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• North Yorkshire Talking Therapies

It’s 2024 – are New Year’s resolutions still a thing? Goal-setting is an integral part of what we work on with you at NHS North Yorkshire Talking Therapies.

Setting and achieving goals. How many of us set out to achieve our goals with full gusto only to find that a few weeks later we’ve given up? This is often because our goals are unrealistic and overwhelming. We inadvertently put pressure on ourselves to achieve the unachievable. For example, if you don’t exercise often, then aim to go to the gym five times a week but haven’t realistically considered your work or family commitments, or that your fitness may need building up gradually, then the goal easily becomes unsurmountable.

The consequence of not achieving our goals can have a negative impact on our wellbeing. It may cause unhelpful thinking patterns, affect our motivation, leave us feeling demoralised, and prevent us from making positive changes. It’s possibly no surprise that the feeling we are not achieving, or struggling to find direction in our lives, can feed into symptoms of depression and anxiety. Therapists can support you in setting specific, measurable, achievable, realistic and timely goals, often referred to as SMART goals. Sustainable changes, those we can maintain, make it more likely for us to achieve the results we want – making us feel happier, more confident, and less anxious.

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. It’s important to note that it is normal to feel anxiety in certain situations. It’s the body’s way of responding to feeling threatened, under pressure or stressed; for example, if we have an exam, job interview, or dentist appointment. Anxiety isn’t always a bad thing. It can improve our performance by helping us stay alert, motivate us to solve problems and make us aware of risks. However, if anxiety affects your ability to live your life, becomes a persistent feeling, is hard to control or out of proportion for your situation then it can be a sign of a mental health problem.

In the UK, one in 10 people are living with an anxiety disorder. That’s over eight million people who experience an anxiety disorder at any one time (Mental Health UK). While fewer than 50% of people with generalised anxiety disorder access treatment, those who do often experience a significant reduction of their symptoms (Mental Health Foundation).

Anxiety affects our

• Minds: a feeling of dread or fearing the worst, on edge or panicky, difficulty concentrating, irritability, feeling detached from yourself or the world around you,
• Bodies: restlessness, feeling dizzy or lightheaded, shortness of breath or hyperventilating, sleep, nausea, needing the toilet more or less often, sweating, wobbly legs or pins and needles in your hands or feet, panic attacks,
• Behaviours: withdrawing from friends and family, feeling unable to go to work or avoiding certain places, finding ways of hiding your anxiety so others don’t notice it.

How to get help. If you’re experiencing any of these symptoms and would like support in making changes or setting SMART goals, please reach out to North Yorkshire NHS Talking Therapies. You can self-refer via the website or telephone or by visiting your GP practice.

Harrogate & Ripon talking therapies service: 01423 852137,

Hambleton, Richmondshire & Catterick talking therapies service: 01609 768890,

Whitby, Scarborough & Ryedale talking therapies service: 01947 899270.

Cognitive behavioural therapy (CBT) is a talking therapy that is recommended as the most effective treatment for anxiety (National Institute for Health Care and Excellence). CBT aims to change the way we think (cognition) and act (behaviour) to help cope with and manage problems we may face in our lives. It aims to help us learn to recognise these unhelpful patterns, and break down and approach problems in a different way to improve how we feel.

Case study: how CBT helped Marianne* take back control

‘I attended a six-week online Healthy Minds course following a referral from my GP. This had some useful information, but I still felt I needed some more help. A review was arranged following completion of the course and I was offered one-to-one talking therapy sessions.

‘I have had battles with anxiety and depression for most of my life, starting with some traumas in my teens, followed later by undiagnosed postnatal depression and the passing of a close family member. I had received some trauma counselling, following the first lockdown of the pandemic, when my mental health had worsened. I realised I had also been traumatised by my first relationship and had stayed in the situation for the wrong reasons.

‘Once the one-to-one sessions started with Scott, I felt I had someone who actually listened and had some helpful insights where needed. The first task was to set some goals on what I wanted to achieve with the sessions. I felt a little overwhelmed thinking these had to be really big goals. However, Scott helped me to see they didn’t have to be and together we made smaller more achievable goals. These included using thought diaries.

‘Thought diaries took some getting used to and my usual practise would have been to give up when things became difficult. But, when someone is empathetic, understanding and patient as Scott was, it helps to keep you committed. Once I had done some of the thought diaries, they became very useful to change many of my negative thoughts to more positive ones. Some of these thoughts were long-standing ones and there were also some new ones.

‘Thought diaries play a big part in my plan for moving forward and recognising if things start to deteriorate in the future. Scott helped me complete this plan which gave me confidence to move forward. In my plan I have set a reminder on my calendar to encourage me to check my mental health regularly. I started these weekly but have felt comfortable to change these to fortnightly.

‘What I have taken away from my time with Scott is a realisation I will never completely eliminate negative thoughts from my life, but that is okay. Negative thoughts are part of everyone’s lives, and I now have some valuable tools to help me if these become overwhelming in the future. Scott has had a very positive effect on my wellbeing, and I will always be grateful for that.’ *Patient’s name has been changed.

Scott, Senior Psychological Wellbeing Practitioner, NHS Talking Therapies North Yorkshire

‘When depression and anxiety take over it can be debilitating for anyone to deal with. People can very easily fall into a negative outlook, especially with how they can view themselves, the world and others. This can lead to more personalising and negative thinking about themselves, which can be detrimental to making changes or finding hope and in turn can increase anxiety about the future.

‘Low intensity, guided self-help CBT interventions are designed to guide people to understand the signs and symptoms of depression and anxiety, increase knowledge and self-awareness and facilitate change to improve their wellbeing.

‘Marianne had been able to recognise the symptoms of anxiety and depression and reached out for help. In our first treatment appointment we explored her long-term goals for what she wanted to change and where she wanted to be.

‘Goals are integral for low intensity guided self-help cognitive behavioural therapy. We can adapt the way we approach treatment to setting goals, making small in-between session goals which are both realistic and achievable if necessary.

‘Having realistic goals at each appointment appeared to spur Marianne on to make more positive behavioural changes. Initially, we started off by doing one goal in between each appointment, then Marianne would increase this herself. This caused a ripple effect of positive changes, and her motivation would increase to do more without expectations. It helped change her thinking around what she could do on a day-to-day basis and she started to reflect the positive changes she had made.

‘As a clinician, working with patients and seeing them make the changes to help themselves is very rewarding. The knowledge, understanding and insight they gain can be remarkable at times, as they then have all the tools and techniques they have learnt, for life, to help them challenge any lapses or relapses in the future or help any friends or family that may experience similar symptoms of depression and anxiety.

‘Low intensity, guided self-help interventions are extremely accessible and can fit into any person’s life. Treatment can be offered face to face or virtual clinics, over the phone or via an online format using computerised cognitive behavioural therapy.’

• NHS North Yorkshire Talking Therapies offer help and support through a range of talking therapies designed for supporting people with symptoms of depression, panic, anxiety, stress, worry and scary thoughts. Patients usually start with easy-to-access activities that are short and available online or by phone and then go on to more one-to-one therapies as needed. If you’re struggling with your mental health, take that first step to reach out for help. Once you take that first step and ask for help, you’re no longer alone in your journey to recovery.