The 4 CBT4T ELEMENTS are based on the Stages of Change

What are CBT4T's Four Elements

Pre-Contemplation - Not interested or not considering change

BEFORE ENROLMENT ON CBT4T

Contemplation - Thinking about change:

• Identify that we want to change

• Explore available information

• Clarify what can help us change

• Commit to the decision we have made, for example, enrol on CBT4T

AFTER ENROLMENT ON CBT4T

Preparation - Build strong foundations

CBT4T Element 1: Preparation

• CBT4T Stages 1-3

• The regular and consistent breathwork and relaxation routine practices enable your nervous system to reach a sufficiently well REGULATED STATE in preparation for making full use of brain plasticity to CHANGE unhelpful behaviours (REACTIONS) and cognitions (ATTITUDE, STREAMS OF THOUGHTS, BELIEFS) that begin from Stage 4

Action - Making changes

CBT4T Element 2: Moving Forward

• CBT4T Stages 4-6

• Building on - and further improving - your already established routine breathwork and relaxation practices (in Element 1), you begin working with the bespoke (developed and provided by Debbie Featherstone specifically for the CBT4T programme) cognition tools. Also Goal Setting & Action Planning; Easy Problem, Hard Problem, Real Problem; Brain Plasticity

Reinforcement - Embedding changes

CBT4T Element 3: Resilience-Building, Meaning & Belief

• CBT4T Stage 7

• Includes FOUR modules: Continue with reframing (Meaning Adjuster) as needed; Identify Negative Core Belief(s); Set Your New Core belief; New Core Belief Follow-through

Maintenance - Maintaining changes

CBT4T Element 4: Consolidation & Completion

• CBT4T Stage 8

• By Stage 8, your work with CBT4T is almost complete. Time is best taken for a period of consolidation before final completion

Relapse - Temporary Relapses occur intermittently throughout the Change Stages

• Temporary relapse can occur on any day, any week, any time

• Progress is not LINEAR - we all experience good days and not so good days

• Learn to recognise them for what they are, and

• Know what to do when they happen

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Support Provided during the CBT4T programme

• BY CHOOSING TO ENROL WITHOUT APPOINTMENT(S) INCLUDED, PLEASE BE AWARE THAT YOUR ENROLMENT DOES NOT INCLUDE IN-DEPTH 1-1 CLINICAL SUPPORT BY EMAIL

• Impact Statements (Past, Present, Future) - assessing trauma indicators, as where present, they are likely to have a bearing on the person's current level of nervous system dysregulation

• Calculating initial assessments for an on-boarding report, and compiling each person's comparison reports (TFI, THI, GAD-7, PSS, ASQ, HSQ, HAQ) with reflective feedback at Stages 4 (the first appointment is sent with the Stage 4 report), 6 and 8

• Daily Relaxation Logs

• Progress Checks when a Stage is completed and a new one begun

• The weekly SITREPs that arrive throughout the day each Friday

• Two Arrows practicals*

• Costs & Benefits Transactions*

• Cognitive Distortions Practicals*

• Reaction Analysis*

• Meaning Adjusters*

• Core Belief work in Stage 7**

• PLUS!!! CBT4T Substack

*Relates to Cognition tools developed for CBT4T by Debbie Featherstone (Intellectual Property of Debbie Featherstone)

** Relates to Core Belief work authored by Christine Padesky, Mind over Mood

SITREP

Weekly SITREP

The weekly SITREP was introduced in to CBT4T in August 2023. It has been become a significant benefit to CBT4T participants. In response to the question:

Q: The weekly SITREP was introduced in August 2023. Have you found it useful to report in weekly and if so, why?, feedback has included:

• "It is useful to report in on a weekly basis and it keeps me in touch with the process and keeps my focus as life is busy and can get in the way!" - Ingrid, UK (Ingrid was enrolled with TWO appointments and 1-1 email support included)

• "Yes, absolutely. Were it not for the SITREP, I think I would have lost focus and engagement, possibly even gone for months at a time without doing any work on the course. Ever since Week 1, I have submitted a weekly SITREP and this has nudged me into reviewing course materials and doing exercises. I think the SITREP is a vital part of the course - without it, I don't think I would have felt as supported as I did. It also represented a record of my progress." - Nathaniel, UK (Nathaniel was enrolled with THREE appointments and 1-1 email support included)

It is important that you use the CBT4T process consistently and AT YOUR OWN PACE. Any process must fit the individual. Processes will always fail when there is an expectation for individuals to fit a process. Were you to be attending appointments at a clinic, you would go through the process at a pace that suits your needs.

The weekly SITREP is an email that you send in each week. Details about the SITREP, when and how to use it are on the CBT for Tinnitus E-Programme website. Click the button for details:

Adding a 1-1 using Zoom

1-1 appointments are carried out using Zoom. 

BY CHOOSING TO ENROL WITHOUT APPOINTMENT(S) INCLUDED, PLEASE BE AWARE THAT YOUR ENROLMENT WILL NOT INCLUDE IN-DEPTH 1-1 CLINICAL SUPPORT BY EMAIL

The optimum time for your first 1-1 with me is on completion of Stage 4, when two of the clinical measures you completed at Stage 1 are repeated: Tinnitus Functional Index (TFI) and Anxiety/stress Symptoms (ASQ). When I receive these from you, I email you your results and ask if you wish to book a 1-1 appointment - normally for the following week.

I have worked remotely since 2012, so even if meeting up on a screen is new to you, it isn't to me.

You do need a good internet connection, which most of us have nowadays, and you can use a computer with camera, microphone and audio, a tablet or a smart phone.

Most one-to-ones are around 60-90 minutes (average 1 hour 20 minutes).  We will have been in touch via your SITREPs, logs and Progress Checks so I'll have a good idea about your needs by then, plus you will have completed a Mini-history.

1-1 appointments

BY CHOOSING TO ENROL WITHOUT APPOINTMENT(S) INCLUDED, PLEASE BE AWARE THAT YOUR ENROLMENT DOES NOT INCLUDE 1-1 CLINICAL SUPPORT BY EMAIL

95% of users don't need any more than TWO 1-1 appointments, and 80% only use ONE appointment.

A normal consultation is 60-90 minutes with a fee of £195, so make full use of the CBT4T rate: £125.00 where your enrolment did not include appointments.

BY CHOOSING TO ENROL WITHOUT APPOINTMENT(S) INCLUDED, PLEASE BE AWARE THAT YOUR ENROLMENT DOES NOT INCLUDE 1-1 CLINICAL SUPPORT BY EMAIL