How I work
Cognitive behavioural therapy (CBT)
The therapy most of my work is built on. I am BABCP-accredited and I see clients online across the UK, in English or Spanish.
What CBT helps with
CBT is the most heavily researched talking therapy there is, and it is what NICE — the body that writes the NHS's clinical guidelines — recommends first for most of what I treat: OCD, panic disorder, generalised anxiety, social anxiety, health anxiety, body dysmorphic disorder, specific phobias, depression, and, in its trauma-focused form, post-traumatic stress disorder.
That is the formal list. In practice, people come to me with anxiety that has quietly started making their decisions for them, with OCD that eats hours of every day, with a low mood that has flattened everything out, or with one specific fear that has grown big enough to shape where they will and will not go.
What those have in common is a loop that keeps itself going. CBT is unusually good at finding that loop and interrupting it. It is not the right tool for everything, and I will say so when I think another approach fits you better — but for the problems above it has the strongest evidence behind it, which is why it is usually where I start.
I am accredited by the British Association for Behavioural and Cognitive Psychotherapies (BABCP), the UK's lead body for CBT. Accreditation means my training, supervision and ongoing practice are checked against a national standard rather than self-declared.
How CBT works
CBT starts from a simple observation: what you think, what you feel in your body, what you do and what happens next are all connected, and they feed each other. Change one part deliberately and the rest moves with it.
The first job is to map your particular loop. Not anxiety in general — yours. What sets it off, what goes through your mind at that moment, what you do to make the feeling stop, and what that costs you. Most people find this stage a relief on its own: the thing that felt random and personal turns out to have a shape, and the shape is recognisable.
Then we work on the part of the loop that is keeping it alive. Very often that is the coping itself — the checking, the reassurance, the avoiding, the rehearsing, the leaving early. Each of those works beautifully for about ten minutes and teaches your brain, every time, that the danger was real and you only just escaped it. Retiring them is uncomfortable, and it is also the fastest route out.
Alongside that we test the predictions your anxiety makes, rather than argue about them. If your mind says you will freeze in the meeting, we design a way to find out. Behavioural experiments like these move belief in a way that reasoning on its own rarely does.
Between sessions you practise. CBT is an active therapy — the hour with me is where we plan and make sense of things, and the week is where the change actually happens. I will never ask you to do something you have not agreed to, and we go at a pace you set.
What to expect
We start with a free 15-minute call so you can hear how I work and I can hear what is going on. If we go ahead, the first one or two sessions are an assessment: your history, what you have already tried, and what you want to be different.
Out of that comes a formulation — a shared picture of how your problem works, drawn out together. Everything after it follows from that picture, so you always know why we are doing what we are doing.
Sessions are 50 minutes, usually weekly at first. A typical course runs somewhere between 8 and 20 sessions depending on what we are treating; OCD and PTSD generally take longer than a specific phobia. We agree a rough number at the start and review it as we go, rather than drifting.
I use short questionnaires along the way so progress is measured rather than guessed at. If the numbers are not moving, that is information — we change the plan.
Sessions are online by secure video, wherever you are in the UK, and can be in English or Spanish. Working from your own home is often an advantage rather than a compromise: the practice happens where the problem actually lives.
Common questions
Is CBT just positive thinking? No. CBT is not about replacing a dark thought with a cheerful one — that rarely survives contact with real life. It is about testing what your mind predicts against what actually happens, and about changing the behaviour that keeps the prediction untested.
Does it work online? Yes. Trials comparing online and in-person CBT find broadly similar outcomes, and for anxiety problems in particular there is an advantage to practising in the setting where the problem occurs.
How long before I notice a difference? Most people feel something shift within the first four to six sessions, often once the formulation lands. Durable change takes longer, and nobody can promise a specific result — what I can promise is that we will measure it honestly.
Do I have to do homework? There is between-session practice, yes, and it is the single best predictor of how well CBT works. We design it together and keep it realistic for the week you actually have.
What if CBT is not right for me? Then we use something else. I also work with EMDR, inference-based CBT, ACT and IFS, and if none of them fits I will tell you and help you find who does.
Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.
Related articles
When your family has started managing you
What usually brings someone to therapy for anger is seeing it in someone else's face, rather than the anger itself. Here is what that means, and what to do next.
Why anger goes from nought to everything in seconds
If your temper seems to skip every stage between calm and shouting, the stages are still there. Here is how to find them, and where the choice still exists.
Anxiety is your threat system doing its job too well
Anxiety is an alarm built for real danger, firing at things that are not dangerous. It is not weakness or a broken mind. Understanding the system is the start of resetting it.
Does online therapy work for anxiety?
Online CBT matches in-person outcomes for anxiety. For some kinds of anxiety it works better, because the work happens where the problem lives.
The short-term relief that keeps anxiety going
Checking, avoiding, preparing, reassurance. Each one makes you feel better right now. Each one teaches your alarm that the danger was real. This is the loop CBT interrupts.
What happens in a first CBT session for anxiety
Not knowing what therapy involves is itself a reason people put it off. Here is what the first sessions actually contain, from the assessment to the first thing you try.
The video work in social anxiety therapy
Seeing yourself on video is the part of social anxiety treatment people dread most, and the part they most often describe afterwards as the moment something shifted.
The post-mortem after social events, and why it hurts
The replaying afterwards is where social anxiety does a lot of its damage. Here is what the post-mortem is actually doing, and how CBT stops it rewriting the evening.
Social anxiety: the habits that feel like they save you
Gripping the glass, over-preparing, rushing your sentences, having a drink first. Each safety behaviour feels like it got you through. Each stops you finding out you did not need it.
Is it shyness or social anxiety?
Shyness is a temperament. Social anxiety is a condition that shrinks your life, one declined invitation at a time. Here is how to tell which one you are dealing with.
Why desire does not survive being monitored
You cannot feel anything for your partner any more, and you have taken that as the answer. Testing for a response is close to the most reliable way to abolish one. It returns when the checking stops.
SO-OCD runs in every direction, and that is the tell
Straight people get it about being gay. Gay and bisexual people get it about being straight, or not gay enough. If this were about orientation it would not be so indifferent to the answer.
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