Let's Talk about CBT- Practice Matters

In this episode of Practice Matters, Rachel is joined once again by Professor David Veale, this time to explore emetophobia, the specific phobia of vomiting. David explains why this is the most common specific phobia presenting for treatment, despite being largely overlooked by researchers for years, and the devastating impact it can have, from avoided pregnancies to missed medical care.
Together they unpack what drives the fear, how it differs from OCD and eating disorders, and why tolerating uncertainty rather than seeking reassurance is at the heart of effective treatment. David also shares his "vicious flower" formulation, practical tips for therapists who might be squeamish themselves, and exciting developments in virtual reality treatment.
Further resources:
David's self-help book, Free Yourself from Emetophobia, co-authored with Alexandra Keyes, is available here
Find out more about David's work and publications here
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 Autumn 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

In this episode of Practice Matters, Rachel Handley is joined by Professor David Veale, consultant psychiatrist and cognitive behavioural therapist, to explore body dysmorphic disorder (BDD). Together they unpack what BDD really is, how it differs from vanity, social anxiety, and OCD, and why so many people suffering with it end up seeking cosmetic solutions rather than psychological support.
David shares the CBT formulation for BDD and explains the key maintenance processes that keep people locked in distress: self-focused attention, comparing, ruminating, checking, and safety behaviours. He also discusses imagery rescripting, the challenges of engagement, and why targeting processes rather than the content of beliefs is so important in this work.
The episode also covers what effective therapy looks like in practice, who is most likely to benefit and why persistence matters, the current evidence base, and where David hopes future research will take the field.
Further resources:
Find out more about David's work and publications here
More information on BDD can be found via the BDD Foundation
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 Autumn 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

In this episode of Practice Matters, Rachel Handley is joined by Professor Alicia Meuret to explore anhedonia, the reduced ability to feel pleasure, and the development of Positive Affect Therapy (PAT). Together, they unpack why so many clients struggle not just with feeling bad, but with a profound absence of positive emotion, and why traditional CBT approaches may not fully address this gap.
Alicia explains the science behind the brain's reward system, breaking it down into three key processes: wanting, liking, and learning. She also introduces PAT, the evidence-based treatment she developed with Professor Michelle Craske, and shares what the randomised controlled trial evidence tells us about its effectiveness compared to more traditional CBT approaches to treating depression.
The episode also offers a practical overview of what PAT looks like in the therapy room, including behavioural activation with a positive focus, savouring, gratitude practices, and building a richer emotional vocabulary. Alicia addresses some of the trickier clinical questions too, including how to present a positive-focused rationale without invalidating clients' very real distress, and how these ideas might just change how you look after yourself as a therapist.
Further resources:
Find out more about Alicia's work here- including links to all the trials mentioned in the podcast
Alicia's most recent trial published in JAMA Network Open can be found here
Positive Affect Treatment for Depression and Anxiety: Therapist Guide can be bought from Oxford University Press here
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

In this episode of Let's Talk About CBT- Practice Matters, Rachel Handley is joined by Professor Paul Farrand to unpack the theory and practice of low intensity CBT. They explore what low intensity really means, challenging common misconceptions and clarifying its evidence base, including its focus on single-strand interventions and stepped care delivery. Paul discusses how low intensity approaches improve access, efficiency, and patient empowerment, while maintaining clinical rigour through strong practitioner competencies in engagement and risk assessment. The conversation also highlights adaptation for diverse populations, evolving delivery formats, and future directions, including digital innovation and applications in physical health settings. A great listen for anyone wanting to learn more about low intensity CBT or thinking about applying it in different contexts.
Further resources:
Find out more about Paul and his work here
Paul's publications, including the systematic review he mentions can be found here
Find out more about the Cognitive Behaviour Therapist Low Intensity special issue here
The Sage book in which Paul's chapter on low intensity CBT is included is:
Farrand, P. (2024) Low-intensity CBT Skills and Interventions: A Practitioner's Manual. London: SAGE. 
More information about NHS Talking Therapies can be found here
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

In this episode of Let's Talk About CBT: Practice Matters, Rachel Handley speaks with Professor Shirley Reynolds about behavioural activation for depression in children and young people.
Shirley reflects on what we know about depression in adolescence, the challenges of access to effective treatment, and why brief, values-based approaches may be particularly well suited to this developmental stage. Drawing on findings from large clinical trials, she explains how young people often attend fewer sessions than are offered, prompting important questions about engagement and the design of therapy.
The conversation explores how behavioural activation helps young people identify what matters to them and gradually increase meaningful activity. Shirley outlines what a course of BA looks like in practice, from early psychoeducation and activity monitoring through to parent contracting and relapse prevention, and discusses the importance of supervision, system support and therapist wellbeing.
Further resources:
Find out more about Shirley and her work: https://www.drshirleyreynolds.com/about
More information about the online training with Shirley and Laura Pass can be found here: https://www.cbtreach.org/pass-reynolds
The IMPACT trial:
Goodyer, I. M., Reynolds, S., Barrett, B., Byford, S., Dubicka, B., Hill, J., Holland, F., Kelvin, R., Midgley, N., Roberts, C., Senior, R., Target, M., Widmer, B., Wilkinson, P., & Fonagy, P. (2017). Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial. The Lancet Psychiatry, 4(2), 109–119. https://doi.org/10.1016/s2215-0366(16)30378-9
 
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