Using the CPCAB model to address Common Mental Health Problems
Your GP and other trained clinicians use ‘The Medical Model’ when looking at Common Mental Health Problems (CMHP); their focus is on the dysfunction in their patient, the correct diagnosis, they problem-solve to treat any biological and physical aspects of the disease. The process is informed by scientific evidence, GP advice and interventions for health improvement. Psychiatrists also use the medical model to improve and validate bio-psychosocial psychiatric medicine. Neuroscience continues to investigate the brain and the mind.
Counselling was originally formed in the 1940s as a direct challenge to The Medical Model as it was back then, which was seen as ‘reducing the patient to symptoms’ and ‘did not include context’. Counselling provided an alternative ‘whole system’ approach which included client problems, client change and supporting that change. According to research 80% of clients seeking counselling today are not ready to make change and are instead at the ‘pre-contemplation stage’. Therefore before change people need time to explore how their problems arise and how they are connected to themselves and their lives. Counsellors can support this by listening to clients explore their thoughts, problems and self beliefs helping to develop more insights and self awareness which can lead to making change.
The Counselling and Psychotherapy Central Awarding Body (CPCAB) developed ‘The CPCAB model’ in the 1980’s and is now used by counsellors and psychotherapists firstly in their training and then later in their work with clients. The CPCAB model supports client change by considering treatment factors, but also considering context factors such as the client, the counsellor and the client-counsellor relationship formed. People are referred to as clients not patients to indicate an equal relationship and the responsibility for well-being is placed with the clients not the counsellor. The belief in many counselling theories is that people have the potential for growth and self actualisation.
“As no one else can know how we perceive, we are the best experts on ourselves.” (Gross, 1992).
The CPCAB model conceptualises CMHP in the following way:
The 3 Levels of Client Problems:
- Service Level A (Everyday Problems e.g. divorce, bereavement, work related issues)
- Service Level B (CMHP e.g. Anxiety, Depression)
- Service Level C (Severe and Complex CMHP e.g. psychosis)
- Counsellors are trained to work with clients who have problems assessed at Service Level A & B, whereas Service Level C requires clinical training and therefore a referral to your GP/psychiatrist would be advised
The 3 Dimensions of Client Problems:
- Thoughts and Feelings
- Life/Developmental Stage
As problems do not exist in isolation, a good example from the CPCAB gives is a client who initially comes into counselling with the goal of stopping smoking (Service Level A). As the sessions continue it transpires that smoking calms the clients social anxiety (Service Level B). Smoking is therefore a coping mechanism and it is not wise to remove a coping mechanism without either another in place or looking at the root cause. Therefore in this example to achieve the original goal counselling work would now need to change to explore the underlying cause of social anxiety and express those feelings. If a coping mechanism was still required to support anxiety a healthier alternative could be explored.
- The CPCAB model (Ver. 7.2)
- Simple Psychology.org
- Royal College of Psychiatrists
- Mental Health Foundation
- Person Centred Counselling (book list)
- Journal of Person Centred model
- UK Faculty of Public Health
- Natural Therapy for All.com