Psychological Therapies – Plymouth Options (IAPT)

Scope

Plymouth Options is an IAPT (Improving Access to Psychological Therapies) Service.

Plymouth Options provides talking therapies to clients over 16 with a common mental health problem. Clients will need to be registered with a Plymouth GP.

What are our Aims?

To Improve access to early help support for people with common mental health problems in the community.
Providing support at the appropriate level for their needs. We work within the stepped care framework to identify appropriate therapy for need
NICE Pathway - Common mental health disorders in primary care - overview...
Promote wellness and prevent deterioration in problems

Out of scope

Under 16 year old's
People who are at current risk of suicide or recent suicide attempt which has left them unstable.
Self-harming that would require medical attention. To include clients who abuse alcohol and drugs who are unstable and live chaotic lives
People with a long standing problems or severe symptoms
People who have Anger problems without signs of anxiety and depression
People who have long term Psychological disorder/ long term emotional difficulties
People with complex or severe mental health diagnosis
People that have had little benefit from many different treatments over a long period of time
People that present as a risk to themselves or others
People who misuse alcohol or drugs and are living unstable
People who are receiving Psychological Therapy, i.e. counselling or therapy from another person/service

Assessment

Signs and Symptoms of common mental health disorders

Depression causes feelings of sadness, hopelessness, helplessness, and worthlessness, apathy and low self-esteem .You can also lose interest in things you used to enjoy and become quite tearful.

There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and complaining of various aches and pains. People with mild to moderate depression can also suffer with symptoms of anxiety.

Anxiety can present in many ways and there are different formats of Anxiety.

Generalised Anxiety Disorder is sometimes difficult to diagnose. Symptoms can often look like depression.

Symptoms may include:-

Worrying to an extent that it affects your daily life, job and social life.
You worry about all sorts of things and tend to think the worst which is extremely stressful and upsetting. You have felt worried nearly every day for at least six months and you can't seem to stop.

Simple Phobias or fears

A phobia is an overwhelming and exhausting fear of an object, place, situation, feeling or animal.

Phobias are more extreme than fears. They develop when a person has an exaggerated or unrealistic sense of danger about a situation or object.

If a phobia becomes very severe, a person may organise their life around avoiding the thing that's causing them anxiety. As well as restricting their day-to-day life, it can also cause them considerable distress.

Health Anxiety – worrying that simple health problems are serious problems often frequent trips to see the GP, or searching for explanations on the internet. Many people become involved in checking behaviour, for example checking moles, or marks, or feeling for lumps and ask people close to them to check as well. This in turn can increase physical symptoms of anxiety (such as an increased heart rate, chest pain or tightness in the chest, dizziness, blurred vision, confusion, dry mouth or sweating).

Obsessive Compulsive Disorder (OCD)

Obsession is a sudden thought, image or urge to do something this in turn causes feelings of anxiety. The Anxiety leads to a pattern of behaviour/compulsion which may bring temporary relief.

Some common obsessions that affect people with OCD include:

fear of deliberately harming yourself or others – for example, fear you may attack someone else, even though this type of behaviour disgusts you
fear of harming yourself or others by mistake or accident – for example, fear you may set the house on fire by accidentally leaving the cooker on
fear of contamination by disease, infection or an unpleasant substance a need for symmetry or orderliness – for example, you may feel the need to ensure all the tins or jars in the cupboard face the same way

Post-Traumatic Stress disorder (PTSD)

People who suffer flashbacks and, or nightmares to events that have been very stressful and traumatic. Sometimes this can start months or years after the event. Such events could include serious road accidents, violent personal assaults, witnessing violent death, incidents from serving in the Military, Hostage situations, or being involved in a natural disaster such as floods or earthquakes. Sometimes people with PTSD will have problems with Insomnia (trouble sleeping) and concentration.

Social Phobia

Social anxiety disorder (social phobia) is a persistent and overwhelming fear of social situations. It's one of the most common anxiety disorders.

Social anxiety disorder is much more than "shyness". It can be intense fear and anxiety over simple everyday activities, such as shopping or speaking on the phone.

Adults with social anxiety disorder may dread meeting strangers, talking in groups, working, eating or drinking with company, shopping etc.

Panic Disorder with or without Agoraphobia (which is a fear of being in situations where escape might be difficult, or help wouldn't be available if things go wrong)

Common Symptoms of Anxiety include

Feeling of losing control or going crazy
Heart palpitations (pounding) or chest pain
Feeling like you're going to pass out
Trouble breathing or choking sensation
Hyperventilation ( taking your breath in and out too quickly)
Hot flashes or chills
Trembling or shaking
Stomach upset

History and Examination

If a person has had symptoms for a long time and they seem complicated/complex it may be more appropriate for their GP to complete a written referral. The most appropriate service can be identified.

Red Flags

Plymouth Options does not operate an emergency or out of hours service. If you think you need urgent help either contact your GP or call 111, or attend your nearest Emergency Department in a crisis.

Referral

Plymouth Options does not operate an emergency or out of hours service. If you think you need urgent help either contact your GP or call 111, or attend your nearest Emergency Department in a crisis.

Referral Criteria

The primary diagnosis being Depression and /or Anxiety Disorders to include:

Generalised Anxiety Disorder
Simple phobia
Health Anxiety
Post Traumatic Stress Disorder
Obsessive compulsive Disorder
Social Phobia
Panic Disorder with or without agoraphobia

We also offer a Psycho-Sexual therapy service for individuals and or couples.

Supporting clients with sexual dysfunction.

Refer via e-Referrals service selection unless the person has had symptoms for a long time and they seem complicated/complex, in these cases it may be more appropriate for their GP to complete a written referral, so the most appropriate service can be identified.

Plymouth Options is a non-urgent service and do not offer crisis intervention.

Long-term Condition Self-Management Programme

GPs and patients can refer to Improving Lives Plymouth for patient support with any long-term physical or low level mental health condition. The service helps people to better manage their condition and to achieve a better quality of life.

Referral Instructions

For referral to Plymouth Options

e-Referral service selection
- Specialty: Mental Health
- Clinic type: Not otherwise specified
- Service: DRSS-Western-Mental Health-Adult- Devon CCG-15N