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Fine-tuning skills for working with persistent worry problems at Step 2

Liz Ruth

2 May 2024


In the reporting year 2022/23 more than 240,000 people accessed NHS Talking Therapies services and received care only at Step 2 (NHS Digital. 2024); they received a Low Intensity psychological intervention (Saffran et al. 2021). Around 6% of the UK population live with symptoms of Generalised Anxiety Disorder (GAD), including persistent worry that impacts on their quality of life and daily functioning. There is good evidence that Low Intensity treatment interventions for Generalised Anxiety can achieve significant recovery outcomes that are similar to those achieved by High Intensity CBT (Wakefield et al. 2020.) and that effective Low Intensity worry management treatment can be delivered through a variety of communication modalities (Farrand et al. 2024.). Effective Low Intensity worry management interventions can range from pure bibliotherapy, through cCBT (Cumpanasoiu et al. 2023.) and group psychoeducation (Dolan et al. 2021) into a supported Low Intensity intervention that is delivered one to one (NHS Digital. 2024). 

Anecdotally, a multistrand ‘Worry Management’ intervention is one of the most-used treatment interventions delivered by PWPs in NHS Talking Therapies. This workshop will review the theoretical underpinnings of this intervention, consider potential barriers to patient engagement and successful outcome, and ensure that practitioners are refreshed on ‘why’, ‘how’ and ‘when’ worry management is the right treatment intervention to deliver.  

The event will be equivalent to 2.3/4hrs of CPD.


This workshop will include:
• An overview of persistent worry: symptoms and prevalence
• A background of treatment strategies, with an emphasis on the recommended Low Intensity CBT approach to worry
• Describing the stages of effective worry management in Low Intensity CBT
• Consideration of potential barriers to engagement and good outcomes, including contra-indications for this treatment strategy
• Adaptations to worry management and multistrand delivery

Learning Objectives

You will learn:
1. An understanding of worry and generalised anxiety
2. How to effectively deliver Low Intensity Worry Management treatment interventions
3. Key considerations that support effective adaptations to this treatment intervention

Training Modalities

Didactic content, Q&A, polls

Key References

1. Population Health, Clinical Audit and Specialist Care Team, NHS England. Lead Analyst: Elliot Broadhurst. NHS Talking Therapies, for anxiety and depression, Annual reports, 2022-23. Published by NHS Digital, part of the Government Statistical Service. Copyright © 2024, NHS England. URL:

2. Cumpanasoiu D, Enrique A, Palacios J, Duffy D, McNamara S, Richards D. Trajectories of Symptoms in Digital Interventions for Depression and Anxiety Using Routine Outcome Monitoring Data: Secondary Analysis Study. JMIR Mhealth Uhealth 2023;11:e41815. URL: DOI: 10.2196/41815

3. Farrand P, Raue PJ, Ward E, Repper D, Areán P. Use and Engagement With Low-Intensity Cognitive Behavioral Therapy Techniques Used Within an App to Support Worry Management: Content Analysis of Log Data. JMIR Mhealth and Uhealth. 2024 Jan;12:e47321. DOI: 10.2196/47321. PMID: 38029300; PMCID: PMC10809068.

4. The National Collaborating Centre for Mental Health. The Improving Access to Psychological Therapies Manual Version number: 6. First published: June 2018 Updated: February 2023

5. Shafran R, Myles-Hooton P, Bennett S, Öst LG. The concept and definition of low intensity cognitive behaviour therapy. Behav Res Ther. 2021 Mar;138:103803. doi: 10.1016/j.brat.2021.103803. Epub 2021 Jan 5. PMID: 33540242.

6. Small, F., & Lockwood, K. 2020. Chapter 15 Worry Management: A practical solution to a problem of hypotheticals. In Low Intensity CBT SKILLS & Interventions: A practitioner’s manual. Farand. P. (ed). Sage.

7. Wakefield, S., Kellett, S., Simmonds-Buckley, M., Stockton, D., Bradbury, A. and Delgadillo, J. (2021), Improving Access to Psychological Therapies (IAPT) in the United Kingdom: A systematic review and meta-analysis of 10-years of practice-based evidence. Br J Clin Psychol, 60: 1-37 e12259.

About the presenter

Liz Ruth is an Assistant Professor and Psychological Wellbeing Practitioner course leader at the University of Bradford. She trained as a Low Intensity Psychological Practitioner at the University of Sheffield in 2010 and practiced as a PWP, Senior and Lead PWP in IAPT for more than a decade before transitioning into education. Liz is an elected member of the Board of Trustees in the BABCP, and co-author of A Pragmatic Guide to Low Intensity Psychological Interventions: Care in High Volume (2023).

Who should attend

This event is suitable for anyone with an interest in effective Low Intensity CBT-Oriented interventions for persistent worry. The primary focus will be on working with adults in the NHS Talking Therapies environment, but the information and skills may be transferrable to other settings.

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.


The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

View Survey

This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS England Talking Therapies National PWP Leads Network

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