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Overview of Positive Step and Cognitive Behaviour Therapy Adrian Dugmore, Clinical lead

Overview of Positive Step and Cognitive Behaviour Therapy Adrian Dugmore, Clinical lead Philip Adkins, Service Manager. Agenda. Who are Positive Step? How do I refer? Service targets and 25% access rate What to expect, the patient journey through our service and stepped care

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Overview of Positive Step and Cognitive Behaviour Therapy Adrian Dugmore, Clinical lead

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  1. Overview of Positive Step and Cognitive Behaviour Therapy Adrian Dugmore, Clinical lead Philip Adkins, Service Manager

  2. Agenda • Who are Positive Step? • How do I refer? • Service targets and 25% access rate • What to expect, the patient journey through our service and stepped care • CBT and the various therapies on offer • Resources to use

  3. What is Positive Step? NHS Primary Care IAPT Service Partnership between AWP and Second Step Work with Common Mental Health issues such as depression and anxiety disorders Based at the Coast Resource Centre in Worle and work at local surgeries

  4. Additional services • Long Term Health Conditions (LTHC) pathway • Carers pathway • STEPPS programme (Systems Training for Emotional Predictability and Prevention).

  5. Referral pathways • Self referral – 0300 300 0834 • GP/Health Professional referral via the website • Booking on to courses via the website www.positivestep.org.uk

  6. Referral Statistics • North Somerset Population approximately 167,111 (GP registered adults) • Mental Health Population based on 15% 25,066 • 15% annual target – 3,760 • 2015 – 2016, 4681 referrals received • 3,867 went on to receive treatment

  7. Looking Ahead • North Somerset Population approximately – 215,000 • Access targets for IAPT services nationally will increase to 25% by 2020 • Positive Step will need to treat 6,266 to hit target in 2020, an increase of 2,506 • Areas to target include 16-17 year olds, over 65’s and males

  8. What to expect and the patient journey through our service

  9. Step 1GP Management Watchful waiting, Books on Prescription, Internet resources, Self-help material, Signposting to relevant agencies. Step 2 Receive, process and triage referrals – Book patients on to Psycho-education courses or book initial telephone assessment appointments with Step 2 workers. Low Intensity Intervention by Step 2 Worker Assessment, Books on Prescription, Internet, relevant agencies, Computer CBT, Guided self help, psych-education courses, individual low intensity CBT intervention and reviews. Step 3 High Intensity Intervention by Step 3 Worker Assessment, Individual CBT up to 12 sessions, Therapy groups spanning 8 to 16 weeks, EMDR. Step 4 Secondary Services, Recovery Teams, Early Intervention for Psychosis Team, Intensive Support Team, Consultant Psychiatrist. Step 5 In-patient services.

  10. CBT and the various therapies on offer Phone Assessments Various resources and guided self help Psycho-educational courses 1:1 Cognitive Behaviour Therapy Step 3 therapy groups Long term health conditions Carers Workshops and Individual Sessions Signpost to other services Restricted counselling provision

  11. Our Psycho-education Courses Last 4-6 weeks 20 or less participants in the room Led by a presenter at the front of the room Education and develop skills and techniques to practice at home through the use of workbooks Involve informal discussions and activities

  12. What courses we offer Low Mood Anxiety/Worry Self-Esteem Stress and Mood Management Getting Ready for Change / Weight Management Carers’ Workshops Keeping Well

  13. Individual InterventionsLow Intensity – Single Strand, Up to 6 sessions • Sleep hygiene • Medication review • Cognitive restructuring • Behaviour experiments • Behaviour activation • Graded exposure • Panic management • GAD • Problem solving

  14. Individual High Intensity CBTUp to 12 sessions • Formulation incorporating disorder specific protocols • Beckian longitudinal formulation • Therapy incorporating above interventions

  15. Different types of anxiety • General Anxiety • Social Anxiety • Panic Disorder • Health Anxiety • Specific phobia • OCD • PTSD • Mild to Moderate Eating Disorder

  16. Symptoms of Anxiety • Frequent worrying or nervousness • Rapid heartbeat or palpitations • Dizziness / light headed • Nausea / stomach problems • Avoiding people or situations • Difficulty concentrating • Thoughts that you can’t cope • Thoughts that something bad will happen

  17. Symptoms of Depression • Feeling sad • Feeling guilty or worthless • Irritable • Less interest in usual activities • Trouble making decisions or concentrating • Focussing on the negative • Tired / loss of energy /difficulty sleeping • Thoughts of death or hopelessness • Withdrawal and isolation • Loss of appetite

  18. Resources to UseHelpful CBT Websites • Psychology.tools • Self-help.tools • Northumberland self help • Centre for Clinical Interventions • Living Life to the Full • Mood gym

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