My approach

I work in two evidence-based therapies — Cognitive Behavioural Therapy (CBT) and Cognitive Analytic Therapy (CAT). I don't lead with one as a house style. The right approach depends on what the problem actually looks like, and we decide together, early on, what fits. Here's what each looks like in the room.

How CBT looks in the room

CBT works the present-tense loop — the cycle of thoughts, feelings, and behaviour that's keeping a problem going now. Early on we build a collaborative formulation: a shared map of what maintains the difficulty. From there the work is practical and testable — behavioural experiments to check the predictions anxiety keeps making, exposure (including ERP for OCD) to loosen avoidance, behavioural activation for low mood, and cognitive restructuring to examine the thoughts that don't hold up. It's structured and time-limited, and you can usually feel the shape of the work change between sessions one, four, and twelve.

How CAT looks in the room

CAT works the pattern underneath — the way of relating to yourself and others that was laid down earlier in life and keeps reasserting itself. We name those patterns as reciprocal roles, and early in the work I write you a reformulation letter: an account, in your own words and story, of how the pattern formed and what keeps it going. We map it on a diagram you can carry, so you can recognise the pattern as it happens, and we work out the exits — the points where a different move becomes possible. CAT is collaborative and time-limited too, usually around sixteen sessions.

When each is the right call

As a rough guide: CBT fits when a current, specific problem is held in place by a present-tense cycle — panic, generalised worry, a phobia, a recent low patch. CAT fits when the difficulty is relational or recurrent — the same painful patterns repeating across relationships, or a sense of "here we go again." Plenty of presentations could reasonably go either way — which is exactly what the first session is for. I'll tell you plainly what I think fits, and why. You can see the conditions I most often work with for how this plays out in practice.

What sessions look like

Sessions are fifty minutes, weekly to begin with, in person in Saint Helier or online — and £100 each (see fees). Between sessions there's usually something to try or notice. Not homework for its own sake, but the part where the change actually happens. We review as we go whether the work is doing what we hoped.

Whichever route we take, the aim is the same — changing the patterns that don't shift on their own. I promise to think with you.