Availability
Brett is accepting new clients at The Northern Beaches Psychiatrist and Psychologist Family Medical Practice in Dee Why, NSW. To schedule an appointment, you may contact the practice here. Brett also maintains a small private practice at his home in Mount Pleasant, near Wollongong (see here for more information). To discuss working with Brett privately, please contact him here.
Brett is accepting new clients at The Northern Beaches Psychiatrist and Psychologist Family Medical Practice in Dee Why, NSW. To schedule an appointment, you may contact the practice here. Brett also maintains a small private practice at his home in Mount Pleasant, near Wollongong (see here for more information). To discuss working with Brett privately, please contact him here.
Expertise
Given his extensive training and experience (see bio), Brett has thorough and scientifically up-to-date expertise in psychology broadly, including most issues that prompt individuals to seek help. In addition, Brett is an expert in anxiety. He has devoted much of his career to understanding why people have anxiety problems and how they may be optimally overcome. Brett is an internationally-renown expert in the most effective and scientifically supported approach for anxiety: exposure therapy. This approach involves facing feared situations, with the help of the therapist, while eliminating avoidance behaviours and pursuing a full life.
Brett co-authored a critically acclaimed book on exposure therapy and has extensive experience using this approach with clients. He has trained therapists from around the world to use exposure therapy and has published many peer-reviewed scientific articles on this approach. Exposure is the most scientifically supported therapy for anxiety-related issues including panic attacks, social anxiety, obsessions and compulsions, phobias, generalised anxiety, posttraumatic stress, health anxiety, and body image concerns. Brett is passionate about exposure therapy because of how well, and quickly, it can transform the lives of clients struggling with anxiety. He uses this approach with clients on a daily basis and tries to live his own life in accordance with its principles.
Although exposure therapy is typically delivered in once-weekly sessions, in some circumstances it can be delivered in a brief and intensive format. For example, some phobias can be successfully treated in a half-day session, and individuals who experience panic attacks can overcome their fear of panic in a 1 to 1.5-day approach Brett developed (see here and here for published outcome data). Brief, intensive exposure therapy is highly effective, works quickly, and is popular with clients who desire immediate improvement. It is also a convenient option for clients whose busy schedule does not allow for weekly sessions spread across several months. Other anxiety issues such as social anxiety and obsessions and compulsions may also be effectively treated in a brief, intensive format. Please contact Brett if you are interested in seeing him privately for this type of therapy.
Given his extensive training and experience (see bio), Brett has thorough and scientifically up-to-date expertise in psychology broadly, including most issues that prompt individuals to seek help. In addition, Brett is an expert in anxiety. He has devoted much of his career to understanding why people have anxiety problems and how they may be optimally overcome. Brett is an internationally-renown expert in the most effective and scientifically supported approach for anxiety: exposure therapy. This approach involves facing feared situations, with the help of the therapist, while eliminating avoidance behaviours and pursuing a full life.
Brett co-authored a critically acclaimed book on exposure therapy and has extensive experience using this approach with clients. He has trained therapists from around the world to use exposure therapy and has published many peer-reviewed scientific articles on this approach. Exposure is the most scientifically supported therapy for anxiety-related issues including panic attacks, social anxiety, obsessions and compulsions, phobias, generalised anxiety, posttraumatic stress, health anxiety, and body image concerns. Brett is passionate about exposure therapy because of how well, and quickly, it can transform the lives of clients struggling with anxiety. He uses this approach with clients on a daily basis and tries to live his own life in accordance with its principles.
Although exposure therapy is typically delivered in once-weekly sessions, in some circumstances it can be delivered in a brief and intensive format. For example, some phobias can be successfully treated in a half-day session, and individuals who experience panic attacks can overcome their fear of panic in a 1 to 1.5-day approach Brett developed (see here and here for published outcome data). Brief, intensive exposure therapy is highly effective, works quickly, and is popular with clients who desire immediate improvement. It is also a convenient option for clients whose busy schedule does not allow for weekly sessions spread across several months. Other anxiety issues such as social anxiety and obsessions and compulsions may also be effectively treated in a brief, intensive format. Please contact Brett if you are interested in seeing him privately for this type of therapy.
Values and Philosophy
Brett has adopted the values of the Mayo Clinic where he trained as a postdoctoral fellow. Chief among these is "the needs of the client come first.” Brett emphasises respect, autonomy, collaboration, transparency, and a commitment to offer clients the most effective approach available for their issues in an environment of shared decision-making. His approach is active, present-focused, straightforward, efficient, practical, and emphasises behaviour change. Brett believes in "doing therapy," not "talking therapy." He views psychological problems like depression and anxiety as able to be fully overcome, not "chronic illnesses" to be "managed" over the long-term. Brett works with clients to become their own therapist and acquire the knowledge, skills, and confidence to overcome their issues and reach their full potential.
Brett rejects the scientifically unsubstantiated and disempowering notion that psychological problems are medical diseases (see here to learn why). There is no reliable scientific evidence that any psychological problem (e.g., anxiety, depression, addiction, hyperactivity) is caused by brain or genetic defects. Popular claims to the contrary, such as the debunked "chemical imbalance" story of depression, are scientific myths that can harm those who believe them. Diagnoses like "Obsessive-Compulsive Disorder" simply describe types of psychological struggles; they do not explain them, nor do they indicate a "broken brain," faulty genes, or other defect in the individual. Brett does not view thoughts, feelings, and behaviours as "symptoms" of "mental illness" (he discusses why here) but rather psychological experiences whose meaning can be understood in light an individual's history and context. This perspective opens up the possibility that therapy need not focus on "symptom reduction" (e.g., using "coping skills" or psychiatric drugs to control negative thoughts and feelings) and can instead encourage clients to move forward, behaviourally speaking, in important life directions while being willing to accept rather than control their inner experiences.
Brett has adopted the values of the Mayo Clinic where he trained as a postdoctoral fellow. Chief among these is "the needs of the client come first.” Brett emphasises respect, autonomy, collaboration, transparency, and a commitment to offer clients the most effective approach available for their issues in an environment of shared decision-making. His approach is active, present-focused, straightforward, efficient, practical, and emphasises behaviour change. Brett believes in "doing therapy," not "talking therapy." He views psychological problems like depression and anxiety as able to be fully overcome, not "chronic illnesses" to be "managed" over the long-term. Brett works with clients to become their own therapist and acquire the knowledge, skills, and confidence to overcome their issues and reach their full potential.
Brett rejects the scientifically unsubstantiated and disempowering notion that psychological problems are medical diseases (see here to learn why). There is no reliable scientific evidence that any psychological problem (e.g., anxiety, depression, addiction, hyperactivity) is caused by brain or genetic defects. Popular claims to the contrary, such as the debunked "chemical imbalance" story of depression, are scientific myths that can harm those who believe them. Diagnoses like "Obsessive-Compulsive Disorder" simply describe types of psychological struggles; they do not explain them, nor do they indicate a "broken brain," faulty genes, or other defect in the individual. Brett does not view thoughts, feelings, and behaviours as "symptoms" of "mental illness" (he discusses why here) but rather psychological experiences whose meaning can be understood in light an individual's history and context. This perspective opens up the possibility that therapy need not focus on "symptom reduction" (e.g., using "coping skills" or psychiatric drugs to control negative thoughts and feelings) and can instead encourage clients to move forward, behaviourally speaking, in important life directions while being willing to accept rather than control their inner experiences.
Approach to Therapy
Science-based approaches to therapy, like cognitive-behavioural therapy (CBT) and acceptance and commitment therapy (ACT), offer therapists a number procedures from which to choose. These include techniques that address thoughts, feelings, and behaviour. Behaviour change strategies, such as modifying one's environment, facing feared situations, reducing avoidance, and increasing engagement in values-consistent activities, have consistently been shown in scientific research to be cornerstone of effective therapy. However, these strategies are not used by most therapists. Instead, therapists tend to emphasise coping skills for reducing negative thoughts and feelings, like controlled breathing, muscle relaxation, positive thinking, and mindfulness techniques.
Unfortunately, the therapy offered to most clients in the community does not take advantage of our most powerful strategies for improving lives. This is because clinicians tend to "drift" from behaviour change strategies toward feel-good techniques that are less challenging but also less effective. Work with clients emphasizes "talking therapy" instead of "doing therapy." This talking therapy typically focuses on coping skills for controlling negative thoughts and feelings rather than behaviour change.
Brett does not emphasise coping skills for controlling negative thoughts and feelings. Rather, he focuses on living, more specifically making behaviour changes that provide valuable learning opportunities and allow people to live a more full and values-consistent life. Here is why:
Science-based approaches to therapy, like cognitive-behavioural therapy (CBT) and acceptance and commitment therapy (ACT), offer therapists a number procedures from which to choose. These include techniques that address thoughts, feelings, and behaviour. Behaviour change strategies, such as modifying one's environment, facing feared situations, reducing avoidance, and increasing engagement in values-consistent activities, have consistently been shown in scientific research to be cornerstone of effective therapy. However, these strategies are not used by most therapists. Instead, therapists tend to emphasise coping skills for reducing negative thoughts and feelings, like controlled breathing, muscle relaxation, positive thinking, and mindfulness techniques.
Unfortunately, the therapy offered to most clients in the community does not take advantage of our most powerful strategies for improving lives. This is because clinicians tend to "drift" from behaviour change strategies toward feel-good techniques that are less challenging but also less effective. Work with clients emphasizes "talking therapy" instead of "doing therapy." This talking therapy typically focuses on coping skills for controlling negative thoughts and feelings rather than behaviour change.
Brett does not emphasise coping skills for controlling negative thoughts and feelings. Rather, he focuses on living, more specifically making behaviour changes that provide valuable learning opportunities and allow people to live a more full and values-consistent life. Here is why:
- Coping skills do not make behaviour therapy more effective. Instead, they waste time, money, and effort, delay improvement, and reduce the amount of behaviour therapy clients receive. Given that the Australian healthcare system's Better Access program provides a rebate for only 10 therapy sessions per year, it is important that time spent in therapy is used wisely, emphasising effective strategies and excluding those that don't work and slow improvement.
- The use of coping skills is based on the idea that internal experiences like unwanted thoughts, emotions, memories, images, urges, and body sensations are bad and need to be controlled or eliminated in order for the person to live a full life and have good "mental health." Brett rejects this view because negative thoughts and feelings are universal and expected in light of one's history and context, especially during periods of high stress. Don't take his word for it - check out this recent study showing that 83% of people experience a diagnosable psychological problem by age 38! This doesn't mean that nearly everyone is "mentally ill," but rather that experiencing significant psychological distress at times is part of the human condition. Accordingly, Brett works with clients to become more accepting of their moment-to-moment internal experiences while directing their energy toward behaviour change in the service of living a full life; in other words, to Get Out of Your Mind & Into Your Life (a book he often uses with clients). He also works with clients to develop a more adaptive belief system, acquired principally through new life experiences, that helps them live a more valued life.
- For many individuals, coping skills are a major part of the problem. Habitual attempts to control unwanted thoughts and feelings by suppressing them, distracting oneself from them, and avoiding or withdrawing from situations that evoke them - also known as experiential avoidance - are largely ineffective despite whatever short-term relief they provide, maintain and worsen distress over time, and reduce quality of life as people withdraw from important pursuits and relationships. Therapists who emphasise the use of coping skills may contribute to this experiential avoidance agenda by providing clients with more tools for controlling negative thoughts and feelings. Psychological struggles are often fuelled by the combination of an unwillingness to have negative internal experiences and habitual efforts to cope them away that ironically intensify the very thoughts and feelings they are intended to control. From this perspective, the problem isn't that clients are insufficiently skilled in the use of coping skills for controlling their internal experiences, but the belief that such coping skills are necessary in the first place.
- Behaviour therapy works best when it is delivered without the concurrent use of coping skills. This approach involves encouraging clients to fully engage in important behaviours, without using coping skills to control negative thoughts and feelings along the way, in order to (a) learn important lessons, such as discovering that distress is tolerable and that important actions can be successfully performed even when one is distressed, and (b) pursue goals that move them toward valued life directions, such as having better quality relationships and regularly engaging in activities that provide a sense of accomplishment or purpose, and (c) become willing to live a full and values-consistent life while accepting rather than controlling the internal experiences that show up along the way. Brett aims to help clients learn that coping skills are unnecessary in order to prevent catastrophe, tolerate distress, function adequately, and pursue important life directions. In contrast, when therapy emphasizes coping skills, clients are taught that it is necessary to control negative thoughts and feelings in order to fully live their life. Clients are encouraged to become skilled "copers" who habitually battle negative thoughts and feelings with "skills" for controlling them. The mental energy needed to fight this internal battle can make it difficult to be in the present moment and fully engage with life. This approach is also a recipe for trouble in situations where coping skills are unavailable or ineffective. Rather than working with clients to become skilled at controlling negative thoughts and feelings when they occur, Brett focuses on helping them live better (according to their own vision of what this means) while encouraging acceptance of the internal experiences that are an inevitable product of their life experience.
- Our research shows that therapists who emphasise the use of coping skills, and de-emphasise behaviour therapy, do so to manage their own discomfort with the approach. Many therapists are concerned that their clients will be unable to tolerate the discomfort associated with making difficult behavioural changes (e.g., facing feared situations), and also believe it is unethical to subject their clients to temporary distress even if it is in their best long-term interests. These concerns lead therapists to focus on equipping their clients with coping skills for controlling their short-term distress rather than making important but temporarily uncomfortable behavioural changes that might improve their lives in the longer-term. Brett rejects these ideas. Brett views his clients as resilient, not fragile, and uses behaviour therapy to build distress tolerance and acceptance of thoughts and feelings so clients can fully pursue living a valued life, even when they feel distressed. Life is meant to be lived, not coped with!
