Psychological Skills Service

• A trauma informed formulation that helps make sense of difficulties in the contect of what happened to you, how you made sense.
• Different types/ level of group and individual interventions. These aim to offer different intensities and different therapeutic approaches (phased approach/ rebuilding the brain from the bottom up)
• Transdiagnostic therapies. We provide therapy that helps you with the difficulty you have rather than categorise/ exclude by diagnosis.
• Supervision, training and teaching to staff in and outside CPFT on request

What is a formulation?

A psychological formulation attempts to make sense of your present difficulties in the context of your life history, recent events, and understandable survival strategies you have adopted that may help in the short-term but maintain your difficulties in the long term. It also acknowledges your strengths that can help you to address your difficulties.Please see resources section for an example template of what a formulation might look like from our service

The different types of therapy we provide:

Support work sessions (see leaflet in the resources section)

Therapeutic Support Workers provide support and assistance to individuals with complex trauma related mental health challenges. The role involves working closely with patients to help improve their well-being and quality of life.

Key aspects of a Therapeutic Support Worker's role:

• Support people in building skills when lack of skill is a contributing factor to their current difficulties e.g. support people who struggle to struggle to establish a manageable routine.
• Using therapeutic techniques and interventions to encourage positive behaviour and reduce negative behaviours.
• Supporting clients in developing social and life skills.
• Encouraging participation in activities that promote mental and physical health.
• Educating patients about coping strategies and available resources.
• Promoting available resources for additional support e.g., housing/financial 

The support work sessions are often the most important first step in your recovery.  Both the current guidelines recommending a phase based approach to the treatment of complex trauma (Herman, 1992) and the Neurosequential model (see resources) talk about the importance of helping you to regulate yourself and the environment before trying to make sense of what has happened.

Structured psychological skills teaching

In this intervention you will work with one of our team on a one to one basis and receive 8 sessions that based on your formulation we think would be most helpful for what you are struggling with. There are 8 sessions in total.

Your therapist will work through one of seven manuals (see descriptions below and leaflets in the resource section). These manuals focus on: anxiety management, managing low mood, how graded exposure can help you face fears; acceptance and commitment therapy, compassion focused therapy, coping with voices and understanding and coping with complex trauma.

We have developed these manuals within the service after researching the different ways in which trauma can effect people and different approaches that can help. You will get a copy of the manual. The person working with you will explain how strategies apply to specific situations you struggle with on a daily or weekly basis. For these strategies to be effective there will be work to do between sessions so that you can practice skills and test some of your fears. The person working with you might help you to try out some of these strategies in the sessions either in or outside of the office- depending on what your goals are.

Breakdown of psychological skills taught in the service (see leaflets)

1. Managing low mood - helping people to reduce the vicious cycle of depression by increasing activity levels.

2. Graded exposure - helping people who are unable to leave their homes due high anxiety, to be able to overcome and manage anxiety and get to places they have previously been avoiding.

3. Anxiety management - helping people learn strategies to cope with anxiety that interferes with daily life.

4. Coping with hearing voices - helping people to learn how to make experiences of voices feel less distressing and interfering in everyday life.

5. Acceptance and commitment therapy - helping people to live life more fully informed by their values, learning how to feel in control of their lives and even when feeling the inevitable difficult feelings that come with being alive

6. Understanding and coping with complex trauma - we also offer this as a group and a lot of people find the group is more helpful because it is reassuring and challenging to their sense of shame that other people experience similar difficulties

7. Compassion focused therapy (CFT) - learning ways to be more self-compassionate (kind, gentle, empathic, courageous), overcome shame, increase self-soothing skills and find ways of tackling an internal critic (a critical voice/bully that puts down everything that you do). CFT also helps people learn how to self soothe/ develop a soothing system that may be underdeveloped due to early experiences

8. Psychological therapy (10 sessions) - sometimes learning skills can be enough for a person to tackle problems and reach their goals. For other people we know that it is important to try and understand in more depth how these problems relate to earlier experiences and how or why certain difficulties link to together e.g. why do my early experiences mean I feel alert all the time, hate myself and hear voices that tell me I worthless. 

For some people making sense of and linking things together is needed for them to work towards goals.  If this is the case we offer psychological therapy.  If you are assigned to this type of therapy you will meet with a therapist who will review and breakdown your initial formulation, talk through what this means and how it links to your past and make a plan for therapy. 

They will use this to make a plan with you about what difficulties to tackle and in what order. They will base this on a psychological model which they will talk through with you so that you can understand why certain strategies are being recommended.  This therapy involves homework between sessions to be effective. In sessions because links between past and present are made this can be more painful or triggering of past memories and emotions than the skills sessions.  Although you won’t be asked to go into detail about any past traumas even the understanding that something traumatic that happened may link to now is often hard. The therapy will draw on the models described in the section on skills.

9. The sense-ability group (see leaflet in resources section) - we understand that there may be a variety of reasons why people have sensory problems (either being over or under sensitive to certain sensory cues) (see resources Developmental-Trauma-Close-Up-Revised-Jan-2020.pdf (beaconhouse.org.uk). This can be due to developmental trauma, natural temperament or neurodivergence.

We understand that if you struggle with the management or processing or sensory information life is more overwhelming. In light of this we have developed a face to face group that aims to help you build sensory awareness of yourself, others, and the environment, increase self control. You will learn to understand your senses and which of those might be hypersensitive or hypo sensitive. You will learn how to use this awareness to increase energy or help you feel calmer and more focused (depending on what you need at the time). This will help you improve your ability to pay attention to activities you want to, complete activities and mean you are better able to problem solve.

10. Trauma stabilisation group (12 sessions) - this is an online group programme providing information about what complex trauma is, how and why exposure to complex trauma impacts on many areas of development, strategies for how to cope and develop of more compassionate perspective on the difficulties you face.

11. Individual Occupational therapy - for people who are struggling more with understanding their sensory problems you will meet with one of our occupational therapists who will help you complete an assessment of your sensory profile and develop an understanding of your specific sensory processing difficulties. You will then learn some strategies of how to manage and adjust your home and working environment so that you can focus on what is important to you.

12. Schema therapy group - schemas are templates that we form about the world through are early experiences and are reinforced by how we interact with the world.  Early maladaptive schemas are formed when our core needs were not met (e.g. we did not have secure attachments to others, we were not able to be ourselves and have our own identity, we were not free to express emotions without negative consequences and we had an environment that was predictable, and had boundaries and realistic limits set).

Schema’s are thought to “sleep” in the background until they are woken up by a situation in the present that is similar to one in childhood.  If a schema is activated the past intrudes onto the present- so you feel the same painful emotions and strong beliefs that you did in the past.  In schema therapy we help you understand the templates that you developed and why situations in the past seem to trigger bigger emotions and reactions than you would expect.

In schema therapy we also talk about schema modes. Modes are what is seen in the present moment when a schema is activated.  Modes are like the different parts of ourselves/ different reactions that we have at once when something happens. 

Schema therapy talks about four types of modes;

1. Child modes (when you feel like you did as a child when needs were not met)
2. Critic modes (when you find yourself being either overly demanding or critical of yourself in the same way people were to you)
3. Coping modes (strategies you developed from a young age to block out emotions or avoid your templates being triggered)
4. Healthy adult mode (the part of ourselves that is aware of what is going on and why we are reacting in this way now and can consider the how we can make the most effective choices).  In schema therapy we try and help you develop the healthy adult mode through a range of exercises that help you to empathise with the modes, feel what it is like to receive a healthy adult mode and develop your own.

13. Trauma processing therapy - this is individual therapy focused on the reprocessing of trauma memories.  You and your therapist will identify specific memories that you think are stuck and need to be reprocessed.  These will be the memories related to the flashbacks, nightmares or problems you have which are understood as the past feeling like it is in the present.  You will not be processing all your trauma memories - just the ones that appear to be stuck and impacting on you now. 

You and your therapist will initially contract for 12 sessions. Using questionnaires and monitoring between and before sessions you and your therapist will continue to measure how helpful the therapy is in targeting your difficulties.  These measures are really important to understand anything that is getting in the way and what is working.

How do I refer?

All referrals from outside of CPFT come via the GP and our primary care mental health service

See information on how to refer below: 
Information for referrers.docx [docx] 69KB 
Guidelines for referrers for referrals for CPTSD.docx [docx] 868KB

Referrals from within CPFT (see table attached here) 

Most referrals are received electronically through S1. We do not take referrals by emails. We are aware that some of our referrers do not have S1. If this is the case please contact pssadmin@cpft.nhs.uk

Please see below document on how to make a referral on System 1. PSS - Making an Electronic Referral on SystmOne.docx [docx] 329KB

Assessment and monitoring

Watch an introduction to the CPTSD Guidelines here.
Overview of guidelines on CPTSD 2024 3 (1).pptx [pptx] 3MB
Differentiating between ALT TT and PSS 2.docx [docx] 964KB

Watch a film about differentiating between ACT, CFT, DBT and Schema : 
Differentiating between ACT, CFT, CBT, schema and DBT 1 (1).pptx [pptx] 2MB

Assessing a client’s suitability for CT-PTSD: Assessment video
 

 

 

Will I be seen online or in person?

Please note: PSS is both an online and face to face service. For some therapies there will be an option, for others it will only be available either online or face to face.

Where to park and are there parking charges?

Limited free parking at Chesterton Medical Centre. Peterborough clients should use the public car parks, or phone ahead for parking advice.

Is there access and support for patients and visitors with a disability?

Please ring the team before your appointment to discuss any requirements.

How to cancel your appointment

Please call and leave a message 01733 746811.

 

 

The effects of developmental trauma PSS poster.pdf [pdf] 1MB
PSS simplified powerpoint.pptx [pptx] 1MB
Occupational therapy and Sensory approaches in PSS.pptx [pptx] 4MB

Trauma body workshop part 1- What do we mean by trauma and how does it effect us.pptx [pptx] 8MB
Trauma body workshop part 2 - Understanding the link between trauma and chronic pain.pptx [pptx] 20MB
Trauma body workshop part 3 - Understanding the link between trauma and chronic fatigue.pptx [pptx] 10MB
Trauma body workshop part 4- Understanding the relationship between trauma and FND.pdf [pdf] 2MB
Trauma body workshop part 5- Other physical problems linked to trauma.pdf [pdf] 847KB
Trauma body workshop part 6 Top down approaches to treatment and where to find them.pptx [pptx] 17MB
Trauma body workshop part 7- Bottom up approaches and references.pdf [pdf] 4MB

Trauma Body workshop - film 1
Trauma Body workshop - film 2
Trauma Body workshop - film 3
Trauma Body workshop - film 4

Schema Group.pdf [pdf] 446KB
The effects of developmental trauma PSS poster.pdf [pdf] 1MB
Understanding and Coping with Trauma Group (1).pdf [pdf] 1003KB
Support Work.pdf [pdf] 1MB
Trauma Body Workshop.pdf [pdf] 288KB
Psychological Therapy - Complex Trauma.pdf [pdf] 998KB
Psychological Skills - Low Mood.pdf [pdf] 1MB
CFT Leaflet.pdf [pdf] 879KB
AIT Leaflet.pdf [pdf] 569KB
Psychological Skills - Anxiety.pdf [pdf] 266KB
Psychological Skills - Graded Exposure.pdf [pdf] 306KB
PSS simplified powerpoint.pptx [pptx] 1MB
The effects of developmental trauma PSS poster.pdf [pdf] 1MB
CFT for Voices.pdf [pdf] 631KB
Sense-Ability Group.pdf [pdf] 1MB

 

A carer is anyone, including children and adults who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid.

At Cambridgeshire and Peterborough NHS Foundation Trust, we value the often life-long support carers provide and recognise them as equal care partners. We want to offer as much guidance and reassurance as possible, to help you in your caring role. You can find general information and support for adult carers, young carers and parent carers by following this link.