What is Guided Self Help?  

Guided self-help (GSH) is a treatment based on the principles of Cognitive Behavioural Therapy (CBT). GSH is not the same as CBT, but an alternative brief one to one treatment which involves working through your difficulties with support from a Psychological Wellbeing Practitioner (PWP).  

What is GSH helpful for?  

It is a therapeutic approach for people with mild to moderate common mental health problems such as depression, generalised anxiety disorder and panic disorder.  

What does GSH entail? 

GSH consists of up to 6 sessions which may be delivered by web video or by telephone sessions in one of our clinics.  

Each session will last up to 30 minutes; therefore sessions will be focused and structured in order for you to get the most out of your treatment. Guided self-help is a collaborative treatment, so together in each session, you and a Psychological Wellbeing Practitioner will aim to:  

• Set an agenda for the session.   
• Identify your priorities and goals for the session.  
• Work through a range of guided self-help booklets. 
• Guide you in how to use the guided self-help techniques and apply them to your daily life.  
• Set in-between session tasks to help you practice the techniques.  
• Review how you get on with in-between session tasks.  

What are in-between session tasks and why are they important?  

In-between session tasks are set at the end of each session and are a key method of change in guided self-help. As the sessions are only 30 minutes long, most of the practical work will be done outside of sessions, which enables you to try out the techniques in your everyday life and test out how well they work for you.

It is important to complete the in-between session tasks because many of the techniques will be new and will need to be developed through repeated practice. Regular practice of the techniques is essential in order for change to come about and for you to see improvements in symptoms of depression and anxiety.  

How can I access GSH?  

After we receive your referral, you’ll be invited to book an assessment with us. This helps to understand more about what you’re going through and match you to the right therapy. Together we will determine the most suitable treatment following NICE guidelines and a discussion with a clinical supervisor.  

Computerised Cognitive Behavioural therapy (cCBT) is a computer based self-help treatment using CBT self-help materials.  The work is self-directed with support from a Psychological Wellbeing Practitioner (PWP). 

• Cognitive Behavioural Therapy (CBT) is a structured and focused intervention that aims to help you achieve goals. CBT is based on the idea that the way we feel is affected by our thoughts, beliefs and by how we behave. Rather than concentrating on the past causes of your difficulties, CBT focuses on problems in the ‘here and now’ and teaches you how to use practical approaches to improve how you are feeling.  
• The National Institute for Health and Care Excellence (NICE) recommend CBT in the treatment for a range of emotional problems, including depression and a range of issues relating to anxiety.  
• If CBT is recommended, you will usually attend a session with a therapist once a week. From there you’ll work with your therapist to break down your problems into their separate parts, such as thoughts, feelings and actions. CBT involves planning practical exercises with your therapist and carrying these out together or as homework between sessions. CBT encourages people to engage in activities and to write down their thoughts and problems for discussion during therapy. CBT can also involve problem-solving and learning how to deal with worry or with difficult memories. 
• CBT focuses on the problems you are currently experiencing whilst emphasising the relationship between life events, thoughts, feelings, body symptoms and your behaviours. It helps you to address the way you think and what you do in order to improve how you feel. 
• It is suitable for people who are motivated to change and interested in a solution-focused approach. 
• It is a short-term therapeutic approach involving 50-minute sessions with a qualified or trainee CBT therapist. 
• In the first few sessions you will work with your therapist to form a clear understanding of your problems and set goals for therapy. 
• Together you will then develop a plan that will enable you to break out of the cycles that are keeping your problems going. 
• You and your therapist will set an agenda at the beginning of each session, to structure, prioritise and manage each session enabling you to get the most from therapy. 

• At the end of each session, you and your therapist will decide ‘in-between session exercises’ for you to do. These are important as they allow you to incorporate and practice what you have covered in sessions into your everyday life. 
• Your therapist will advise and encourage you throughout your recovery. The more you practice the agreed techniques, the greater benefits you are likely to experience. 

Group courses/therapies   

• Our group courses will help you learn relevant cognitive behavioural therapy (CBT) techniques to help you break out of negative patterns and make positive steps forward.  
• The strategies you learn will be useful well beyond the duration of the programme and will introduce helpful techniques that you can continue to practice at home.  
• We provide a wide range of different courses and workshops that focus on individual topics to help with anxiety, depression, long term physical health conditions, Stabalisation, low self-esteem, perinatal support, and much more (availability may vary ).  
• The benefit of a group setting is that you can have a shared understanding of your problems, and shared learning of how to manage and overcome these problems in your life.  
• If you are interested in attending one of our   group courses you can self-refer to our service online and discuss this as a treatment option during your triage .  
• The range of support can vary depending on availability . During your triage we will help you to identify the most appropriate options/ group . 

Talking Therapies for Long Term Conditions (LTC) service is designed to work with those who have certain LTCs and mild to moderate common mental illnesses, including depression and anxiety disorders. 

Clients may be offered computerised Cognitive Behavioural Therapy, Guided Self Help or Cognitive Behavioural Therapy following an initial assessment. 

Treatment will be adapted to focus on how LTCs impact on mood and how clients can manage their conditions and mood together going forward. 

Examples of conditions that we are able to work with might includes:

• Type 1 & 2 Diabetes 
• Pre-Diabetes 
• COPD 
• COPD related breathlessness 
• MSK/Chronic Pain* 
• Cardiac Illnesses 
• Cancer (if in remission) 

*MSK/Chronic Pain usually refers to chronic pain (not short term, acute pain) that stems from a Musculoskeletal condition. 

Please see sections on cCBT, GSH and CBT for more information on these types of therapy. 

EMDR (Eye Movement Desensitisation and Reprocessing) is a talking therapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. 

EMDR therapy aims to tap into the minds natural ability to heal from psychological trauma much as the body recovers from physical trauma. 

EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound does not heal and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures, EMDR therapists help clients activate their natural healing processes. 

• In EMDR therapy – your therapist will review your personal history, consider the symptoms and problems you are having today and think about what your future goals are. 
• You will select events/memories together and do desensitisation work on – using bilateral stimulation (commonly eye movements, but there are other methods) to assist the brain’s natural ability to heal and potentially improve the difficulties experienced from the previously blocked or unprocessed memories. 

Please note that the availability of EMDR varies according to our staff in post. The service will think carefully with you about your treatment and only suggest therapies where there is a good clinical rationale for selecting one therapy over another that may be far more available. 

Counselling  can be helpful when experiencing painful emotions, or facing difficult decisions, in order to improve or change relationships. Counselling within our service is offered specifically for people who are experiencing low mood and depression. In particular, counselling may be helpful if the low mood and depression has been triggered by some of the following:

• Something particularly unsettling has happened (such as bereavement, a redundancy, or a change of relationship), and help offered by friends and family is not enough, or not available, and it is impacting on your mental health in a significant way.

• There has been something that occurred in the past that has not been dealt with, and is now interfering with daily life. This may be a particular trauma that happened in childhood or later life, such as the death or illness of an important person in your life, or it may be something that happened over a long period, such as being bullied or abused in childhood (and perhaps beyond).

• It can help explore feelings and thoughts to resolve emotional distress

• It can help you towards a better understanding of yourself and others which in turn may lead to an improved ability to relate to important people around you.

• It is important to identify a focus, where an understanding and exploration of feelings, relationships and past experiences leads to you being able to making changes in the here and now. For example being able to better articulate your needs and assert yourself in relationships following an exploration of past experiences.

Counsellors cannot:

• Prescribe drugs – only an appropriate medical practitioner can do this

• Offer help with practical problems, such as financial or housing issues

• Help with benefit applications

• Manage physical health conditions for you and or intervene between you and your doctors to advocate for you.

Dynamic interpersonal therapy (DIT) can help people with emotional and relationship problems. 

• When a person can deal with relationship problems more effectively, their psychological symptoms often improve. 
• DIT is a time-limited psychodynamic therapy. Time-limited therapy happens over a fixed number of sessions. 
• One of the main ideas in psychodynamic therapy is that when something is very painful, we can try to ignore it. Most of the time we know when we’re doing this, but sometimes we bury something so successfully that we lose sight of it completely. This is why difficult experiences in the past can continue to affect the way we feel and behave in the present. 
• DIT provides a safe place to talk openly about how you feel and to understand what might be causing your difficulties. 
• During the initial phase your therapist builds a picture of what you find difficult in your life and how this affects you and people close to you. A questionnaire is used to help with this. 
• You may find that your therapist is more ‘silent’ than you are used to. This isn’t because they’re unfriendly, but because they want you to have space to work out what is on your mind. This can take a while to get used to, but your therapist knows how hard it can be and helps if you find this difficult. 
• Dynamic interpersonal therapy uses what happens in the relationship between you and your therapist to help think about the problems in your life. This means that your therapist often draws your attention to what you feel in the session. The idea is that by exploring the relationship between you and your therapist, you get a better understanding of what is troubling you. 

Behavioural Couples Therapy (BCT) is an evidence based treatment for depression. It is suitable for couples where low mood or depression is affecting one or both partners and leading to distress within the relationship. Research suggests that this treatment works as well as, and sometimes better than, individual treatment for depression when relational difficulties are the cause of the symptoms, or maintaining them.  

A couple is defined as two people who are in a stable, committed relationship and living together for at least six months. 

BCT aims to help depressed individuals in committed relationships learn to cope with their depression as a team with their partner. Additionally, couples are helped to enhance and strengthen their relationship by improving their communication skills. 

In order to engage with Behavioural Couples Therapy both partners need to be keen to be involved in the treatment and therefore both will need to refer themselves or be referred to Talking Therapies. 

Couple Therapy for Depression helps people suffering from depression by using the relationship as a resource to help support the individual and their partner. It is an evidence-based therapy that focuses on the relationship in the context of depression. 

People might benefit from couple therapy for many different reasons. It may be that the relationship has broken down or that there is anxiety that it might. Sustaining a fulfilling and stable relationship is never easy. Pressures from work, money, children, family tensions and ill health can all contribute to creating problems and these problems can lead to depression and other difficulties for one or both partners. Sometimes couples can’t talk to each other, and meeting with a couple therapist can open the way to better communication, which is a key part of improving relationships. Couple therapy aims to help you to achieve: 

• recovery from depression 
• better communication and ability to work together 
• greater awareness of each of your needs 
• greater understanding of your partner and yourself, and of the differences between you 
• a better sense of closeness between the two of you 
• being less stuck in repeating patterns in your relationships 
• help with feelings of anxiety and stress in facing the challenges of your relationship and family life 
• help with coming to terms with life changes such as the arrival of children, bereavement or separation 
• a more stable family life 
• greater confidence about the future 
• an improved sexual relationship if this is needed. 

We work together with Twining Enterprise non-profit organisation that helps individuals to get work and stay in work despite the mental health difficulties they might be dealing with. They aim to make a real difference in people’s lives by offering everyone the opportunity to enjoy the benefits of being employed. 

Twinning Enterprise offers tailored practical support to boost individuals’ confidence in finding, securing and maintaining job opportunities. Individuals can receive one-to-one support with things like: 

• Career advice and guidance 
• Writing CV and filling out application forms 
• Job search strategies 
• Interview and presentation skills 
• Preparation for first days at work 

Together with employment specialists, individuals can develop their own employment goals and plans. Everyone is then supported through the process for as long as needed, even after starting a job role. 

If you are interested in receiving work-related support, a referral to the employment specialists can be considered after completing the initial assessment with our service.