Cognitive Behavioural Therapy (CBT) is a talking therapy that can help clients to manage problems by changing the way they think and behave.

CBT is based on the concept that thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can create a negative cycle.

CBT aims to help clients deal with overwhelming problems in a more positive way by breaking them down into smaller parts. Clients are shown how to change these negative patterns to improve the way they feel.

CBT has been shown to be an effective way of treating a number of different mental health conditions.

• Depression
• GAD
• OCD and Body dysmorphic disorder
• Social Anxiety disorder
• Panic Disorder
• Health Anxiety
• PTSD

What will the Journey look like?

Treatment starts with assessment which allows you and your therapist to get a good understanding of your issues and how these may have developed. You can then explore together how they affect your life, and what keeps them going. Although we may talk about past experiences, CBT is structured to work in the here and now.

You may be offered individual sessions or therapy as part of a group. If you have access to a computer or smart device you may be offered the option to attend virtually.

Will it work for me?

NICE (National Institute of Clinical Excellence) recommends CBT as an excellent therapy with great success in addressing issues such as anxiety and depression. Sometimes a combination of medication and CBT can also lead to good results; your therapist will discuss this with your during your assessment and treatment.

We understand that finding new ways of coping with distressing thoughts can be upsetting at times. Your therapist will guide you through this in a sensitive and caring way with support available. Staff in the Southern Trust CBT Team are fully qualified CBT therapists, and this means you can be assured you are receiving the best evidence-based care and treatment.

What does a CBT session look like?

Typically CBT sessions might involve:

Discussing problems that you want to work on

Setting specific goals to work towards

Exploring thoughts, feelings, and behaviours (sometimes using charts, whiteboards or diagrams)

Practising skills you have learned during and between sessions, or reading material that will help you better understand your situation.

Sessions are weekly and last 50 minutes. We will agree together tasks for completion at home, and this may involve recording things like thoughts, moods or other activities for discussion at the next session.  

A really important part of CBT is working together with a therapist to address your difficulties and set goals you think are important.

How many sessions will I need?

After your assessment your therapist will discuss a specific treatment plan for your needs and this can be between 6 and 20 sessions. To benefit from CBT, you will need to be prepared to attend sessions on a regular basis.

Who will deliver my treatment?

The Southern Trust CBT service staff provide treatment and are all fully qualified trained and accredited CBT therapists. This means you can be assured you are receiving the best evidence based delivery of care and treatment

In line with Stepped care model patient presentation requires Step 3 CBT intervention, following NICE guidance as below:

Referrals to Cognitive Behavioural therapy must be able to meet the following criteria:

• The individual is over 18
• Step 3 CBT intervention for common mental health problem is indicated as in line with stepped care model and NICE guidance for ‘Depression in Adults’, Generalised anxiety disorder and Panic in adults’, ‘Obsessive Compulsive disorder and Body Dysmorphic disorder, ‘Social Anxiety Disorder’ or Post Traumatic Stress Disorder’.
• Client has not responded to time-limited and evidenced based Step 2 therapeutic intervention where indicated e.g. depression, panic disorder, GAD
• Mental health difficulties are having a severe direct impact on current functioning
• The person has consented and is motivated to engage in Cognitive Behavioural Therapy
• Any presenting risk issues are being actively managed in order to enable the person to participate with CBT interventions.

In addition, individuals are likely to gain most from a cognitive behavioural approach if:

• Individuals are aware of the commitment required including attending weekly, working collaboratively and completing agreed tasks between sessions.
• They have the ability to define their presenting problems and work towards attainable goals.
• They demonstrate a willingness to accept they have a problem.
• They are motivated to bring about change to alleviate current difficulties and to take responsibility to bring about change.
• They are willing to commit time to homework assignments outside of the therapeutic encounter.
• They can access their thoughts/ feelings
• They have an understanding of the need for ongoing engagement over a period of time. Some individuals may have more complex presentations (multiple psychological problems) necessitating lengthy intervention.

Many of the above listed individual characteristics are likely to support any therapeutic approach. However, they are perhaps particularly relevant in the case of CBT, where heavy emphasis is placed on the patient working actively towards change. These features must be considered with the specific defined problem, to determine suitability.

Presenting Conditions

Specific conditions that may be appropriate for Cognitive Behavioural Therapy include:

• PTSD
• Obsessive Compulsive Disorder / Body Dysmorphic Disorder with mild to severe functional impairment- Not consenting to group treatment
• Depression, moderate/severe/relapsing/recurrent, where there has been limited response to Step 2 intervention or step 3 clients who have had limited response to psychological treatment previously within Community Mental Health Team (CMHT).
• Generalised Anxiety Disorder, moderate to severe, where there has been limited response to Step 2 intervention or step 3 clients who have had limited response to psychological treatment previously within CMHT
• Panic disorder, Moderate to severe, where there has been limited response to Step 2 intervention or step 3 clients who have had limited response to psychological treatment previously within CMHT
• Social Anxiety /Health Anxiety, in the absence of any health problems. Not consenting to group treatment
• Specific Phobias.ie blood/needle.

For all needle/blood phobias- This type of referral is required to be seen in a medical facility/ Bluestone Unit. Arrangements need to be made to book room and secure a personal alarm for staff in case a Crash trolley is required.  

Evidence based models support the use of CBT as an effective treatment choice for psychosis and Bi-polar disorder. However further training updates are required to deliver these. Currently SHSCT CBT staff are unable to treat this client group until training is complete. These criteria will be reviewed accordingly.

Referrals that would not be appropriate for Cognitive Behavioural Therapy include those for individuals where the presenting/primary problem is;

• Active Suicidal Ideation
• Current harmful use/dependence on alcohol/illicit substance use impacting on functioning
• Reaction to situational/social crisis
• Impaired cognitive functioning impacting on ability to engage in psychological intervention
• Childhood Sexual Abuse, as primary problem
• Anger Management
• Personality Disorder- emotion dysregulation, poor tolerance of distress as primary problem.
• Emotional Over- eating/Obesity/ disordered eating
• Physical health problems as primary problem, i.e. fibromyalgia/M.E./brain injury/tinnitus
• Tourette’s disorder/involuntary movements
• Functional Neurological Disorder.
• Pathological grief reaction
• Psycho-sexual problems

Referrals accepted form GP Via: CCG and internally from other trust services.

Consent must be sought from service user to make referral.

Appointments can be offered virtually via MS Teams, telephone or in person in CBT service premises.

• Armagh- Milford Building
• Dungannon- South Tyrone Hospital - Dept. of Psychological Therapies.
• Banbridge- Banbridge Health Centre
• Craigavon, Lurgan, Portadown- Trasna House
• Newry- Mournes Resource Centre- Kilkeel Health Centre

** Clients may be offered an appointment in any facility in Southern Trust area, this helps to reduce the waiting times.**