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Depression and Anxiety in long term medical conditions (LTCs): When and how to put the LTC at the heart of the formulation

Prof. Rona Moss-Morris

Tuesday 8 July 2025

Introduction

Around 30% of people with long-term physical health conditions (LTCs) experience comorbid anxiety and depression.  For many, comorbid anxiety and depression (or distress) is linked in part to difficulties adjusting to the challenges of the LTC. Based on the existing empirical literature, Professor Moss Morris and colleagues have developed a transdiagnostic model of adjustment to LTCs (TMA-LTC)1.  The model proposes that acute critical events or ongoing illness stressors can disrupt emotional equilibrium. Whether a person returns to equilibrium and achieves good psychological adjustment depends on a range of individual level cognitive and behavioural factors, as well as interpersonal, intrapersonal, environmental, and illness-specific contexts. This empirically and clinically informed model provides clinicians with a useful guide for assessment, formulation, and treatment in the context of psychological adjustment to LTCs.


The event will be equivalent to 5.1/2 hrs of CPD.

Content

The workshop will begin by eliciting any challenges the audiences may have had working with people with LTCs with co-morbid depression and anxiety to help confirm the agenda of the day. We will discuss the difference between a primary mental health disorder versus depression and anxiety (distress) linked to living with a LTC. A new transdiagnostic questionnaire to measure illness-related distress will be presented and how this can be used alongside more traditional measured of depression and anxiety will be discussed.

The transdiagnostic theoretical model of adjustment to LTCs (TMA-LTC) and therapeutic approach developed based on this model will be presented, alongside the evidence-base for this therapy to date. The next more interactive part of the workshop will discuss how to include LTC challenges in the assessment process and the application of the TMA-LTC to some case studies. The distinguishing features of treating LTC-related distress compared to treating primary anxiety and/or depression will be highlighted in each of these.

The afternoon will focus on specific aspects of the TMA-LTC treatment which depends on time and audience priorities may include managing uncertainty, engaging in good health behaviour and managing symptoms.

Learning Objectives

1. Discuss the difference between a primary mental health disorder and depression and/or anxiety linked to living with a LTC.
2. Describe the Transdiagnostic Model of Adjustment to LTCs (TMA-LTC).
3. Discuss the assessment and formulation relevant to LTC distress.
4. Discuss specific cognitive and behavioural methods relevant to adjustment to key LTC challenges, such as managing uncertainty, difficult symptoms and lifestyle changes.

Training Modalities

The workshop will include didactic content, Q&A, and experiential components.

Key References

Carroll S, Moon Z, Hudson J, Hulme K, Moss-Morris R. An Evidence-Based Theory of Psychological Adjustment to Long-Term Physical Health Conditions: Applications in Clinical Practice. Psychosomatic Medicine. 2022 Jun 1;84(5):547-559. doi: 10.1097/PSY.0000000000001076.

Hudson, J.L. & Moss-Morris, R. Treating Illness Distress in Chronic Illness. European Psychologist. 2019;24(1): 26-37. https://doi.org/10.1027/1016-9040/a000352.

Picariello F, Hulme K, Seaton N, Hudson JL, Norton S, Wroe A, Moss-Morris R. A randomized controlled trial of a digital cognitive-behavioral therapy program (COMPASS) for managing depression and anxiety related to living with a long-term physical health condition. Psychological Medicine. 2024 Jun;54(8):1796-1809. doi: 10.1017/S0033291723003756.3.

Sweeney L, 4. Windgassen S, Artom M, Norton C, Fawson S, Moss-Morris R. A Novel Digital Self-management Intervention for Symptoms of Fatigue, Pain, and Urgency in Inflammatory Bowel Disease: Describing the Process of Development. JMIR Form Res. 2022 May 18;6(5):e33001. doi: 10.2196/33001

About the presenter

Rona Moss-Morris is Professor of Psychology as Applied to Medicine at the Institute of Psychology, Psychiatry and Neuroscience, King’s College London. She has been researching psychological factors that affect symptom experience and adjusting to chronic medical conditions for the past 30 years. This research has been used to design cognitive behavioural interventions, including digital interventions, for a range of patient groups. Randomised controlled trials to test the clinical and cost effectiveness of these interventions form a key component of her research. More recently her work has turned towards implementation research.

In 2015 she was awarded the British Psychological Society Division of Health Psychology’s Outstanding Contribution to Research Award and in 2020 the British Psychological Society Distinguished Contribution to Practice Award. Her work on Multiple Sclerosis (MS) was awarded the MS Society Annual Award for MS Research of the Year in 2013 and her work on irritable bowel syndrome, the King’s Excellence in Innovation and Impact Award in 2019. She was National Advisor to NHS England for Improving Access to Psychological Therapies for People with Long Term and Medically Unexplained conditions from 2011-2016. She is a past editor of two international journals, Psychology and Health and Health Psychology Review.

Who should attend

This workshop is suitable for people who have at least some CBT training including both low and high intensity practitioners. The focus is on treating adults

Details coming soon

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