Anxiety UK

• Services available through the NHS
• General questions about therapy
• Self-help Groups

One of the most effective ways to deal with anxiety is to learn to understand it. Here you will be able to find out more information on anxiety disorders, conditions and phobias. You can find out more about your specific anxiety problem on this website.

[click here to find out more about anxiety]

You can also read about the different type of therapies and medicines related to anxiety disorders in the ‘about anxiety’ section of this website. Links to further information available from Anxiety UK and elsewhere will allow you learn more about specific conditions. To find out more about the recommended treatments for anxiety, see our information on the NICE guidelines.

Primary Care Mental Health Services include members of the Primary Care team, such as your GP and more specialist workers, such as the Primary Care Mental Health Team. They tend to work with mild- moderate mental health problems (including anxiety, panic and phobias). Each team is different, but most work towards a model called “stepped care” which means that patients get the lowest intensity intervention appropriate for their needs. This means there will be workers with different skills and experience and often you will be asked to come in for an assessment so they can identify which part of the team would meet your needs best.

Here is an example of a team’s structure:

• Mental Health Workers and Graduate Mental Health Workers who see people with mild to moderate mental health problems and work using CBT based brief interventions to help people manage symptoms.
• Mental Health Practitioners who work with moderate mental health problems but usually work on coping strategies and CBT based interventions.
• Counsellors who see people with moderate mental health problems but usually focus on the past, and help people explore their feelings.
• Psychologists who see people with longstanding or complex difficulties, are able to work with people for longer time periods using a range of methods (including CBT and counselling).

Most work Monday to Friday 9am – 5pm, and provide a range of evidence based psychological therapies. Some provide home visits and most are accessed through a GP.

If you would like information about your local Primary Care Mental Health Team then please call the Anxiety UK helpline on 08444 775 774.

Improving Access to Psychological Therapies (IAPT)

The IAPT program has been running for a number of years and could be classed as a specific ‘primary care mental health service’ model. The government has invested in rolling this program out across England and its purpose is to ensure that people are able to obtain fast access to therapy. IAPT services include a new group of workers that are able to offer a range of treatments and numbers of sessions. Some of these include:

• Low intensity practitioners or psychological wellbeing practitioners: these workers can offer guided self help (a type of CBT that focuses on helping you to use techniques to make changes in your life). Sessions are usually 20-30 mins in length and will last for around 6 sessions.
• High intensity practitioners: these workers are often trained in full CBT. They are able to offer sessions of 40 mins to 1 hour in length and over a period of 12-15 sessions.

Click here for a guide from IAPT about talking therapy

Taken from Department of Health psychological therapies guidelines (2001).

Applied relaxation therapy

teaches systematic approaches to relaxation, for example, progressive muscle relaxation, often combined with breathing techniques then asking people to encounter the places or triggers to their anxiety. It is similar to the ‘behavioural’ component in CBT, but will additional relaxation.

Autogenic training

is often combined with relaxation methods to create a conditioned relaxation response to an internal stimulus, such as a word of phrase.

Behaviour therapy

is a structured therapy originally derived from learning theory, which seeks to solve problems and relieve symptoms by changing behaviour and the environmental factors which control behaviour. Graded exposure to feared situations is one of the commonest behavioural treatment methods and is used in a range of anxiety disorders.

Cognitive analytic therapy (CAT)

is a brief (8-25 session) integrative therapy combining elements of cognitive behavioural and psychodynamic therapies in an active, structured and collaborative approach, based on written summaries and diagrams of your problems. It can be useful for looking back over time at how people have coped and examining their patterns.

Cognitive behaviour therapy (CBT)

Looks at the impact of your thoughts and behaviours on how you feel. It then helps you to identify strategies for changing your thinking patterns and behaviours.

Cognitive therapy

is a structured treatment approach derived from cognitive theories. Cognitive techniques (such as challenging negative automatic thoughts) and behavioural techniques (such as activity scheduling and behavioural experiments) are used with the main aim of relieving symptoms by changing maladaptive thoughts and beliefs.

Dialectical behaviour therapy (DBT)

is a longer term cognitive behavioural treatment devised for borderline personality disorder which teaches patients skills for regulating and accepting emotions and increasing interpersonal effectiveness.

Eclectic therapies

Many NHS therapists formulate the patient’s difficulties using more than one theoretical framework and choose a mix of techniques from more than one therapy approach. The resulting therapy is pragmatic, tailored to the individual. These generic therapies often emphasise important non-specific factors (such as building the therapeutic alliance and engendering hope). By their nature, they are more idiosyncratic and difficult to standardise for the purposed of randomsied controlled trials research.

Eye movement desensitisation and reprocessing (EMDR)

is a form of imaginal exposure treatment for post-traumatic conditions where the traumatic event is recalled whilst the client makes specific voluntary eye movements.

Focal psychodynamic therapy

identifies a central conflict arising from early experience that is being re-enacted in adult life producing mental health problems. It aims to resolve this through the vehicle of the relationship with the therapist, giving new opportunities for emotional assimilation and insight. This form of therapy may be offered in a time-limited format, with anxiety aroused by the ending of therapy being used to illustrate how re-awakened feelings about earlier losses, separations and disappointments may be experienced differently.

Hypnotherapy

refers to any therapeutic approach using hypnosis as a main technique, for example, to promote imaginal re-exposure or relaxation.

Integrative therapy

refers to a formal theoretical and methodological integration of, for example, behavioural, cognitive, humanistic or psychodynamic approaches.

Interpersonal therapy (IPT)

A structured, supportive therapy linking recent interpersonal events to mood or to other problems, paying systematic attention to current personal relationships, life transitions, role conflicts and losses.

Problem-solving therapy

systematically teaches generic skills in active problem-solving, helping individuals to clarify and formulate their life difficulties and apply principles of problem solving to reduce stress and enhance self-efficacy.

Psychoanalytic psychotherapy

is a longer-term process (usually a year or more) of allowing conscious conflicts opportunity to be re-enacted in the relationship with the therapist and, through interpretation, worked through in a developmental process.

Psychoanalytically informed day hospital treatment

is designed to help patients understand their unconscious conflicts as they are enacted in their relationships with other patients and staff in the groups and activities of the day hospital programme.

Psychodynamic-interpersonal therapy

(formerly known as the Conversational Model of Therapy) assumes that symptoms and problem arise from, or are exacerbated by, disturbances of significant personal relationships. It explores feelings using cue-based responses and metaphor; links distress to specific interpersonal problems and uses the therapeutic relationship to test out solutions in the ‘here and now’.

Rational emotive therapy

is a form of cognitive therapy that identifies underlying assumptions and patters of thinking linked to negative unwanted emotions and challenges these.

Schema-focused cognitive therapy

is an integrative, long-term form of cognitive therapy, which addresses the deeply held, enduring beliefs (schemas) found in personality disorders.

Social skills training

is a form of behaviour therapy in which patients are taught skills in social and interpersonal relationships.

Stress inoculation therapy

is a type of behaviour therapy that involves exposure to increasing levels of stress to enhance ability to cope with stress.

Supportive psychotherapy

refers to any psychotherapeutic approach that supports existing ways of coping with problems rather than challenges and attempts to change ways of thinking and responding.

Systemic therapy

Systemic therapy (whether treating individuals, couples or families) focuses on the relational context, addresses patterns of interaction and meaning, and aims to facilitate personal and interpersonal resources within a system as a whole. Therapeutic work may included consultations to wider networks such as other professionals working with the individual or the family. Therapy aims to identify and explore patterns of belief and behaviour in roles and relationships. Therapists actively intervene to enable people to decide whether change would be desirable and to facilitate the process of establishing new, more fulfilling and useful patterns.

Therapeutic community

refers to a residential treatment in which patients learn to understand their problems and to change through their interactions with other patients and staff throughout the 24 hours of community life.

Counselling

is a systematic process which gives individuals an opportunity to explore, discover and clarify ways of living more resourcefully, with a greater sense of well being. Counselling may be concerned with addressing and resolving specific problems, making decisions, coping with crises, working through conflict, or improving relationships with others. Counsellors therefore focus on client choices in their life circumstances, as a basis for their work. Counsellors may practice within any of the therapeutic approaches listed here, using psychodynamic counselling, cognitive behavioural counselling, systemtic counselling and so on. However, most are influenced by humanistic, process-experiential and psychodynamic priniciples.

Other psychotherapies

The above list is by no mean comprehensive. Other types of therapy practised in the NHS include bibliotherapy, existential therapy, functional analytic therapy, humanistic therapy, process-experiential (client-centred) therapy, feminist therapy, personal construct therapy, art therapy, drama therapy, neuro-linguistic programming, solution-focused therapy, transactional analysis and group analysis. Further information about psychotherapy types can be obtained from the UK Council for Psychotherapy.

Self-help Groups

The power of self-help should not be underestimated in the treatment of anxiety disorders. Many people find it enormously comforting to attend a self-help group and in doing so, meet others experiencing similar difficulties.

Anxiety UK maintains a register of externally provided self help groups for members. Click here to view or click here to become a member.