Bespoke Members
Introduction
Around one in three people in the UK live with a long-term physical health condition (LTC), and many experience associated distress, anxiety, or depression. For PWPs, supporting this client group can present unique challenges, particularly when physical health symptoms interact with low mood, fatigue, and reduced motivation.
This two-hour session will explore how evidence-based low-intensity CBT interventions can be adapted to meet the needs of people with LTCs. The training will cover practical strategies including behavioural activation, pacing, worry management, and cognitive restructuring, with an emphasis on understanding the LTC adjustment curve and recognising the emotional and behavioural impact of adapting to ongoing physical symptoms.
Attendees will learn how to support patients to explore their values, develop meaningful goals, and work towards greater acceptance of limitations while maintaining motivation and hope. The session will also introduce helpful frameworks and analogies such as COM-B, the Stress Bucket, and Spoon Theory to enhance psychoeducation and patient engagement. Overall, the focus will be on reflective, compassionate, and clinically grounded ways to help patients live well alongside their LTC.
The event will be equivalent to 2.3/4hrs of CPD.
Content
The session will cover:
1. Understanding the interaction between physical health, emotional wellbeing, and behaviour in people living with LTCs.
2. Introducing the LTC adjustment curve to help patients recognise and normalise their emotional responses to long-term conditions.
3. Applying behavioural activation and pacing strategies to manage fatigue, prevent “boom and bust” cycles, and promote sustainable activity patterns.
4. Integrating worry management techniques to address illness-related uncertainty, rumination, and fear of symptom fluctuation.
5. Adapting cognitive restructuring to reflect health-related thoughts and limitations while maintaining a compassionate, realistic stance.
6. Exploring patient values and using values-based goal setting to foster engagement, motivation, and meaning.
7. Discussing acceptance as a key aspect of adjustment and learning how to introduce this concept within a low-intensity framework.
8. Using models and analogies such as COM-B, the Stress Bucket, and Spoon Theory to support understanding and behaviour change.
9. Clinical reflections and practical examples to enhance confidence in delivering low-intensity work with LTC presentations.
Throughout, emphasis will be placed on reflective discussion, clinical application, and skill development to strengthen practitioners’ ability to adapt interventions sensitively and effectively.
Learning Objectives
By the end of this session, participants will be able to:
1. Understand the links between LTCs and psychological distress and deliver relevant psychoeducation.
2. Adapt low-intensity strategies including Behavioural Activation (BA), Worry Management (WM), and Cognitive Restructuring (CR) for patients with LTCs.
3. Apply the LTC adjustment curve, acceptance strategies, and explore patient goals and values to support adjustment.
4. Utilise models and analogies (e.g., COM-B, Spoon Theory, Stress Bucket) to enhance understanding and engagement.
5. Critically reflect on their own clinical practice to improve care for patients with LTCs.
Training Modalities
The workshop will include didactic content, Q&A, and experiential components.
Key References
Blakemore, A., Lockwood, K., & McGahey, S. (2024). Low-intensity CBT for people living with long-term conditions. In P. Farrand (Ed.), Low-intensity CBT skills and interventions: A practitioner’s manual (2nd ed.). Sage Publications Ltd. https://uk.sagepub.com/en-gb/eur/low-intensity-cbt-skills-and-interventions/book285643#contents
Gilbody, S., et al. (2024). Behavioural activation to mitigate the psychological impact of long-term conditions: A randomized controlled trial. The Lancet Healthy Longevity, 5(1), e1–e10. https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(23)00238-6/fulltext
Zainab, R., et al. (2023). Behavioural activation for comorbid depression in people with non-communicable diseases: A feasibility study. JMIR Research Protocols, 12(1), e41127. https://www.researchprotocols.org/2023/1/e41127/
Ronaldson, A., et al. (2025). Physical long-term conditions and the effectiveness of NHS Talking Therapies for working-age adults with mild to moderate depression or anxiety. BMJ Mental Health, 28(1), e301632. https://mentalhealth.bmj.com/content/28/1/e301632
Bennion, M., et al. (2025). Barriers and facilitators to engagement with between-session work in low-intensity CBT-based interventions: A qualitative study of UK Psychological Well-being Practitioners. BMC Psychiatry, 25(1), 1–10. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06501-3
Lainidi, O. (2025). Is behavioural activation cost-effective for depression in older adults with long-term conditions? National Elf Service. https://www.nationalelfservice.net/mental-health/depression/behavioural-activation-depression-older-adults/
About the presenter
Kirby Fabon:
Kirby Fabon is a Senior Psychological Wellbeing Practitioner at Oxfordshire Talking Therapies and leads the Step 2 LTC project, improving access for patients with long-term conditions. She is involved with the service LTC workgroup and collaborates with integrated care pathways across Oxfordshire, including diabetes, pulmonary, and cardiac rehabilitation teams.
A psychology graduate with an MSc in Health Psychology, Kirby brings lived experience of chronic pain and a strong interest in invisible LTC. Her master’s dissertation explored stigma among young women with fibromyalgia, reflecting her commitment to amplifying patient voices. Kirby has clinical experience in Oxford University Hospitals’ specialist surgery wards and Cirencester Hospital’s rehabilitation wards. She combines practical insight with evidence-based practice, compassion, and creativity to support patients, and she also volunteers for the Samaritans, demonstrating her wider dedication to mental health and wellbeing.
Michael Winiarski:
Michael Winiarski has been a Psychological Wellbeing Practitioner since 2022 and recently started as Lead PWP for the Oxford City locality. Part of this role involves the co-ordination of our LTC rehabilitation talks for pulmonary, cardiac and diabetes collaborating with local hospitals to ensure that those with a diagnosed LTC have a brief introduction to LICBT and how the tools can help them. Michael is also interested in working with the older adult population focussing on improving access and better outcomes for the older population.
Who should attend
This training is suitable for Psychological Wellbeing Practitioners (PWPs) working in primary care Talking Therapies services who wish to build confidence and competence in adapting low-intensity interventions for patients presenting with long-term conditions.