Stephen Hillier-Davies - Accredited CBT Psychotherapist & Clinical Supervisor
My name is Stephen Hillier-Davies.
I am an Accredited Psychotherapist and Clinical Supervisor in Cognitive Behavioural Therapy (CBT) with the British Association for Behavioural and Cognitive Psychotherapies (BABCP), the lead organisation for CBT in the UK and Ireland with extensive clinical experience in the UK and USA.
I worked for more than 25 years within the National Health Service (NHS) in a wide variety of services - primary care, mental health, addictions, forensic psychotherapy and physical & sexual health - both as a clinician and supervisor.
For the last 17 years, I worked as a Forensic Psychotherapist within the South London & Maudsley NHS Foundation Trust (part of King’s Health Partners Academic Health Sciences Centre bringing together a world-leading, research-led university (King’s College London) and three successful NHS Foundation Trusts (Guy’s and St Thomas’, King’s College Hospital and the Maudsley), providing psychological therapy and specialist consultation in CBT for individuals with a wide range of mental health and emotional, behavioural difficulties including trauma, anxiety, depression, Obsessive Compulsive Disorder (OCD), phobias, addictions, anger, abuse and personal, social and sexual relationship difficulties.
This experience has made me an extremely informed, clinically-experienced practitioner and I have a reputation for compassion and an emphasis on the practicalities of offering help rather than just the theory of the client-based work. Having broad specialist mental health experience of treating a range of complex difficulties, I have extensive skill and ability which provides the knowledge experience to provide safe and structured treatment options.
I provide face-to-face CBT psychotherapy and counselling in London, Cardiff, Ogmore-by-Sea, Bridgend and nationally/internationally via FaceTime/WhatsApp/Skype for individuals and couples.
Cognitive Behavioural Therapy (CBT) is an active, goal-orientated and time-limited approach to psychotherapy.
It is guided by a shared understanding of the problems (formulation) you experience and helps you to develop and test out your individual set of tools which allow you to deal with and transform unhelpful thoughts and feelings.
The usefulness of CBT has been intensively investigated. For a large variety of conditions, it has proven to be more or equally effective as other forms of psychotherapy.
Active - you will be involved in practical work - during and outside the sessions - to check some of your beliefs or new behaviours
Goal Oriented - you set your goals in the first sessions and we will regularly review them throughout the course of your therapy
Setting specific, measurable, achievable, realistic and time-framed (SMART) goals
Time-limited - a course of CBT usually lasts for about 6-12 sessions; the usual range is between 6 to 30 sessions
Collaborative - you and your therapist work together side by side, your experience, input and feedback being equally important
Evidence based - CBT is a scientifically-evaluated therapy approach
How does CBT work?
Cognitive Behavioural Therapy looks at the connection between thinking (cognitions), feelings (emotions), bodily sensations (physiology) and actions (behaviours). If these interact and form unhelpful feedback loops, one can get trapped in negative emotional states. This can lead to people feeling excessively anxious, depressed or angry.
In CBT, both client and therapist work together and develop a shared understanding of the current difficulties, their original cause and, in particular, what keeps them in place now.
This is often put down on paper as a drawing or diagram (formulation) which will guide the work of the following session and introduces a variety of specific techniques or tools to address unhelpful thinking and less successful behaviours.
My approach involves guiding you to how use these tools in the session and, most importantly, in your day-to-day life. This practical work will often result in an even more precise understanding and give you some effective tools to tackle difficulties.
Towards the end of the treatment, you will know a variety of techniques which work well for you. Finally, we will make a plan of when and how to use them should you be faced with similar difficulties in the future (relapse prevention). We can then review this in subsequent booster sessions.
How does CBT differ from other therapies?
Most therapies, including CBT, share many similarities, such as talking openly to a person you can trust, being respected and listened to or having a regular time and space dedicated to some work on changing oneself. Some researchers have argued that it is only these shared or general aspects which make change happen.
In CBT, we know that all these aspects are important and necessary to provide an effective treatment. However, we also know that for some conditions, like anxiety disorders, such as Obsessive Compulsive Disorder, these general factors on their own are not sufficient to help clients to overcome their problems. Indeed, research has shown that some specific ingredients (tools) are needed in addition to provide results.
Emphasis on Collaborative Working
CBT is primarily a collaborative venture. Both of us work side by side, with me bringing in my training and experiences and you being the expert in what works for you. It is important that what we discuss or put down on paper makes sense to you and that you understand what makes you stuck and what helps you to get going again.
As a therapist, I will also bring into our meeting my own thoughts and personal experiences. I think, if some of this can help you to progress let's make use of it. If some of this gets in the way, let's speak about it. Feedback is important and I am as keen as my clients to learn and make changes.
Main components of CBT
Formulation guided: the treatment is guided by a shared understanding of the difficulties (formulation) which is based on your lived experiences and the existing scientific knowledge of the specific condition. This can be drawn out in a diagram for easier understanding and helps in planning the therapy. Some of the formulation’s elements and their connections might be clear from the beginning; others might be checked out and added throughout the course of the therapy.
Time limited: a course of CBT does not usually last for years. For specific, isolated problems, treatments can be as short as 10 sessions or even fewer. Often, between 16 and 20 sessions are offered and a longer duration for the treatment can be negotiated with the therapist. With the exception of some longstanding personality related issues, CBT rarely lasts longer than a year.
Goal Oriented: to help you to overcome current difficulties and to tackle successfully some of the challenges, we will be working towards your own personal goals. This focus helps to keep track of the success of the therapy and to experience a fuller life.
Active therapy: although most of the sessions are spent talking, therapy also includes more active parts. This may include testing out new behaviours, behavioural coaching, home study/reading psychoeducational resources and checking out your thoughts or assumptions in specific situations, for example, at work, with family or in social settings. This can initially feel a bit unusual, but it provides a highly effective way of learning.
Put into practice in your everyday life (work between sessions): one of the most important aspects of CBT is to help you to use your new skills in your day-to-day life. In order to get the most benefit from the therapy, you will be asked to do a certain amount of work between the sessions. We can talk about what would be acceptable and suitable for you and adapt homework assignments. However, it is a proven fact that clients who engage in work between the sessions make faster progress.
Progress tracking: the success of a treatment is highly personal and only you, and sometimes the people who know you well, can decide if a treatment is effective for you. CBT is specifically tailored to suit your own needs and goals and helps you to progress most successfully. Your regular feedback will guide us and help us to see if therapy is helping you to move in the right direction.
In addition, I suggest a progress review using, if available, an established questionnaire for the problems we are working on. With feedback from different sources, both of us can decide throughout the course of the therapy if it needs to be adapted further.
Evidence base for CBT
The CBT philosophy is to provide treatment that works. From its conception in the 1970s, CBT was one of the first treatments to undergo rigorous evaluation of its effectiveness. Starting with Aaron Beck, the founder of CBT, many researchers have compared CBT with not having any therapy, CBT as opposed to psychiatric medication or in comparison with other psychotherapies. CBT has demonstrated again and again that it works better than a “wait and see approach”. Over the years, CBT has been shown to be as effective, if not even more effective, than psychiatric medication, such as antidepressants for mood and anxiety disorders.
Whereas a variety of psychotherapeutic approaches work well for depression, CBT has been shown to be superior to other psychological therapies and is sometimes the only effective approach for many anxiety disorders.
What happens in CBT?
After exploring your background, your strengths and current struggles within the first one or two sessions, we will then discuss if and how CBT can help you.
Therapy will help you to understand how some of your difficulties relate to your thoughts, emotions and actions. Often, we will draw this in a diagram which will make sense to the two of us. In this way, you can become more attuned to recognise some of the existing connections. In a second step, you will learn to change previously unhelpful ways of thinking and less helpful behaviours. Over time, you will build your own set of tools which are most effective for the situations you encounter.
CBT is tailor-made for your purpose. In therapy, we will test drive these tools, optimise them for you, and practice so that they become second nature. For this, we work as a therapeutic team. Your feedback about the session, the techniques and the way I approach you is a very important part of the treatment, allowing us to get it right for you.
Over time, you will become more and more self-sufficient and, towards the end of the course of therapy, you will set your own session agenda, and have learned how to ‘become your own therapist’. In the last couple of sessions, we work on relapse prevention and summarise the treatment, the techniques you found particularly helpful, and a step-by-step approach of what you can do if things start to move in the wrong direction.
All anxiety disorders are characterised by both physiological and psychological anxiety symptoms. Body anxiety can cause increased breathing, heart-racing, hand-trembling and sometimes even sensations such as pins and needles.
In one’s mind, anxiety-related thoughts often predict the worst possible outcome. Those sensations and thoughts can lead us to engage in a variety of behaviours, which are meant to keep us safe or sane – but these behaviours have their own shortcomings and often contribute to the on-going problem. For example, if someone always avoids going to places with which they are not familiar, they cannot discover new pleasures or passions.
In all anxiety disorders, the anxiety causes significant stress, and affects social, psychological or work performance.
Examples of anxiety disorders are:
Obsessive Compulsive Disorder (OCD) - a condition characterised by obsessive thoughts (distressing thoughts which cause excessive anxiety) and compulsive behaviours, such as checking, counting or cleaning. One feels compelled to “control” the situation. Usually people suffering from OCD spend at least one hour a day distracted by these thoughts or behaviours.
Social Anxiety - one feels excessively judged in social situations and is afraid of showing signs of anxiety which are assumed to have grave negative consequences. Often certain social situations are avoided.
Post-Traumatic Stress Disorder (PTSD) - Sufferers experienced a significant trauma in the past but still tend to experience spontaneous memories (flashbacks) or nightmares many months or even years afterwards. Frequently, people avoid a range of situations, so as not to re-experience the trauma, either mentally or physically. People find it difficult to feel close to their loved ones. Often they can feel similar physical sensations, such as pain or sounds, when those memories occur.
General Anxiety Disorder - a condition in which one excessively worries about a broad range of themes, such as the welfare of loved ones, work, or having done something wrongly. The worry seems to be out of control. Because of the excessive worries it becomes difficult to fall asleep and to relax. One feels on-edge all the time. Other anxiety symptoms such as shaking or heart-racing can also be present, either constantly or intermittently.
Panic Disorder - a panic attack is a sudden surge of anxiety over a period of approximately 10 minutes. It is accompanied by physical symptoms, such as heart-racing, a dry mouth, butterflies in the tummy, shortness of breath, and thoughts of dying or losing control. A variety of safety-seeking behaviours are often employed to avoid ‘the worst’ from happening.
Agoraphobia – this describes a condition in which panic attacks occur when outside. One does not leave the home and strictly avoids certain difficult situations or places, such bridges, buses or tubes. Fears are often related to the loss of bodily functions. Life becomes more and more restricted because of the increasing amount of avoidance.
Specific Phobias - often more related to natural hazards such as snakes, rats, dogs, the sight of blood or situations of perceived excessive risk - flying, lifts, enclosed spaces. Being in the phobic situation causes excessive anxiety and is mostly avoided.
CBT has largely contributed to the understanding and the treatment of most anxiety conditions. For some problems, such OCD, CBT has been shown to be the only effective psychological treatment.
Depression is a common condition. Approximately a quarter of all people experience at least one depressive episode during their lifetime. When depressed, one feels low in mood, tired and has trouble getting motivated. It is hard to enjoy most things. Sleep is often too short or frequently interrupted; appetite changes and sex drive declines. When depressed, one’s thoughts are mostly negative and down-putting. Typically, one remembers situations in which one felt one had failed or which had caused one shame. Not wanting to live on is a common thought in depression. Sometimes, if depression is severe, unusual sensations (voices/visions/smells) or beliefs can be experienced.
Bipolar Affective Disorder (previously manic-depression) brings one close to the extremes of the mood spectrum. The mood phases last for several days, weeks, or sometimes months. Most of the time, depression or even severe depression, is experienced. However, there are times when one’s mood is so elated (or even irritable) and thoughts race. Sometimes this is to a degree that others, who are listening to us speak, find us hard to follow. This can be quite frustrating. Little sleep is sufficient yet we still seem to have a lot of energy. Usually, one is over-talkative and much more sociable. During this time, lots of new projects are started but rarely finished. One cares less about risk-taking or overspending. Often our partners, relatives or friends will notice it as a significant change. This characterises a manic, or if less intense, hypo-manic phase. These phases last for several days. On occasions, people can exhaust themselves, experience unusual sensations, or have unshakable beliefs about their special abilities.
Other mood variations - there are a variety of different conditions, which all describe a temporary or ongoing excess of mood in either direction. Each of them can, in their own way, impair one’s functioning.
CBT for depression was one of the first psychotherapies which underwent rigorous scientific evaluation in psychological treatment trials. It has shown to be more effective than anti-depressants and at least as effective as other forms of psychotherapy.
Health Anxiety (Hypochondriasis) - describes a condition where one has an increased concern about having a serious, yet undiagnosed medical condition. Visits to the GP, and specialists only temporarily reassure that things are alright but soon doubt creeps in leading to high levels of anxiety and stress. Often sufferers obsessively check their body.
Body Dysmorphic Disorder (BDD) - Excessive concerns about appearance is the core of this condition. This can be related to specific areas, or refer to more general aspects of one’s appearance. Others characteristically are not able to see a major fault, which causes the sufferer even more distress. Checking, camouflaging, avoiding situations, and excessive thinking about the perceived defect are often present.
CBT has effective treatment models for health anxiety and some other somatic disorders. It is on the forefront in the development of treatments for Body Dysmorphic Disorder and demonstrating its specific benefits.
Low Self Esteem and Performance Anxiety
Low Self Esteem - No-one is competent in everything they are doing, and all of us were beginners at one time. However, persistently low self-esteem, and the connected negative thoughts and feelings of anxiety and low mood, can get the better of us. This prevents us from learning effectively from our experiences.
Performance Anxiety - In situations when our performance is judged, such as in a job interview, playing or acting on stage, all of us get a bit flustered and nervous. Often, the adrenalin rush of these situations can help us to be vigilant and perform better. If however, anxiety (and connected, self-judgmental thoughts) takes over, our attention can drift from the task at hand. This can cause us not to perform our best.
In CBT we use a model which is adjusted to your own background and links past experience with current negative thoughts and emotions and unhelpful behaviours to enable you to reach your full potential.
Compulsive habit disorders
Conditions such as OCD, BDD and other anxiety disorders, include characteristic behaviours which the sufferer feels compelled to do, otherwise the anxiety seems to mount up to uncontrollable levels. Similarly, conditions such as compulsive skin picking or hair pulling are characterised by such compulsive, sometimes almost automatic, behaviours.
When done in excess over longer periods, other regular behaviours, such as eating, sexual behaviour, or exercise, can lead to a feeling of loss of control. One can feel trapped and addicted to the behaviour, as one cannot stop it, or perform it at a healthy frequency or intensity. These conditions are essentially behaviour addictions, similar to say gambling or substance addiction. In the brain, the neuro-chemicals released in behaviour addictions are similar to those released in substance addictions (dopamine and endorphins).
Many compulsive or addictive behaviours involve an interaction between thoughts, feeling and behaviours. CBT has developed models of compulsive behaviours, as well as more classical (alcohol, substance-related, gambling) addiction treatment plans.
For everybody, adjustment to change (positive as well as negative events) can be a stressful time. Most of us would employ our own individual stress management strategies, or social networks to help us cope with these situations. However, at times one can get overwhelmed by events or a whole range of individual stressors. Sometimes this can lead to anxiety disorders, depression or mania and become a problem in its own right.
Events such as being diagnosed with a serious health condition (cancer, HIV, diabetes), break-ups with significant others, and changes at work, can cause a variety of emotions as well as negative thinking. These can go on for a prolonged amount of time.
Similar to other conditions, negative emotions and judgements can prevent one from seeing a broader perspective. CBT offers a variety of helpful tools which have been evaluated as components of other effective CBT treatments.
This turbulent emotion, found in everyday life, is a feature of a wide range of disorders. It is commonly observed in a variety of conditions resulting from trauma, psychosomatic and physical illness or other conditions caused or aggravated by mental health factors such as internal conflict or stress.
Treatment aims to minimise anger frequency, intensity and duration and to moderate anger expression. It is an adjunctive (auxiliary) treatment which seeks to remedy the emotional turbulence that is associated with subjective distress, detrimental effects on personal relationships, health impairments and the manifold harmful consequences of aggressive behaviour.
The main components of anger control treatment are cognitive restructuring, arousal reduction and enhancement of behavioural skills. A key feature is therapist-guided progressive exposure to provocation, in conjunction with which anger regulatory coping skills are acquired.
I work face-to-face in my therapy rooms; however, if you think you would benefit from seeing me, but know that you would struggle to fit a series of face-to-face sessions into your busy schedule, online counselling might be the best choice for you. No matter where you are in the world, thanks to today’s technology, therapy can come right into your home or office; you can contact me for online therapy and talk about your issues with me via FaceTime, WhatsApp, other video call methods or by telephone. Research has found that the therapeutic relationship over video therapy can be as strong as meeting face to face.
Training, qualifications & experience
Accredited Psychotherapist in Cognitive Behavioural Therapy (CBT).
Accredited Clinical Supervisor of Cognitive Behavioural Therapy Psychotherapists - www.babcp.com.
Registered with the United Kingdom Council for Psychotherapy (UKCP).
I have worked in adult mental health within the NHS for nearly 30 years, of which the last 17 years were working for South London and Maudsley NHS Foundation Trust, specialising in forensic mental health, providing specialist guidance and the treatment of behavioural and emotional difficulties.
I currently have a practice at Harley Street, W1, and London Bridge in London, and Ogmore-by-Sea, Bridgend and Cardiff, working within the private and corporate healthcare sectors.
I also work via FaceTime, WhatsApp and other video call methods to enable access to therapy at flexible hours or when individuals are working or travelling out of the country.
I have worked with people experiencing various life and relationship problems, including complex mental health difficulties, both in the United Kingdom and in the USA.
Accredited register membership
Areas of counselling I deal with
- Affairs and betrayals
- Anger management
- Asperger's syndrome
- Behaviour problems
- Bipolar disorder
- Body dysmorphic disorder
- Borderline personality disorder
- Career counselling
- Carer support
- Chronic fatigue syndrome/ME
- Domestic violence
- Drug addiction
- Emotional abuse
- Family issues
- Feeling sad
- Generalised anxiety disorder
- Health anxiety
- Hearing voices
- Internet addiction
- Low self-confidence
- Low self-esteem
- Narcissistic personality disorder
- Obsessive compulsive disorder (OCD)
- Obsessive-compulsive personality disorder
- Panic attacks
- Passive aggressive behaviour
- Personality disorders
- Physical abuse
- Post-traumatic stress disorder (PTSD)
- Postnatal depression
- Relationship problems
- Seasonal affective disorder (SAD)
- Separation and divorce
- Sex addiction
- Sex problems
- Sexual abuse
- Suicidal thoughts
- Work-related stress
Other areas of counselling I deal with
I have a specialist interest in the treatment of the effects of trauma, anger, alcohol and sexual difficulties.
- Acceptance and commitment therapy (ACT)
- Behavioural therapy
- Cognitive and behavioural therapies
- Cognitive behavioural therapy (CBT)
- Cognitive therapy
Bridgend, Ogmore-by-Sea, Cardiff Individuals £85
London (London Bridge) individuals £130 - £150
Harley Street, London, W1 by individual arrangement.
Couples on request
Clinical Supervision by individual arrangement.
I also work via FaceTime / WhatsApp / other video call methods to enable access to therapy/clinical supervision at flexible hours or when working or travelling out of the country.
If you are unable to attend a session due to illness or unforeseen circumstances, please call and let me know and we may be able to re-schedule. Please bear in mind, however, that such re-arrangement may not always be possible. My flexibility is limited by the fact that I see clients on a regular basis, at the same time and day each week, so alternative appointment times are not freely available and weekends can be used only exceptionally. I will expect you to pay for any sessions you decide to miss altogether, as I cannot make any other use of ‘your time’. If I am able to offer you an alternative appointment in the same week in which you need to cancel, I will not charge you for the missed session.
I will also bill pro rata for any reports that I may be required to write or read in connection with your therapy.
I offer reduced rates for trainee counsellors who require personal therapy and/or supervision as requirements of their Integrative or Cognitive Behavioural Therapy Counselling training programme.
Specific Cognitive Behavioural Therapy Clinical Supervision
Within a collaborative approach, I provide CBT supervision for counsellors and psychotherapists to meet their monthly clinical needs and those wishing to work towards accreditation to meet the appropriate standards of supervision for accreditation - I incorporate four interacting supervision processes:
- Enhancing learning
- Attending to interpersonal issues
- Clarifying Contractual agreements
- Attending to the practical context.
Integrative Therapy Supervision
I also offer personal therapy and clinical supervision for counsellors/psychotherapists and trainee therapists working within a broadly Integrative approach,
Disclosure and Barring Service (DBS)
I have undergone Enhanced Vetting by the Disclosure and Barring Service (DBS) which helps... make safer... decisions and prevent unsuitable people from working with vulnerable groups, including children. It replaces the Criminal Records Bureau (CRB) and Independent Safeguarding Authority (ISA).
Maps & Directions
Type of session
|Face to face counselling:||Yes|
8.00 am - 9.00 pm
Types of client
|Employee Assistance Programme|
Supervision & training
Specific Cognitive Behavioural Therapy Clinical Supervision.