another founding member of BABCP.
Ivy Blackburn: At that point well, I was a qualified clinical psychologist. I’d just finished my PhD, I trained in Edinburgh. And I was working in a research set up, an MRC unit called the Brain Metabolism Unit.
Dr Lucy Maddox: And so, CBT at that time was quite a new thing?
Ivy Blackburn: Very, very new. I actually had just discovered Beck as it was, while I was going the research for my PhD, which was in depression. And I used to correspond with him and he used to send me his early papers and things like that.
Dr Lucy Maddox: Ivy’s talking there about Aaron Beck, also sometimes known as Tim Beck. Also sometimes called the father of CBT.
Ivy Blackburn: With Aaron Beck I always signed I M Blackburn. And the story he used to tell at conferences was he always thought I M Blackburn was an old Scottish man. (Laughs) So once he came to Edinburgh, he was on a sabbatical, and we were sitting at I think it was a case conference. He was sitting next to my boss, who was somebody called Dr Ashcroft, and I was sitting next to him.
He turned to Ashcroft and said, “Could you show where I M Blackburn is?” Dr Ashcroft said, “You’re sitting next to her.” Yeah. So that’s how it all started, you know, we were a small group in those days, very small group.
Dr Lucy Maddox: Do you remember what you were excited about by CBT at that time?
Ivy Blackburn: I thought the research that Beck was doing about the factors in depression, about the role of thoughts I thought that was very interesting. The unit where I was working one of their things was working with treatment resistant depression. And they used to go through, the research was a series of drugs. You start with Drug A. If Drug A doesn’t work, you go to B, to C to D.
By the time they’d got to E and had nothing else to do I said, “I’ll take them.” And that’s how I started. I just thought it was very meaningful to me. They loved it, people talked to them and they could talk about what mattered to them, and they actually got better. Not long after that we decided to do the famous first ever trial in cognitive therapy for depression. That was published in 1981.
Oxford started at the same time, they also had started, John Tisdale and his group, a treatment trial. So ours came out in 1981 and theirs came out in 1984, I think. So we were actually the two centres, Edinburgh and Oxford. But cognitive therapy has developed so much. There’s all sorts of offshoots, I don’t know very much about. But another big person who did his PhD with me, big one at the moment who’s still active I think is Paul Gilbert. He was one of my PhD students.
Dr Lucy Maddox: Was he? Wow, yes. Because of course he founded compassionate mind therapy, yeah.
Ivy Blackburn: That’s it.
Dr Lucy Maddox: If you want to hear more about compassion focused therapy, you can check out the earlier podcast with Paul Gilbert. And in fact, if you’re interested in any of the different flavours of CBT which are now around, series one is a really good place to start. We go through lots of different types of CBT there and we hear from therapists and also people who’ve had those different types of CBT. Am I right in thinking as well you were a chair of BABCP?
Ivy Blackburn: That I was a what?
Dr Lucy Maddox: A chair? Like a president of the organisation, is that right?
Ivy Blackburn: Yes, I was. I was president, yes.
Dr Lucy Maddox: Yes, and were you the first woman president?
Ivy Blackburn: Yes. And I am of mixed race, so that was a bit of first as well. I went to Newcastle from Edinburgh in 1993. I think it was 1993.
Dr Lucy Maddox: And what was your experience like of being president?
Ivy Blackburn: As I say, we were so small in those days, you know, we had these little cosy conferences. We met in Newcastle every month. I was very, very well supported by Paul Salkovskis so he sort of guided me through. It was easy and of course some of those people are still there.
Dr Lucy Maddox: Yeah, you’re the big names.
Ivy Blackburn: (Laughs) We are, we are the oldies. Have I enjoyed it? Yes. Yes, I have enjoyed this work very, very much, yeah.
Dr Lucy Maddox: What have you enjoyed about it?
Ivy Blackburn: My work was very diversified because I was obviously also an academic so I did research, I did teaching, I organised a course. But I always carried on with my clinical work and I think that’s what I enjoyed the most, clinical work. This is what’s rewarding, isn’t it?
Dr Lucy Maddox: For sure. Yeah, absolutely.
David Clark: It was an exciting time. And people talked about it as a cognitive revolution. And I think it was a revolution.
Dr Lucy Maddox: That’s David Clark. He’s based at the Oxford Centre for Cognitive therapy, which Ivy was talking about. We also met David in the very first episode of this podcast. He joined the BABCP in the late 70s, when the dominant approach was still behaviour therapy. But as we heard from Ivy Blackburn, there was a crosspollination of ideas from the United States, where Aaron Beck was working on cognitive therapy for depression.
The idea that the way we perceive the world and our future can affect how we feel about it is now rather taken for granted. But at the time it was quite a radical idea.
David Clark: We suddenly started looking at a whole range of different potential therapy manoeuvres. There are thousands of ways you can change people’s beliefs and it was really exciting.
Dr Lucy Maddox: The interlock between beliefs, behaviours, memory and attention was really the basis of cognitive behavioural therapy as we now know it, with the model of thoughts, feelings, behaviours and bodily sensations, which is a fundamental part of most explanations of CBT today. Another root which CBT grew out of was rational emotive behaviour therapy, which Albert Ellis pioneered in the 50s and which also included thoughts, behaviours and emotions in its way of thinking about problems.
In the late 80s and 90s, CBT as we now know it, grew out of all of these roots, behaviourism, rational emotive behaviour therapy, and influenced by the work of Aaron Beck and the bringing together of all of these different ideas. Through the 80s and 90s, lots of disorder specific psychological models were created, to try to tackle specific problems. For example, models for panic disorder, obsessive compulsive disorder, posttraumatic stress disorder, and other problems were developed and really changed the treatment for those difficulties.
David Clark: And then, of course people start spotting ah, yeah, but some of the maintenance processes that had been invoked in a disorder specific model are also applying in other disorders. safety behaviour which Paul Salkovskis of course really pioneered is a good example of that. And also changes in attention, ways in which memory processes can go wrong. And so, you start moving into this way of thinking which is a bit more transdiagnostic.
Dr Lucy Maddox: Yeah, lovely, so actually it’s kind of gone from a very transdiagnostic one treatment fits all at the very start to then getting much more specific and nuanced. To then zooming out again to a bit more of a broader picture again.
David Clark: Yeah. And I think this is the sort of healthy dialectic that you experience when a field is moving forward.
Dr Lucy Maddox: And I suppose that’s one thing that I feel like CBT I mean, other therapies too perhaps, but CBT in particular it feels like it really is a learning therapy, where it’s very good at creating an evidence base. And then holding that evidence base up to the light and saying, “Hang on, what could we be doing better here?” And it does feel like it’s continually evolving perhaps because of how well evidenced it is.
David Clark: I think that’s right. I think it’s always had a very close link to the evidence base. But I think other therapies are going in a similar way, and I think this is really all to the good.
Dr Lucy Maddox: What do you think of the? Because the sort of family of CBTs if you like, I think of them as a family, there different therapies that have developed I guess a little bit more recently which still draw on cognitive and behavioural principles. But maybe sort of run with a different strand of it each time. So I suppose I’m thinking about APT and DBT and compassion focused therapies. How do you see those fitting?
David Clark: I’m just an empiricist, so I think what I think of them depends on what the outcome data is (laughs) with the particular conditions that they’re involved with. But when you get an approach which seems to be doing well and maybe improving on something else, then one always has to look at it. One of my friends, close friends through much of my career was Tim Beck who sadly died last year.
But he was a very jokey person in many ways. But one of the points that he would sometimes make when someone said to him, “Well, what’s cognitive therapy?” He would say, “Well, anything that works.” And of course, it was a joke in a sense, but it was also serious because he was always watching for what other people did in other therapy approaches to see if they’d got something which cracks open beliefs in a way that he hadn’t seen before.
And if so, it miraculously got incorporated into cognitive therapy. It’s really important that we as therapists always keep our eyes open to these things. One of the big developments more recently in the field has been to think well, how can we bring these advances to the public so that really large numbers of people benefit?
Dr Lucy Maddox: Yeah, and of course improving access to psychological therapies has been a massive part of that.
David Clark: Yes. It’s been a great honour to work with so many wonderful people who put in such hard effort to lobby for that. And then, to create the services and crucially, to make them work so effectively that successive governments across the whole political spectrum have cherished and expanded the programme.
At the moment it is the only aspect of our mental health services where outcomes are recorded on everyone and are published. In my worst nightmares I would not have dreamt that we’d still have almost every other area of mental health provision in the dark ages in terms of public transparency. And also in terms of learning.
Dr Lucy Maddox: As David said there, a national improving access to psychological therapies programme in England doesn’t only include CBT. But it has been instrumental in increasing access to CBT as well as other evidence-based therapies within England. It’s also been responsible for creating a whole generation of low intensity therapists, who deliver CBT as part of a stepped care model.
Where briefer interventions, often in the form of guided self-help, are offered for less severe presenting problems. Now we move a little later in the history of CBT. I got in touch with the outgoing president of BABCP, Andrew Beck, and asked him how he first came across CBT. He told me about his first experience of the BABCP conference as a trainee clinical psychologist back in 1997.
Andrew Beck: I managed to get a free ticket to it by DJing at the social party afterwards.
Dr Lucy Maddox: Did you?
Andrew Beck: Yeah, I did, I DJed at that and got a load of Rod Holland’s photographs from past conferences and made a sort of slideshow of them, which we showed, while I was DJing and it was great. But I really felt like I’d come home because there was such a wide variety of people there. It was people from all different professional backgrounds, all coming together and talking about the real practical aspects of working in mental health.
Yeah, it was a real eye opener for me. Being around people who you feel share the same concerns, the same interests, who want things to be better in the same kind of way that you do is great. You feel like you’re part of a community then, don’t you? And being part of that community sustains you in what you’re doing in a really nice way.
Dr Lucy Maddox: What was it about CBT that you liked?
Andrew Beck: It was pragmatic, and I think there was something about it that was very much about being in the room with someone and helping them to get past the things that were stopping them getting on in life. And it was that really present focused aspect of it that appealed to me. That I felt like as a cognitive behaviour therapist, you were going to help someone find something to take home with them and do differently to improve things. And I think that was what really clicked for me, to be honest, Lucy.
I came in 25 years ago, at a point where CBT had begun to be thought about as a therapy in a very coherent way. A lot of the models that we use now and are familiar with, were all really well established. And it was easy to imagine that it had always been like that. But of course, talking to some of the people who were around in those formative years, it’s been really interesting to hear that history of how the therapy has developed.
And I’m told that there was a raging argument about whether these ideas about behaviour therapy and those ideas about cognitions could be brought together in one therapeutic organisation. And how that might look. Because they were quite distinct camps at times, really, with quite different ideas about what therapy ought to be like. And whether these very disparate ideas could sit well together in one organisation and what that organisation ought to be called.
But of course, by 25 years ago attending conference, what we now think about as second wave CBT felt very formed, actually. And what’s happened in the 25 years since is the third wave therapies have developed their evidence base, developed their theoretical foundations and have really grown in popularity. And there’s a whole group now of therapies that are considered to be part of the family of cognitive behaviour therapies but are the kind of next wave.
Dr Lucy Maddox: So Andrew talks there about first wave CBT, which was really just behavioural therapy. Second wave CBT, where the thoughts got added. And third wave CBT, which is the larger family of therapies we now think of. As I said before, if you want more information on the different sorts of CBT, check out the podcast in series one. As we heard from Howard earlier, not everything about the past history of CBT is rosy by any means. Is there anything that you’re glad that we’ve left behind in terms of how CBT has changed in the last 50 years?
Andrew Beck: Yeah, I am, actually. There’s a few things I think are real problems in the history of our therapy. And probably the one that stands out the most is the role of behaviour therapy predominantly in conversion therapy for people that are LGBT identities. And if you look back at conference proceedings from BABCP conferences 30, 40 years ago this was something that was seen as unproblematic.
That there was an idea that people who were unhappy with their sexual identity could have their sexual identity changed through behaviour therapy. And looking back now that was appalling and actually for many people at the time it would have been seen as appalling, too. So it’s not just one of those things that with the benefit of hindsight doesn’t look great, actually it didn’t look great at the time, I think for a lot of people.
And if you were a gay member of our organisation and came to conference and saw that as part of the conference proceedings, that would have been a really alienating process, really. And I think the other thing is because CBT has often been aligned with diagnostic frameworks over the course of CBT’s history, really see now and understood now as being quite unhelpful.
And the one that most stands out for me, I think is borderline personality disorder, which is a way of describing people who generally experienced extraordinarily abusive and invalidating environments growing up, who have developed all sorts of strategies to manage those difficult environments. But who have been understood by services as having a problematic or disordered personality. And I think broadly speaking, the world of mental health is moving away from that as a diagnostic category.
Dr Lucy Maddox: Andrew is the outgoing president of BABCP, and he’s just about to hand over to Saiqa Naz, which is the last person I spoke to. Her perspective on CBT comes from her training as first a low intensity therapist, then a high intensity therapist and now as a trainee clinical psychologist.
Saiqa Naz: I really enjoyed my training, there was a core group of us. We had a routine, we’d go to Costa and have a coffee beforehand. So for me, I remember that (laughs), the social aspect of it. I think that really makes a difference to a training experience, just having that network of support around you. We’re actually celebrating our 10 years of friendship this year. So I’ve been in CBT for 10 years now this year, so it’s nice to be part of BABCP and hopefully be part of its future as well.
And I’m mindful I’m probably a bit different to the other presidents in terms I might be a bit younger, or not a professor. But hopefully bring something different to the organisation. Yeah, I think when I trained as a low intensity CBT it was in the early days of the IAPT programme. So just really interesting to see something so huge being rolled out nationally. And how it was being developed locally, so I trained in Sheffield and we were based in GP surgeries.
And I really liked that model, working a little bit more closely with other healthcare professionals, GPs. I’ve still held onto the skills that I learnt as a low intensity CBT practitioner, when I trained as a CBT therapist. So it lent itself really well to training as a CBT therapist. And again, I think both are valuable in their own right.
The step care model is really important if you’re thinking about long waiting lists and people having access to treatment sooner rather than later. So I think in that sense, the low intensity CBT role has really revolutionised mental health and how services are delivered today.
Dr Lucy Maddox: David and Andrew both had similar respect for the low intensity role and how it’s changed access to CBT.
David Clark: We now have people with a wide range of backgrounds, non-medical backgrounds, who are delivering evidence-based therapies and are considered on an equal basis and are considered to be real experts. So that sort of democratisation of mental health provision has been obviously an incredibly good thing.
Andrew Beck: We’re really lucky in BABCP in that we’ve got a bunch of great low intensity members who are involved on board level, at committees. And I think that’s going to be a big part of who we are as an organisation.
Dr Lucy Maddox: Saiqa and Andrew were also two of the authors of the IAPT positive practice guide for working with Black, Asian and minority ethnic service users, which is available at www.babcp.com and also in the show notes. Saiqa had some ideas about what would help this to be rolled out more fully.
Saiqa Naz: I think there’s quite a few things that will help. So people like Andrew and myself can take a step back and that’s having representation in those senior leadership roles, decision making roles. What we see is that IAPT has opened the doors for people from underrepresented groups, so working class backgrounds, BAME backgrounds, men, people with disabilities.
But what we need to see is those people in more senior leadership roles. And personally I would like to see ringfenced funding now, to help the implementation of the guide. Otherwise, I think the system will keep relying on goodwill and it could be a bit exhausting.
Dr Lucy Maddox: What about the future of CBT? We don’t know how it will change in the next 50 years. But everyone I interviewed had some ideas.
Saiqa Naz: I think for me looking forward I want us to learn more about our CBT heritage. We were just talking about it at the beginning, thinking about who are we inheriting the knowledge from? Where has it come from? Because it will help us to connect with CBT and also think about what’s the legacy of CBT long after we’re gone what we’re leaving behind for the next generation.
And also, how are we going to support the development in a way we are privileged here with the amount of resources that we do get in mental health and the level of training. But how can we pass it on to more lower middle income countries? Taking CBT to communities I think is really important because sometimes I think an organisation can become too insular and just be focused on the inward and on itself. But having that one foot in, one foot out is really helpful.
Dr Lucy Maddox: Andrew agreed that involving people with lived experience of having had CBT is really important when we think about the future development of the therapy and how it might evolve over the next 50 years.
Andrew Beck: It enables us to think a little bit more about barriers to engaging in therapy, what we need to do differently to bring people in, what we need to do once people are in therapy. And it’s been a really lovely development, I think in CBT to think more about that. We really don’t know, we’re very much at the edges of thinking about how our therapies might develop over the next 25 and 50 years.
So it’s a really exciting time. We need to keep pushing and refining our ideas to improve. But the other one for me is about access and outcomes for diverse populations. CBT needs adaptation and therapists need to be able to take into account cultural contexts in order to do that because the large datasets that we’ve got show that for many communities their outcomes are not as good.
Now, part of that I think is because those communities experience particular social and economic hardship and marginalisation, and therapy can’t fix that. But part of it is because therapists just need to get better at thinking about difference in the way we work. So I think that’s going to be an exciting project over the coming years. And we’re just at the start of that, really.
Ivy Blackburn: I think it will be still there with a lot of development, side developments, as we see at the moment, like compassionate and all sorts. Different branches. But I don’t see it disappearing to be replaced, developing as it should be. The beginning was very, very quick developing from depression it quickly went to anxiety. And then, Paul and David went into panic disorder, all this. One after the other, different methods.
David Clark: I just hope that the speed of progress in the next 50 years is at least as fast as we’ve had in the last 50. And we get to a situation where helping people learn how to deal with setbacks in their life and deal with mental health problems becomes much more routine in society. I assume we’re going to have much more digital. I’m sure AI is going to help with a number of things.
But I’m also sure that the absolutely basic qualities that are in therapy about having someone who really cares what’s going on with you, being warm and empathic and really wanting to understand the world from your perspective will remain dominant and really important.
Isaac Marks: Well, I imagine that new methods will continue to be developed from time to time by people in different countries. And as far as I can see, it’s the sort of approach that I think is likely to continue for the foreseeable future.
Dr Lucy Maddox: I hope that’s given you a bit of a flavour of how CBT has grown and developed, especially in the last 50 years from its behavioural roots to the diverse and flourishing therapy that it is today. Do check out the other episodes of the podcast to hear from people who have actually had the therapy to hear in their own words what it’s been like for different problems and with different types of CBT. Meanwhile from me, that’s goodbye. Take good care and enjoy your summer wherever you are.
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Photo by Ryan Gagnon from Unsplash
Music by Gabriel Stebbing
Produced for BABCP by Lucy Maddox
For more on BABCP check out www.babcp.com
The Memorandum of Understanding Against Conversion Therapy can be found online here: https://babcp.com/Therapists/BAME-Positive-Practice-Guide
The IAPT Positive Practice Guide for BAME Service Users can be found here: https://babcp.com/Therapists/Memorandum-Against-Conversion-Therapy
For more on different types of CBT check out series 1.