Show Notes
In this episode of Practice Matters, Rachel Handley is joined by Professor Alicia Meuret to explore anhedonia, the reduced ability to feel pleasure, and the development of Positive Affect Therapy (PAT). Together, they unpack why so many clients struggle not just with feeling bad, but with a profound absence of positive emotion, and why traditional CBT approaches may not fully address this gap. Alicia explains the science behind the brain's reward system, breaking it down into three key processes: wanting, liking, and learning. She also introduces PAT, the evidence-based treatment she developed with Professor Michelle Craske, and shares what the randomised controlled trial evidence tells us about its effectiveness compared to more traditional CBT approaches to treating depression. The episode also offers a practical overview of what PAT looks like in the therapy room, including behavioural activation with a positive focus, savouring, gratitude practices, and building a richer emotional vocabulary. Alicia addresses some of the trickier clinical questions too, including how to present a positive-focused rationale without invalidating clients' very real distress, and how these ideas might just change how you look after yourself as a therapist. Further resources: Find out more about Alicia's work here- including links to all the trials mentioned in the podcast Alicia's most recent trial published in JAMA Network Open can be found here Positive Affect Treatment for Depression and Anxiety: Therapist Guide can be bought from Oxford University Press here Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: [email protected] Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow
More from Let's Talk about CBT- Practice Matters
In this episode of Practice Matters, Rachel Handley is joined by Professor Ailsa Russell to explore how CBT can be adapted to meet the needs of autistic clients. They unpack common myths, including the idea that CBT is unsuitable for autistic people or that encouraging behaviour change simply means asking clients to mask, and discuss where a neuro-affirmative stance fits into formulation and treatment.
In this episode of Practice Matters, Rachel Handley is joined by Dr Antonia Dittner, consultant clinical psychologist and lead author of "A Therapist's Guide to CBT to Support Adults with ADHD," to explore what CBT has to offer this often misunderstood client group. Together they unpack the diagnostic picture, the overlap with anxiety and depression, and why a formulation driven, transdiagnostic approach can help therapists feel more confident with this client group. Antonia walks through the four core elements of therapy: behavioural work on routines and habits, thinking patterns, managing emotions and impulses (including how procrastination often develops as a way of avoiding difficult feelings), and longer standing beliefs and coping. She also shares practical tips for structuring sessions, addressing shame and self-criticism with compassion, and what services can do to support access for neurodivergent clients. Further resources: A Therapist's Guide to CBT to Support Adults with ADHD by Antonia Dittner and colleagues
In this episode of Practice Matters, Rachel Handley is joined by Dr Scott Waltman, president-elect of the US Academy of Cognitive and Behavioural Therapies, to explore what Socratic questioning really is and why it matters. Scott describes it as thinking with our clients rather than for them, comparing it to Socrates' own idea of being a midwife for thought. They discuss the evidence behind Socratic questioning, the difference between guided and provided discovery, and how Scott's research reshaped Padesky's well known four step model. Scott also shares practical advice on focusing questions, and on working with a client's own definitions to shift stuck beliefs. Further resources: Find out more about Scott's work here Socratic Questioning for Therapists and Counselors can be bought from Routledge here Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: [email protected] Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow
In this episode of Practice Matters, Rachel is joined once again by Professor David Veale, this time to explore emetophobia, the specific phobia of vomiting. David explains why this is the most common specific phobia presenting for treatment, despite being largely overlooked by researchers for years, and the devastating impact it can have, from avoided pregnancies to missed medical care. Together they unpack what drives the fear, how it differs from OCD and eating disorders, and why tolerating uncertainty rather than seeking reassurance is at the heart of effective treatment. David also shares his "vicious flower" formulation, practical tips for therapists who might be squeamish themselves, and exciting developments in virtual reality treatment. Further resources: David's self-help book, Free Yourself from Emetophobia, co-authored with Alexandra Keyes, is available here Find out more about David's work and publications here Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: [email protected] Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autumn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow
In this episode of Practice Matters, Rachel Handley is joined by Professor David Veale, consultant psychiatrist and cognitive behavioural therapist, to explore body dysmorphic disorder (BDD). Together they unpack what BDD really is, how it differs from vanity, social anxiety, and OCD, and why so many people suffering with it end up seeking cosmetic solutions rather than psychological support. David shares the CBT formulation for BDD and explains the key maintenance processes that keep people locked in distress: self-focused attention, comparing, ruminating, checking, and safety behaviours. He also discusses imagery rescripting, the challenges of engagement, and why targeting processes rather than the content of beliefs is so important in this work. The episode also covers what effective therapy looks like in practice, who is most likely to benefit and why persistence matters, the current evidence base, and where David hopes future research will take the field. Further resources: Find out more about David's work and publications here More information on BDD can be found via the BDD Foundation Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcasts Send us your questions and suggestions: [email protected] Subscribe and leave a review – and don't forget to share this episode with your colleagues! If you enjoyed this episode, check out our sister podcasts, Let's Talk About CBT and Let's Talk About CBT – Research Matters for more discussions on evidence-based therapy. Credits: Music is Autumn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow