Blog

• NHS Talking Therapies
• Thomas Boldy, High Intensity Cognitive Behavioural Therapist, NHS East Riding Talking Therapies
  

At East Riding Talking Therapies, Thomas offers free therapeutic support to clients from the ages of 16 and upwards. The team also has specialised knowledge on supporting clients to manage long-term conditions.

Thomas (pictured) says: ‘I’ve worked with patients from teenagers to adults in their eighties who have long-term conditions such as cardiac or respiratory conditions, diabetes, chronic pain, or perhaps they’ve had a major operation and require adaptations to improve physical conditioning. For clients like these I’ve seen the benefits of the work we can do and the beneficial impact it can have on their daily lives and wellbeing.

‘When a client is referred to the Talking Therapies service, or they self-refer, we work with them to examine the difficulty or problem they’re experiencing, the factors that may be causing it, and the impacts of the problem on their lifestyle and the way they think. Once a person has had their assessment we’ll discuss with them which type of evidence-based therapy will be most beneficial based on their symptoms. This might be confidential treatment provided by a Psychological Wellbeing Practitioner (PWP) over six fortnightly sessions if the client is struggling with depression, anxiety or excessive worry.

‘My role as a cognitive behavioural therapist (CBT) comes in where there is more complexity to their problem. CBT is a more intensive therapy, delivered typically over 12 sessions, dependent on the presenting problem. I help guide clients to better understand the development of their symptoms and the factors contributing to their problem persisting. In that way we can devise an individualised treatment plan which follows evidence-based protocols to ensure we’re giving the best care. Working with the patient I’ll map out what we can focus on to challenge potentially unhelpful thoughts, and analyse the potential impact of attempting different behavioural choices. A great joy as a therapist is being able to see patients as they develop and begin to make changes to their lives which benefit them and those around them.

‘One client I supported had been diagnosed with cystic fibrosis and was struggling to adjust her energy levels in line with behavioural choices. The client wasn’t sure psychological therapies could help her but was willing to see how she felt after a few appointments. I explained that we want people to make their own choices and determine if this is the right time to engage with Talking Therapies. A joint decision was made after a few appointments to continue with the appropriate treatment plan after developing a strong understanding and therapeutic alliance.

‘Our work then focused on the client working towards achieving a level of acceptance towards their diagnosis and considering what they could do to better manage this. We looked at what they wanted to do each week to ensure it was realistic and achievable according to their energy levels, adapting routine and introducing pacing, individualised to their current abilities. Now, the patient feels she has a new lease of life, can pace herself in her daily activities, accept her symptoms, and is able engage with others, enjoying what can be experienced in life.

‘This progression in a patient’s wellbeing can be seen across lots of clients’ journeys. We support clients with learning about how they can improve their management of their condition, to improve how they feel physically and mentally. It’s about working with the client to develop trust, share their difficulties as well as their successes and achievements. Sometimes, it takes a lot of thought and consideration before someone contacts Talking Therapies and in my experience, as an accredited therapist, it’s always a step in the right direction.

‘Talking Therapies support is available flexibly to accommodate clients’ daily lives and commitments. Therapy is available by phone, video, and there is an online platform for patients called Silvercloud. With Silvercloud each patient has a confidential account and is assigned a therapist. There are pieces of online reading, and may be tasks that can be completed using the client’s smartphone, laptop or tablet.’

• You can refer yourself directly to an NHS Talking Therapies service. Go to nhs.uk/mentalhealth or a GP can refer you. Help is available in person, by video, over the phone or as an online course. To be eligible you need to be aged 18 years and over and registered with a GP. Some services offer treatment for young people aged from 16 and 17, but you need to check this with individual services. You can either fill in an online form, phone your local service or email. Someone from the service will get in touch.

• With thanks to Humber Teaching NHS Foundation Trust.