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Working with long term conditions and medically unexplained symptoms

Christopher Williams

23 May 2023


When short-term illnesses occur, there is a general expectation that someone will cut down or stop the activities they are doing, seek treatment, take that treatment, and then usually recover – taking up again the responsibilities they have stepped back from when poorly. This workshop will help attendees understand how these often helpful responses often change during times of long-term/chronic physical health problems and can become unhelpful. Using examples drawn from cardiac and respiratory settings, chronic tiredness, pain, arthritis, diabetes and stroke the session will cover a range of helpful and unhelpful ways of responding to illness, that can aid improvement, or cause worsening problems. Crucially, by gaining an understanding of the differences between disease, illness and sickness – the initial assessment and treatment goals can be focused on making changes that help people live their lives more fully.  Crucially, whether disease is present or not, there are a wide range of CBT-informed strategies that can make a difference.

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


• Key symptoms in common chronic conditions.
• How and why CBT-based approaches can help.
• A transdiagnostic model of CBT that incorporates living with physical conditions.
• Finding a language that engages.
• Three vicious cycles – and a virtuous cycle.
• Decision making when new symptoms arise.
• Making sense of symptoms when disease is absent.

Learning Objectives

• You will be able to create disorder-specific whole person assessments for seven chronic conditions.
• You will be able to focus in on six key targets for change so you can “see the wood from the trees” when presentations are complex.
• You will be able to communicate how certain patterns of illness response become either helpful or unhelpful.
• You will come away with a fresh understanding of the importance of systemic (relationship) factors in illness presentation and maintenance.

Training Modalities

Didactic slide-based presentation.
Self-reflective information gathering using self-practice and reflection using worksheets.
Q+A throughout.

Key References

Slow down and Be: using mindfulness every day to live life to the full. (2020). Williams, C., Wilson, S., Wilson, A. Five Areas Ltd: Glasgow.

Reclaim your life from illness, disability, pain or fatigue 2nd edition. (2019). Williams C. Five Areas Ltd: Glasgow.

Overcoming functional neurological symptoms: a five areas approach. (2011). Williams, C., Kent, C., Smith S., Carson A., Sharpe, M. and Cavanagh, J. Taylor and Francis/Routledge.

About the presenter

Dr Chris Williams is Emeritus Professor of Psychosocial Psychiatry at the University of Glasgow, Scotland, UK, a Fellow of the Royal College of Psychiatrists and Honorary Fellow of the British Association for Behavioural and Cognitive Psychotherapies. His main clinical and research interest is in the evaluation of educational self-help approaches based on the cognitive behavioural therapy (CBT) approach. He has twice been President of the British Association for Behavioural and Cognitive Psychotherapies – the lead body for CBT in the United Kingdom. He is a Patron of the charity Triumph over Phobia and a Medical adviser to Anxiety UK. Dr Williams is also Director of Five Areas Ltd which has developed a range of widely recommended wellbeing resources. He is an award-winning author and his books, classes and websites are widely used in the UK, Ireland, and North America.

Who should attend

The session covers topics of high relevance to clinicians who work with people living with long-term conditions including COPD, heart failure, arthritis, chronic pain, diabetes, chronic fatigue, stroke and long-covid. It is relevant to high intensity practitioners, and low intensity practitioners working with chronic illness who want to raise their understanding and clinical skills in working with these patient groups. This includes doctors, psychologists, general and psychiatric nurses, occupational therapists and physiotherapists, general practitioners and psychotherapists.

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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