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Let's Talk about CBT- Practice Matters

Let's Talk about CBT- Practice Matters

Written by: Rachel Handley for BABCP
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 The podcast for therapists using Cognitive Behavioural Therapy to help shape and inform their practice.2024 Hygiene & Healthy Living Psychology Psychology & Mental Health
Episodes
  • Why simplicity does not mean superficiality: exploring Low-intensity Behavioural Activation for Depression with Prof David Ekers.

    Why simplicity does not mean superficiality: exploring Low-intensity Behavioural Activation for Depression with Prof David Ekers.
    Jan 28 2026
    How do we make effective therapy for depression more widely available without losing quality or compassion? In this episode, Rachel Handley is joined by Professor David Ekers, a leading researcher and clinician specialising in behavioural activation (BA). David shares the story of how his clinical experience with long waiting lists led him to focus on scalable, evidence-based approaches to care. The conversation explores the development of behavioural activation, the evidence underpinning low intensity delivery, and key findings from major trials including the COBRA and BASIL studies. David explains why behavioural activation is a robust, practical intervention that can be delivered effectively by a range of practitioners, without losing therapeutic depth or compassion. David reflects on common myths about low intensity work, the importance of supervision and therapeutic relationships, and the challenges services face when balancing access, outcomes, and relapse prevention. Further resources: David's University of York webpage can be found here which details all his publications and research projects Papers and links to further information about the trials mentioned in this episode are listed below: COBRA: Finning, K., Richards, D. A., Moore, L., Ekers, D., McMillan, D., Farrand, P. A., O'Mahen, H. A., Watkins, E. R., Wright, K. A., Fletcher, E., Rhodes, S., Woodhouse, R., & Wray, F. (2017). Cost and outcome of behavioural activation versus cognitive behavioural therapy for depression (COBRA): a qualitative process evaluation. BMJ Open, 7(4), e014161. https://doi.org/10.1136/bmjopen-2016-014161 Richards, D. A., Rhodes, S., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., Barrett, B., Finning, K., Ganguli, P., Warren, F., Farrand, P., Gilbody, S., Kuyken, W., O'Mahen, H., Watkins, E., Wright, K., Reed, N., Fletcher, E., Hollon, S. D., & Moore, L. (2017). Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive–behavioural therapy for depression. Health Technology Assessment, 21(46), 1–366. https://doi.org/10.3310/hta21460 Richards, D. A., Ekers, D., McMillan, D., Taylor, R. S., Byford, S., Warren, F. C., Barrett, B., Farrand, P. A., Gilbody, S., Kuyken, W., O'Mahen, H., Watkins, E. R., Wright, K. A., Hollon, S. D., Reed, N., Rhodes, S., Fletcher, E., & Finning, K. (2016). Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority Trial. The Lancet, 388(10047), 871–880. https://doi.org/10.1016/s0140-6736(16)31140-0 BASIL: Gilbody, S., Littlewood, E., McMillan, D., Atha, L., Bailey, D., Baird, K., Brady, S., Burke, L., Chew-Graham, C. A., Coventry, P., Crosland, S., Fairhurst, C., Henry, A., Hollingsworth, K., Newbronner, E., Ryde, E., Shearsmith, L., Wang, H.-I., Webster, J., & Woodhouse, R. (2024). Behavioural activation to mitigate the psychological impacts of COVID-19 restrictions on older people in England and Wales (BASIL+): a pragmatic randomised controlled trial. The Lancet Healthy Longevity, 5(2), e97–e107. https://doi.org/10.1016/s2666-7568(23)00238-6 Littlewood, E., McMillan, D., Graham, C. C., Bailey, D., Gascoyne, S., Sloane, C., Burke, L., Coventry, P., Crosland, S., Fairhurst, C., Henry, A., Hewitt, C., Baird, K., Ryde, E., Shearsmith, L., Traviss-Turner, G., Woodhouse, R., Webster, J., Meader, N., & Churchill, R. (2022). Can we mitigate the psychological impacts of social isolation using behavioural activation? Long-term results of the UK BASIL urgent public health COVID-19 pilot randomised controlled trial and living systematic review. Evidence-Based Mental Health. https://doi.org/10.1136/ebmental-2022-300530 More information and publications related to the study can be found www.BASILStudy.org CASPER: Gilbody, S., Lewis, H., Adamson, J., Atherton, K., Bailey, D., Birtwistle, J., Bosanquet, K., Clare, E., Delgadillo, J., Ekers, D., Foster, D., Gabe, R., Gascoyne, S., Haley, L., Hamilton, J., Hargate, R., Hewitt, C., Holmes, J., Keding, A., & Lilley-Kelly, A. (2017). Effect of Collaborative Care vs Usual Care on Depressive Symptoms in Older Adults With Subthreshold Depression. JAMA, 317(7), 728. https://doi.org/10.1001/jama.2017.0130 Lewis, H., Adamson, J., Atherton, K., Bailey, D., Birtwistle, J., Bosanquet, K., Clare, E., Delgadillo, J., Ekers, D., Foster, D., Gabe, R., Gascoyne, S., Haley, L., Hargate, R., Hewitt, C., Holmes, J., Keding, A., Lilley-Kelly, A., Maya, J., & McMillan, D. (2017). CollAborative care and active surveillance for Screen-Positive EldeRs with subthreshold depression (CASPER): a multicentred randomised controlled trial of clinical effectiveness and cost-effectiveness. Health Technology Assessment, 21(8), 1–196. https://doi.org/10.3310/hta21080 ‌DiaDeM: More information and publications related to the programme can be found here Insika Yomama: Rochat, T. J., Dube, S., Herbst, K., ...
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    1 hr and 1 min
  • Understanding Historical Context in CBT Practice with Dr Alasdair Churchard

    Understanding Historical Context in CBT Practice with Dr Alasdair Churchard
    Dec 29 2025
    In this episode of Let's Talk About CBT- Practice Matters, Rachel is joined by Dr Alasdair Churchard, clinical psychologist, CBT therapist and NIHR pre doctoral fellow at the University of Oxford. Alasdair's work focuses on ethnic inequalities in psychological therapies, and together they explore why historical context matters in CBT practice. The discussion covers the importance of addressing ethnic inequalities in mental health services and explores practical considerations for therapists, including how to broach difficult historical topics, the balance of asking versus self-education, and the need to focus on histories of strength and self-empowerment alongside trauma. Further resources: Language used: Talking about race and ethnicity at work | The Law Society, Writing about ethnicity - GOV.UKRHO report: Ethnic Inequalities in Improving Access to Psychological Therapies (IAPT)MHA detentions: Detentions under the Mental Health Act - GOV.UK Ethnicity facts and figuresMarmot report: Structural Racism, Ethnicity and Health Inequalities in London - IHEBansal meta-ethnography: Bansal, N., Karlsen, S., Sashidharan, S. P., Cohen, R., Chew-Graham, C. A., & Malpass, A. (2022). Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography. PLoS Medicine, 19(12), e1004139.Some culturally-adapted CBT links:Williams, M. T. (2020). Managing microaggressions: Addressing everyday racism in therapeutic spaces. Oxford University Press.Rathod, S., Kingdon, D., Pinninti, N., Turkington, D., & Phiri, P. (2015). Cultural adaptation of CBT for serious mental illness: a guide for training and practice. John Wiley & Sons.Beck, A. (2016). Transcultural cognitive behaviour therapy for anxiety and depression: A practical guide. Routledge.Iwamasa, G. Y., & Hays, P. A. (2019). Culturally responsive cognitive behavior therapy: Practice and supervision (pp. xi-348). American Psychological Association. Lawton, L., Thwaites, R., & Warnock-Parkes, E. (2025). Using cognitive therapy for PTSD when racism was part of the traumatic event (s): case illustrations and practical considerations for therapists and supervisors. the Cognitive Behaviour Therapist, 18, e31.What is metacompetence?: Whittington, A., & Grey, N. (2014). Mastering metacompetence: The science and art of cognitive behavioural therapy. How to become a more effective CBT therapist: Mastering metacompetence in clinical practice, 1-16.Helen Kennerley on the working relationship: Kennerley, H. (2014). Developing and maintaining a working alliance in CBT. How to become a more effective CBT therapist: Mastering metacompetence in clinical practice, 31-43.Ian Andrew James on kitchen sink formulations: James, I. A. (2010). Cognitive behavioural therapy with older people: Interventions for those with and without dementia. Jessica Kingsley Publishers.Ken Laidlaw on formulation: Laidlaw, K. (2014). CBT for older people: An introduction.Source for Seamus Heaney quotes: Heaney, S. (2014). Crediting Poetry: The Nobel Lecture. Farrar, Straus and Giroux.DPR model:Churchard, A. (2022). How can psychotherapists improve their practice with service users from minoritised ethnicities? An application of the Declarative-Procedural-Reflective (DPR) model of clinical skill development. The Cognitive Behaviour Therapist, 15, e1.Thwaites, R., Churchard, A., Mofrad, L., Wood, D., & Brooks-Ucheaga, M. (2025). Considering the whole self: integrating identity (s), context and power into the declarative procedural reflective (DPR) model of CBT practitioner development. The Cognitive Behaviour Therapist, 18, e35. SP/SR for therapists from minoritised ethnicities:Chowdhury, S. S., Churchard, A., Lawton, L., Malik, Z., Thwaites, R., & Clements, H. (2025). A novel self-practice/self-reflection programme for CBT therapists from minoritised ethnic backgrounds: a multiple baselines single case experimental study. the Cognitive Behaviour Therapist, 18, e15. Stay Connected: Follow us on BlueSky and Instagram: @BABCPpodcastsSend us your questions and suggestions: podcasts@babcp.comSubscribe 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
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    59 mins
  • The what, how and why of Behavioural Activation with Dr Christopher Martell

    The what, how and why of Behavioural Activation with Dr Christopher Martell
    Nov 27 2025

    In this episode of Practice Matters, host Rachel Handley speaks with Dr Christopher Martell, a leading expert in behavioural activation (BA) for depression. Christopher shares his journey from early training in CBT to becoming a key figure in the development of BA, describing how behavioural strategies can help people move toward a more meaningful life when depression keeps them stuck.

    Rachel puts common myths to him, including whether BA is too simplistic for complex cases or ignores thoughts and emotions, and he explains how BA works with both private and public behaviour to support change. They explore the importance of values, small steps, and compassionate coaching, as well as new research into biological mechanisms involved in recovery. Christopher also reflects on therapist challenges, resilience in clients, and why activation sometimes means slowing down.

    Further resources:

    Behavioural Activation for Depression: Second Edition: A Clinician's Guide

    A Darkness Visible- William Styron

    The Noonday Demon- Andrew Solomon

    Find out more about Christopher and his publications here: https://christophermartellphd.com/

    Stay Connected:

    • Follow us on BlueSky and Instagram: @BABCPpodcasts
    • Send us your questions and suggestions: podcasts@babcp.com
    • 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
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    1 hr and 17 mins
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