Choosing a therapist: why professional accreditation matters

Choosing a therapist can feel quite personal. You may be looking for someone who understands the difficulty you are facing, but also someone you feel you could talk to openly and trust. Alongside that personal fit, it is also worth looking at a therapist’s training, experience and professional accreditation, as these give you some reassurance about the standards they work to.

I am accredited with the British Association for Behavioural and Cognitive Psychotherapies (BABCP), the main professional body for CBT in the UK, and I am also a Senior Accredited Registered Member of the British Association for Counselling and Psychotherapy (BACP). These professional memberships and accreditations involve recognised standards of training, practice, supervision, ongoing professional development and ethical conduct. I also have more than 25 years of clinical experience and work with approaches including CBT, Metacognitive Therapy, ACT, EMDR and Deep Brain Reorienting.

For me, good therapy is not simply about applying a particular technique. It is about understanding the individual person, working collaboratively and using the right approach at the right time. Feeling comfortable with your therapist matters, but so does knowing that the person you are working with has the training, experience and professional framework needed to offer safe and effective psychological therapy.

EMDR and Chronic Pain

Living with chronic pain can be a long journey. Over time, people may have tried different treatments, learned a great deal about pain and about themselves, and found ways of doing things that once seemed impossible. And yet there can still be a quiet question: is there anything else that might help?

That question is one of the reasons I continue to develop my work using EMDR with chronic pain. What particularly interests me is that EMDR gives us additional ways of working not only with pain itself, but with the sensations, emotions, memories and experiences that can become connected with living in pain.

Sometimes the therapeutic work may involve a particular memory or experience. At other times the starting point may be the pain itself, a bodily sensation, fear associated with the pain, or the effect that living with pain has had on someone's life. And sometimes something new emerges during therapy — a change in sensation, an unexpected association, a different understanding or a new felt sense of oneself — which we can stay with and work with further.

I recently had the opportunity to attend the second part of Australian psychologist Mark Grant's training on using EMDR with chronic pain. What I particularly valued was the breadth and flexibility of the approach. Rather than treating EMDR as a single technique to be applied in the same way to everybody, the training explored different ways of working according to the person, their pain and what is happening for them at that moment.

The training has broadened the range of approaches and techniques I can draw upon in my existing work with chronic pain. It has also left me wanting to explore further. Mark brings considerable experience to this field, together with a strong sense of what may be possible. I found that genuinely energising — not simply learning more but coming away feeling increasingly confident about putting that learning into practice.

OCD: having an intrusive thought doesn't make you “bad or dangerous”

This week, the BABCP is holding a workshop at Bangor University called “Mad, bad and dangerous”: The cognitive-behavioural approach to OCD. The title reflects a very real fear for many people with OCD: the worry that having a disturbing intrusive thought might mean something terrible about who they are, what they want, or what they might do. Intrusive thoughts can feel so frightening precisely because they are unwanted and completely at odds with a person’s values.

In my work at Symmetry CBT, I help people understand the difference between having a thought and acting on it, and how attempts to gain certainty can keep OCD going. This can include repeated checking, seeking reassurance, mentally reviewing what happened, avoiding triggers or trying to suppress the thought altogether. From both a CBT and Metacognitive Therapy perspective, the aim is not to prove that a thought could never return, but to reduce the importance given to it and change the responses that keep it powerful.

Exposure and Response Prevention (ERP) can also play an important role by helping people approach feared thoughts, situations or uncertainty without carrying out the usual compulsive response. Over time, this can help someone discover that they do not need to neutralise every intrusive thought or obtain complete certainty before moving on. The goal is to help the thought become less significant and less able to dictate attention, behaviour and daily life.

Performance anxiety

Why can skills that feel completely natural in practice suddenly seem to disappear when it really matters?

Most of us know the experience of being able to do something perfectly well in practice, only to find that it suddenly feels much harder when the pressure is on. Whether it is a presentation, interview, sporting event or performance, anxiety can pull attention away from the task itself and towards questions such as “How am I doing?”, “What if I mess this up?” or “Can they see that I’m nervous?”

From a CBT and Metacognitive Therapy (MCT) perspective, this shift in attention can be important. The more we monitor ourselves, check our performance or try to control every detail, the less naturally we may be able to use skills that are already there. The problem is not necessarily a lack of ability, but the way anxiety changes where attention goes and how much importance we give to thoughts about performing badly.

In my work at Symmetry CBT, I help people develop a different relationship with performance anxiety, so that attention can move back towards what they are actually doing rather than towards constant self-monitoring. The aim is not to eliminate every anxious feeling before performing, but to make anxiety less influential so that existing skills have more room to come through.

New Perspectives on EMDR and Chronic Pain

One of the things I value about being a therapist is that the learning never really stops. Our understanding of the brain, trauma, pain and psychological therapy continues to develop, creating new possibilities not only for therapists, but ultimately for the people who come to us for help.

I first had the opportunity to learn from Australian psychologist Mark Grant when he came to London in 2012. Mark has specialised for many years in the use of EMDR with chronic pain, and I am delighted that, fourteen years later, I have the opportunity to learn from him again. This time, rather than Mark travelling to London, I am joining a series of live webinars he is delivering from Australia, timed to enable therapists in Europe to participate.

My own learning about pain, trauma and their treatment has continued throughout those intervening years, through different areas of training and clinical practice. What feels particularly valuable now is the opportunity to return to Mark's work and discover how his own thinking and clinical approach have evolved. It allows me to look again at chronic pain specifically through his perspective, while bringing to that learning the knowledge and experience I have developed since we first met in 2012.

For me, continuing professional development is about remaining curious. However experienced we become, there is always more to understand and another perspective from which to look at something familiar. I feel very fortunate to have this opportunity to deepen my understanding of chronic pain from Mark's particular perspective and to consider how his developing work may further inform my own.

OCD and confidence: why feeling uncertain doesn’t mean you need to check again

People with OCD often describe a powerful sense of doubt: “What if I’ve missed something?” or “What if I’m not really sure?” That feeling of uncertainty can drive checking, reassurance-seeking and repeated mental reviewing. Recent research has highlighted an interesting pattern in OCD, where people may have lower overall confidence even when they are still able to respond appropriately to the evidence in front of them. In other words, the feeling of uncertainty does not necessarily mean that something is actually wrong or that more checking is needed.

This is where approaches such as Exposure and Response Prevention (ERP) and Metacognitive Therapy (MCT) can be helpful. ERP involves learning to tolerate uncertainty without carrying out the usual compulsive response, while MCT focuses on the beliefs and thinking processes that keep doubt and threat-monitoring going. 

In my work, the aim is not to help people achieve perfect certainty, but to help them become less governed by the need for it.

OCD thoughts can feel frightening – but what do they actually mean?

How ERP and Metacognitive Therapy can help change your relationship with intrusive thoughts

People with OCD can experience intrusive thoughts, images or impulses that feel deeply upsetting precisely because they seem so out of character. A person may become frightened not only by the thought itself, but by what they think having the thought says about them. Yet unwanted intrusive thoughts are not the same as intentions, wishes or actions.

One of the things that can keep OCD going is the attempt to work out what a thought “really means”, gain certainty about it, or neutralise the anxiety it creates. This can lead to checking, reassurance-seeking, avoidance or repeated mental reviewing. From a Metacognitive Therapy (MCT) perspective, an important part of the problem is not simply the presence of the intrusive thought, but the beliefs we hold about the significance of that thought and the ways we respond to it through worry, monitoring and attempts to control it.

Exposure and Response Prevention (ERP), a well-established CBT treatment for OCD, can also help people change their relationship with intrusive thoughts. By gradually facing feared situations, thoughts or uncertainties while reducing compulsive responses, people can learn that they do not need to neutralise, avoid or gain certainty about every intrusive experience. Over time, the thought can become less important and less powerful.

In my work at Symmetry CBT, I help people experiencing OCD and intrusive thoughts, including thoughts that can feel embarrassing, disturbing or difficult to talk about. Therapy offers a confidential space to understand what is keeping the problem going and to develop a different way of responding, so that intrusive thoughts no longer have to dominate attention or behaviour.

Trauma-focused CBT or EMDR – does having a choice matter?

Trauma-focused CBT or EMDR – does having a choice matter?

When people seek therapy for post-traumatic stress disorder (PTSD), they may be offered different evidence-based treatments. Two of the main approaches recommended by NICE are trauma-focused Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). A new study from a South London NHS Talking Therapies service has looked at how these two approaches compare in everyday clinical practice.

The researchers found that both EMDR and trauma-focused CBT produced similarly good outcomes across different types of trauma and different groups of clients. There was no clear indication that one treatment was consistently better than the other. This supports the idea that, when both treatments are suitable and available, the individual’s own preference can reasonably play an important part in deciding which approach to use.

The study also highlighted something equally important: some people stopped therapy around the point at which treatment began to focus more directly on traumatic memories. Trauma therapy can understandably feel daunting, and the researchers suggest that careful preparation and discussion about what memory-focused work involves may help people remain engaged with treatment. Sarah has found over many years of clinical work that good preparation often makes a real difference, helping people feel more able to engage with trauma-focused therapy when they are ready to do so.

For someone considering therapy for trauma, the question therefore may not simply be “Which treatment is best?” A more useful discussion may be about how the different therapies work, what feels acceptable to the individual, and which approach they feel most able to engage with. Good trauma therapy should be collaborative rather than something that is simply done to a person.

At Symmetry CBT, Sarah works with both CBT and EMDR when helping people with traumatic experiences and PTSD. Having experience in more than one trauma-focused therapy allows the treatment discussion to take account of the individual person, their difficulties and their preferences, rather than starting from the assumption that one approach will suit everybody.

Using Music in EMDR 🎶

In early May 2026, I attended a workshop presented by Cassandra Manning MA, MSc on her EMDR+Music Integrated Model©: Using Music as an Interweave in EMDR©.

EMDR is already a powerful and well-established therapy approach, and many people benefit greatly from it.

At times, though, some people can find themselves worrying during EMDR:

• “Am I processing properly?”
• “Am I getting it right?”
• “Am I failing because nothing seems to be happening?”

As a practitioner, I already try to create a therapeutic space where there is less pressure to perform or force experience. What interested me about the use of music was the possibility that it might help people who become stuck, overthink the process, or go round in circles during therapy.

During the workshop, we practised experiencing EMDR ourselves in the role of client, which is an important part of learning any therapy approach as a practitioner.

I chose to work on a recent loss. What surprised me was the sense of spaciousness that emerged when music was introduced. I felt at ease with the loss in a grounded way. I noticed something had gently shifted in the way I was holding it.

As someone who has always loved music, I came away feeling genuinely interested in the possibilities this approach may offer for some people, particularly those who feel drawn to music, who become stuck in overthinking during therapy, or who feel apprehensive about EMDR itself.

I am introducing EMDR+Music into my practice for clients who feel it may be helpful for them.

Sarah 

Metacognitive Therapy (MCT), EMDR and DBR for health anxiety

I came to therapy struggling with overwhelming health anxiety that was affecting nearly every part of my life. I was stuck in worry, fear and always assuming the worst.

Working with Sarah has been life changing. We started with metacognitive therapy (MCT) which helped me control my worrying. It was really powerful when we explored and weakened my metacognitive beliefs about my health. The techniques and tools that I learned from these sessions opened my eyes to a new way of thinking and being. We did some Deep Brain Reorienting (DBR), which I found fascinating. 

My therapy also touched on other areas other than health anxiety, and I liked the way we worked together to decide what each session would look like. I now have a stronger sense of self. I just feel wiser, more resilient and hopeful. I am really grateful for Sarah’s expertise, compassion and patience throughout my journey. 

 (Online, female, aged 39, September 2025)