Jane Watkins, CBT Therapist
Based in Bristol

Yes I am qualified. I started off my career as an NMC registered mental health nurse after completing my degree at Kings College in London. I later went on and did my specialist CBT training at the Institute of Psychiatry, also at Kings which qualified me to become a fully BABCP accredited CBT Therapist (considered the gold standard). I have undertaken a lot of training since and am qualified to offer multiple therapies such as CFT (Compassion Focussed Therapy), Solution Focussed Therapy and mindfulness, amongst others. Unfortunately, therapy is what we call an unregulated profession. My take on that is that anyone can call themselves a therapist and offer therapy. Shocking, isn't it? And so the BABCP is an independent regulatory authority that sets down strict regulations about education, ethics and ongoing training, supervision (all of which is audited by the BABCP) to stay up to date to be able to say you are regulated by them. This is entirely voluntary but in my opinion, essential for public protection. I therefore choose to be accredited so that you can be assured I am suitably qualified and continue to be, year on year.

This is a highly contested question at the moment. I can only answer from my point of view. Coaching tends to focus on how to reach goals in the current moment. Coaches have not, in general (unless they are trained therapists), undertaken enough training to keep you safe about talking about the past, in my opinion. Not all coaches undertake supervision to keep their practice safe. I also think that it depends what you want help with. I have two business coaches I work with and I find them so helpful. But I know where that line is for me, where I need to go and talk to my therapist as well. With a therapist I will talk about how the past influences now and how I can work with that in the current moment. I work with my clients in the ways that they need and want to. Some will want to look at how the past impacts them now and resolve that. In that process we are working in the current moment to reach goals in the present. I have also worked with clients who only want to work in the present moment. Whichever you want to do, you can be reassured that I can do both. I am trained in many types of therapy as well, so we can approach things in the way that suits you best be that Cognitive Behaviour Therapy (CBT) or other ways like Compassion Focussed Therapy (CFT), Mindfulness, Solution Focussed Therapy and more. I am also accredited with the BABCP and work withing ethical and legal guidelines, am insured and engage in monthly supervision to ensure I am practising safely and in your best interests.

Each session is one hour in length.

Of course, I offer every new client a free, 20 minute consultation by phone so that you can ask me any questions you have. Please come prepared, the 20 minutes goes very quickly!

I understand that times are difficult at the moment. My costs for running the practice have more than doubled in the last couple of years. I am therefore not able to offer reduced fee work at the current time.

If you go to the contact me page, on the top toolbar, you can find my phone number, email address or a form that you can send me if you prefer.

Sessions cost £100 each. Please check out the pricing page for cancellation policy and payment methods.

Totally confidential. The only time I would breach confidentiality is if I felt worried about your safety of the safety of someone you tell me about. I would talk to you first (unless I felt the risk would be increased in some way), should this arise. Apart from that I hold only basic information about you to facilitate sessions and notes. This is all stored on a highly encrypted electronic system. I do not share information with anyone else or any outside agencies.

This is almost impossible to answer. Most of my clients are with me for about 3 months but some will need less or more.

From 14 years up to adult. The oldest client I have had the privilege of working with was 88 years young!

Yes of course, if you live locally, happy to see you in person.

Most definitely. There has always been research into the efficacy of remote therapy and the evidence suggests that video bases therapy has the same outcomes as face to face. Most of my clients tell me they forget it is a video call after the first few minutes. Since COVID, we know so much more about remote therapy of course and it worked so well for most people then and continues to do so. There is also the convenience of it as you don't have to travel, can fit it in between other commitments more easily and feel comfortable in your own space.

I don't do telephone therapy. I will speak to you on the phone initially to make sure I think I can help thought. The research suggests that telephone therapy does not work as well as via video or face to face. We lose so much in terms of body language that we use so much in our day to day communications with each other.

Particularly at the start I have found that weekly sessions work the best, we get a good momentum going. Later on in therapy we can spread sessions out. I do realise that there are financial considerations as well and so please do talk to me if this is the case for you and we can work it out together.

No. As I have said in other answers, we will according to your choice. We can work in the present moment if you prefer. We will discuss this together to reach the best answer for you.

By BACs transfer, 48 hours in advance our session. Because I am spending so much time chasing clients for their fees, I will not start a session now until payment has been made.

No, weekly therapy for life is not required. Usually, my clients will have a block of sessions to initially address their OCD. After this some clients do not need to come back. But a larger proportion of my clients will come back for a top up session or two from time to time. A lot of my clients like to have check in sessions to keep them focussed on managing their OCD from between every 6 weeks to 3 months as suits them best.

This is another tough question to answer! In very general terms, those clients who do some work between sessions, adapt ideas we talk about to suit them, try things out, have an open mind and willingness to think about things differently, do the best.

All kinds of experiences can affect our self-esteem and cause self doubt and/or lack of self-confidence and anxiety. Experiences like bullying, criticism, feeling different and not fitting in (maybe due to ADHD, Autism, dyslexia or other neurodivergence), academic difficulties, not fitting into our families or not feeling like we have not achieved enough. Even if the evidence says something else!

This is an interesting question. As mentioned above, NICE recommend the most efficacious treatments for mental and physical health disorders. To be able to do this, the word disorder is adopted to identify a problem and what the evidence suggests is the best treatment for it. Weirdly, low self-esteem is not classed as a disorder in the manuals that define for NICE what the disorders are (so the DSM (Diagnostic and Statistical Manual of Mental Disorders and the ICD (International Classification of Disorders). Therefore there are no 'recommended' therapies for in the medical world. However, that being said, what I have found over the years is that low self-esteem is often at the bottom of a lot of difficulties including OCD. In fact, in my personal opinion, many of the anxiety disorders and depression are a 'symptom' of low self-esteem. And often the anxiety disorders appear to be a way of managing the low self-esteem. All this being said, both CBT (cognitive behaviour therapy) and CFT (compassion focussed therapy) very successfully 'treat' low self-esteem and make people feel so much better about themselves, in my experience over the years. It really warms my heart to see clients feel better about themselves, learn to set boundaries, reduce anxiety and increase their confidence.

Absolutely. There is a specific kind of CBT that is directly designed for treating low self-esteem. It is something I use with almost all clients, in some form, for anxiety disorders.

This can be tricky. I have lots of clients who don't believe they can but they want to. I believe it you want to, you will. If you don't want to, you won't. And it does take work on your part. My part of the partnership is to show you how 😊

The National Institute for Health and Care Excellence (NICE) looks at treatment outcomes for both physical and mental health conditions. It looks at what all the research says and suggests what the most effective evidence based therapies should be used. For OCD, NICE recommend CBT with ERP and possibly an SSRI (anti-depressants that also work with the anxiety centres in the brain) alongside. This is for both adults and young people. There is increasing evidence that the use of CFT (Compassion Focussed Therapy) can have a significantly helpful effect on OCD that has components of high shame, self-criticism and avoidance of some emotional experiences. I am trained in CFT and have found it a very useful adjunct to CBT to help clients recover from their OCD.

Usually yes. ERP or Exposure Response Prevention is a therapy where people are encouraged to face their fears and just let the obsessive thoughts flow without engaging in any compulsions. The 'exposure' is where people confront the anxiety provoking 'situation' and the 'response' is making the choice to not carry out the OCD compulsion. Most of my clients do say they cannot imagine doing this as it will make them anxious. We will talk about this in depth in therapy but if you think about it, you are already anxious, but using OCD to try to make the anxiety go away? The idea is that you experience the anxiety naturally disappearing (I know you cannot imagine that happening!) without 'neutralising' the thought using an OCD compulsion. We always start of with small things that are manageable, not the most anxiety provoking thing you can think of! You will find success here that will give you confidence to go on and manage bigger things. I am here to support you through all of this. I can do exposure with you, if you have a phone, even remotely! ERP can be an important part of therapy but it is not to be used alone. It is very important to lay the groundwork of understanding your OCD and how it operates first. We need to understand what is driving the compulsion first. You would not build a house without foundations. I have had many clients come to see me who have done ERP alone and found it has not worked. If this has happened to you, don't worry, I can help by using full CBT with you as per NICE guidelines.

In CBT we will spend our first few sessions looking at how OCD is maintained, that is, what is it, how does it effect you, what are intrusive thoughts, how do the thoughts effect how you behave, effect your emotions and how you experience that physically. We will then look at how OCD tells you to live your life and what life without this bully in your life would look like so you can develop ideas and goals for therapy. We will then start 'experimenting' with what OCD says. You know that OCD makes no sense, but it is a 'better safe than sorry' strategy at the moment. We want to work on more helpful strategies to have a life free from OCD. My experience is that clients who have done standalone ERP do not experience remission from OCD. Standalone ERP is not CBT. Research suggests that CBT could have better long-term benefits. My take on that, personally, is that if you understand your OCD really well, what it is, how it operates then you can develop strong strategies for living your life without it. I tend to incorporate ERP into CBT treatment as per NICE guidelines and what the evidence for treatment tells us. Most clients with OCD have strong feelings of shame and disgust. I also use CFT (compassion focussed therapy) and Mindfulness to help with these feelings. The evidence base is ever growing that a multi-pronged approach tends to help clients more with better long terms outcomes.

This is another question that is pretty unique to you. Many of my clients have recovered from their OCD with therapy alone and many have added medication. I think clients feel a failure if they need medication. This is so far from the truth. It takes such courage to come into therapy and face the horrible anxiety that you feel. The brain is an organ in the body just like any other and sometimes needs some medication support like sometimes a heart or liver does.

You might be surprised how many times I have been asked this question. Having a thought about causing harm alone is not a reason to call the police. Having a thought and then having a thought with the intention to act on it are two different things. People who have thoughts about causing harm to other, make plans about it and enjoy it do not have OCD. People who have thoughts about harming others that are totally abhorrent to them, cause them huge anxiety, disgust and worry, often do have OCD. My clients come to therapy because of the anxiety they feel over their thoughts and how the thoughts do not reflect the person they are at all. My clients are so horrified by the thoughts they are having, it can take them years to come into therapy. Don't be afraid to get in touch about your thoughts.

The only word in this question I am not keen on is 'cured'. But yes, therapy can help you to learn to manage your thoughts without using OCD. We all have intrusive thoughts, those with and without OCD. This is just the way the brain works and so we cannot actually 'cure' OCD as these thoughts will always be present. Those without OCD will experience intrusive thoughts but will not really notice them as they, in effect, filter them out. As part of OCD treatment I can help you learn how to put those filters in place. Most people I have met with OCD are scared that as they have had a thought it means something, like the thought will come true or they are a bad and terrible person as they had the thought. This is just not the case. Whilst you may not believe this right now, reading this, it is true. Please do get in touch so we can talk this idea through more.

The only answer to this is yes. OCD is an avoidance strategy. OCD tells you can feel safe and anxiety free if you do what it says and that intrusive thoughts are dangerous. In fact, most clients tell me they feel anxious all the time anyway. The more we avoid something the more scary it becomes. The only way to decrease the fear is to face it. BUT, we do it in slowly, with kindness, no judgement and gentleness and not in session 1. We will spend about 3 sessions or maybe more, preparing for this. You have my 100% support and understanding all the way.

Totally yes. I have not found anything we cannot do remotely that we do face to face. If we are doing ERP (behavioural experiments is what we call this in CBT) as long as you have a phone, I can go with you. Done this with so many clients.