Listed below (in alphabetical order) are just some of the issues we deal with in our practice. These issues can affect children, young people, adults, couples and/or families. ADDICTION Addictions can be formed to any activity or behaviour that allows people to escape from life and its problems, including drinking, drug use, shopping or spending, sexual activities, gambling, food, etc. When such habits or behaviours come to dominate daily life and people find they are powerless to stop (despite many promises to do so), then it is very likely that an addiction is active. In young people significant substance use / abuse is associated with increased accidents, suicide and violence, mental health and behavioural problems, academic failure, school drop-outs, truancy, sexual promiscuity, family difficulties, etc. (Gilvarry, 2000). CBT is the main therapeutic approach we use with addictions. AD/HD Attention Deficit Hyperactivity Disorder (AD/HD) by definition presents children with high levels of inattention, impulsivity and hyperactivity. These children often suffer substantial impairment in their daily functioning at home, school and at play. Diagnosis and treatments of ADHD vary, but an assessment of the child is vital in diagnosing ADHD before any subsequent treatment programme is implemented. We can work with young people with AD/HD through CBT and play work and with their parents through counselling and family therapy. ADJUSTMENT TO SEPARATION AND DIVORCE The adjustment of adults and young people to the impact of divorce and separation are legendary and include trauma, emotions, pain, stress, etc. For many, added to this are the stresses and strains of moving home, school and/or work and leaving extended family members and friends. Therapy can address the transitional period and an individual’s self-esteem and self-confidence, together with professional positive support, help and advice. ANGER MANAGEMENT Anger can often be as a result of fears, frustrations, disappointment, arguments, stress, anxiety, unmet expectations, and much more. An anger response is often a way of blocking out emotional pain or avoiding dealing with emotional issues. Professional support involves the assessment of the causes and triggers that underlie the anger response and the behaviours displayed, and providing the individual with tools to deal with their anger and situations of conflict. ANXIETY Anxiety can affect people in different ways and there are a number of different anxiety disorders. For some anxiety can purely relate to a specific issue, for others it can mean worrying constantly about all aspects of life and being unable to cope with day to day life, whereas others can become prisoners in their own home, feeling unable to control disturbing or upsetting thoughts. We provide a range of therapeutic methods depending on the individual and the levels of anxiety suffered. BEHAVIOURAL PROBLEMS Behavioural problems can occur in children of all ages and can include displays of verbal and/or physical aggression, temper tantrums, rule-breaking and disobedience. Some eating and sleeping issues can be behavioural. Behavioural problems can affect a child's development, interfere with their ability to lead a normal life, and disrupt everyday family life. Such problems can be addressed using CBT, play work, family therapy and parenting skills work, and other forms of assessment and counselling. BEREAVEMENT Words cannot describe the feelings when one loses a loved one. Everyone copes with grief and mourning in different ways. Bereavement counselling can provide an individual or family with the support and tools to come to terms with such loss. CHILD ABUSE Child physical, sexual and emotional abuse can have a devastating impact on the development of the child. Immediate and short term responses include distress, anxiety, nightmares, shame, guilt, hostility, depression and inappropriate sexual behaviour. Adults who have a history of child sexual abuse are more likely to suffer eating disorders, depression, sexual problems, to behave in self-damaging and suicidal ways, and to have difficulty in sustaining or forming an intimate relationship. We can offer victims of all ages professional help in addressing issues of emotions, self esteem and empowerment, coping skills, dealing with disclosure, etc. in an effort to allow them to live a fulfilled and positive life. CHRONIC FATIGUE SYNDROME Chronic fatigue syndrome (CFS) is also known as myalgic encephalomyelitis (ME), a condition characterised by physical and mental fatigue. CFS can affect adults and young people and has many debilitating factors, which can affect all aspects of an individual’s life. CBT can be used as a pragmatic approach to managing and rehabilitating clients with CFS. DEPRESSION It is estimated that about one in five people suffer from depression at sometime in their lives. Depression can happen at any time for no particular reason or can be triggered by environmental factors such as a past experience, bereavement, monotony, or physical factors such as hormones or giving birth. Symptoms can include a feeling of persistent emptiness, loss of interest in life, tiredness, hopelessness, loss of sex drive, suicidal feelings, etc. The earlier depression is diagnosed and treated, the easier it is to turn around. CBT can work effectively with many people suffering from depression. DOMESTIC VIOLENCE Domestic violence affects women and men from all walks of life, age, ethnicity, social class, disability and sexuality. The violence can begin at any stage of a relationship and may continue after the relationship has ended. Victims of domestic violence live in constant fear and suffer on many levels including health, housing and education issues. Counselling can offer confidential help, support, advice, therapy and much more to victims and their families. EATING DISORDERS Eating disorders are rooted in anxiety and stem from a sense that life is out of control and that the individual is unable to cope. Thus an eating disorder is a strategy used to cope with problems in life and feelings that are making a person unhappy, depressed or under pressure. By controlling food an individual gains a sense of being in control of his/her existence in general. Eating disorders include anorexia nervosa, bulimia nervosa, compulsive overeating, binge eating and other associated disorders. CBT can address the negative cognitions people have about their body and sensitively addresses other unresolved emotional and psychological issues which so often underlie eating disorders. GENDER ISSUES & SEXUALITY Human sexuality and gender do not fall into neat categories. Some people are not sure about their gender or sexuality, others do not feel confident in exploring it due to family pressure, cultural expectations, and social attitudes, etc. Experiencing conflict or confusion about your sexual identity may leave you feeling very isolated and misunderstood. Counselling can address these issues and can help you explore your experiences, give you the opportunity to consider the barriers, and empower you to be proud of your sexuality/gender identity. OBSESSIVE COMPULSIVE DISORDER (OCD) Among adults, one-third to one-half develop OCD during childhood or adolescence. At any given time between 0.5% and 1% of children and adolescents suffer from clinically significant OCD. OCD disrupts normal everyday living, whilst some people become prisoners within their own home. CBT allows clients the opportunity to face their compulsive behaviour and fears. Counselling is also available for families of OCD sufferers. PANIC Panic is an extreme form of anxiety that results in exaggerated physical reactions, including increased heart rate, hyperventilation, sweating and confusion. CBT offers clients the opportunity to address their anxieties in a safe environment. PARENTING SKILLS Parenting is expected to be a ‘natural’ skill, irrespective of individual circumstances. However we all know this is not the case. In seeking advice parents can learn skills to improve parent-child communication and impose effective discipline methods, as well as learning the stages of child development and associated issues. This knowledge can empower parents and promote a positive family environment, making parenting easier, more fun and less stressful. PERSONALITY DISORDERS People with personality disorders often find it more difficult to learn from past experiences and to change their behaviour to cope with life more effectively due to their patterns of thinking, feeling and behaving. This can lead to distress, loneliness, anger, relationship problems, depression, etc. There are several different types of personality disorders, including Borderline, Narcissistic, Paranoid, Schizoid, Schizotypal, Antisocial, Histrionic, Avoidant, Dependant and Obsessive Compulsive. CBT can be used along with other therapeutic approaches to help provide individuals with personality disorders with the tools to cope. PHOBIAS There are many kinds of phobias, such as heights, spiders, dogs, flying, etc. A phobia can be described as an irrational fear, dealt with by avoidance of the feared object and resulting in restrictions in the day to day functioning of the individual. CBT involves providing individuals with the tools to overcome their fears. PHYSICAL HEALTH Coping with discovering you are ill often evokes a mixture of complex, often confused and contradictory, thoughts and emotions. Consultations can provide a valuable support service for suffers and their families, as well as addressing the psychology of pain management. RAPE & SEXUAL ASSAULT Rape is a devastating crime against both women and men. Despite feelings of self blame, shame, fear, etc., the responsibility always lies with the attacker, not the victim. Counselling offers someone to talk to: someone who understands the issues around rape and sexual abuse, someone who is empathic and who will listen without judging or criticising feelings and actions. Sessions can also help victims to begin to move forward by taking back control of their lives. RELATIONSHIPS When communication between people breaks down there are knock-on effects throughout any relationship. Relationship counselling can involve mediation, advice and support with couples, families and individuals on a wide range of issues, including family life, infidelity, separation, sex therapy, etc. SCHOOL REFUSAL School refusal is a persistent school attendance problem that jeopardises a young person’s social, emotional, academic and vocational development; contributes to disharmonising the family environment; and causes distress to parents and school staff. School refusals can occur suddenly or develop over a period of time. The reasons are varied and include bullying, family problems, emotional issues, school phobia, and so on. CBT can be used to help a young person overcome the issues surrounding the school refusal and to encourage the gradual return of the young person back to school. Family therapy can also be used to support this work. SELF-ESTEEM Self-esteem refers to the extent to which we like, accept or approve of ourselves and how worthwhile as person we think we are. How much we like or value ourselves can be an overall judgement or it can relate to a specific area of our lives. Problems with self-esteem can impact on all aspects of our lives, including relationships, education, employment, mental health, etc. CBT can be used effectively to work with people to build their self-esteem. SEX PROBLEMS Many individuals and couples experience problems in their sex lives, including sex addiction, impotence, premature ejaculation, difficulty reaching orgasm, etc. Counselling allows clients to talk openly in a confidential and relaxed environment, addressing issues openly and frankly and identifying the choices and positive ways forward. CBT also works effectively in cases of sex addiction. SPORTS PSYCHOLOGY The increased stress of competitions can cause athletes to react in a stressful manner, both physically and mentally. This negativity can affect their performance abilities. Professional advice and effective NLP techniques enable athletes to focus, prepare and perform positively in the context of a continual learning curve, allowing athletes to increase performance levels, set goals and reach targets. STRESS Stress is recognised to be a contributory factor in a wide range of both physical and mental health issues. The effects of stress can impact on all aspects of our lives. CBT allows individuals to learn about their stress and provides tools to manage their stress levels effectively. For stress issues relating to debt and insolvency see an excellent website called Ladies in the Red ( http://www.ladiesinthered.com ) which provides information, advice, forums, research, etc in relation to debt for females. TRAUMA Trauma as a result of a particular experience or a series of experiences can affect every aspect of our lives. Trauma has many faces, including Post Traumatic Stress Disorder (PTSD), and can be treated in many ways, including CBT and NLP. However treatment programmes vary according to the individual and the circumstances surrounding the trauma.