The North London NHS Foundation Trust (NLFT, a merger of BEH and CANDI) NHS Talking Therapies has a long-term health conditions (LTC) pathway for adults with depression, anxiety and co-morbid LTCs.

Adapted cognitive-behavioural interventions are offered to treat depression and anxiety disorders associated with NLFT NHS Talking Therapies LTC pathway conditions. 

Interventions are time-limited, goal-focused and delivered by clinicians with specialist training in adapting cognitive behavioural therapy.

Eligibility Criteria

Inclusions

• adults (17.5 years and older) with:
  • anxiety disorders
  • depression
  • or primary insomnia at all levels of severity (mild, moderate, or severe) who wish to engage with a structured psychological intervention.
• problems with depression and anxiety that co-occur with specific long-term physical health conditions, as listed on the physical health problems page of NLFT NHS Talking Therapies website
• people who have EUPD traits or where the personality disorder problems are mild (e.g. the person has a historical diagnosis, but their presentation has since changed), if the focus of the work is around anxiety or depression.
• harmful or hazardous drinkers and/or recreational drug users presenting with anxiety or depression, if they are able to attend sessions on a regular basis and are motivated to limit/reduce their substance use and do not need additional support to reduce this.
• mild learning disabilities and/or are neurodiverse if the focus of the work is anxiety or depression and the person is able to engage with a structured psychological intervention.
• problems relating to anger may be seen in NHS TT if this is associated with anxiety or depression rather an underlying personality disorder.

Exclusions

• people requiring multi-disciplinary team (MDT) input/care coordination
• people who require secondary care (specialist) mental health services 
• people presenting with active suicidal risk or risk to others (they will generally be referred to Crisis Response Teams)
• people who are currently receiving talking therapy elsewhere
• people who have had previous treatment in the service
• those presenting with PTSD to multiple incidents of trauma (typically four or more)
• people with complex emotional needs and/or a current diagnosis of a personality disorder. This includes Emotionally Unstable Personality Disorder, sometimes referred to as borderline personality disorder (BPD)
• people with severe substance misuse problems (e.g. dependent alcohol problems) where that needs to be the focus of the intervention
• diagnostic criteria for an eating disorder
• diagnosis of bipolar disorder (exceptions apply)
• diagnosis of psychosis (exceptions apply)
• high medical risk is identified for adults with poor physical health management who require close medical monitoring or input due to risk of hospitalisation or rapid deterioration in their LTCs.
• notable frailty or high risk of falls is identified. 

How to Refer