Is First Step right for me?

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    Is First Step right for me?

    "I feel that First Step has really helped me.  It has had a positive effect on my mental health"

    Please ask yourself the following questions.  If you feel that you are depressed or anxious, and answer NO to all of these questions, please speak to your GP or Practice Nurse who can refer you or use the link on the launch page to refer yourself.

    If you answer YES to any of these questions, First Step may not be the right service for you.  To prevent any delays to accessing services, please contact your GP to discuss before contacting us.

    • Are you currently seeing anyone from another mental health team? (For example the Community Mental Health Assessment and Recovery Team, the Crisis Team or Psychotherapy)
    • Are you looking for help for bipolar disorder, psychosis, schizophrenia or a personality disorder?
    • Are you hearing voices or seeing things that aren’t there?
    • Do you feel that you could be a risk of taking your own life?
    • Are you concerned about your memory in older age?
    • Are you under 18?
    • Are you dependent on drugs or alcohol?

    FREQUENTLY ASKED QUESTIONS

    Is it free?

    YES! First Step is an NHS service. It is free for adults aged 18 and above registered with a GP in Cumbria.

    How do I get help?

    You can either be referred to First Step from your GP, Practice Nurse or other health professionals who are part of the NHS Cumbria Partnership Foundation Trust

    OR

    You can refer yourself using the link on our launch page.

    What happens once I have referred?

    We will offer a brief initial assessment to explore whether the service is likely to be helpful for you. If you have referred yourself then you need to ring up a few days later to book your appointment.

    If we feel that you could benefit from input from First Step, we will discuss with you what we would recommend. Sometimes there may be more than one option and we will help you to decide what might work best for you.  We will write to your GP to inform them of this, and you will be placed on the waiting list.

    The waiting list will depend on the type of therapy that we agreed will be best for you, and the area you are in.  The practitioner that carries out your assessment can give you a better indication of this time scale. When you come to the top of the waiting list, we will write to you to offer you an appointment to start treatment.  Please be aware that if you have specific requirements for when you can be seen, you may wait a lot longer for an appointment.

    Do you offer specific bereavement or grief counselling?

    We do not offer specific grief or bereavement counselling. We can offer support with low mood/depression and/or anxiety which may be associated with loss.

    CRUSE bereavement care (www.cruse.org.uk) is a charity that offers bereavement counselling and they can be contacted on 0844 477 9400.

    Although it is typical after a bereavement to feel low in mood the book Overcoming Grief can be a useful starting point as well as the NHS website page on bereavement: http://www.nhs.uk/Livewell/bereavement/Pages/bereavement.aspx

    If you feel you are not coping after the death of a loved one, speak to your GP about the right help for you.

    Do you offer relationship advice and counselling?

    We are not qualified relationship counsellors however we can offer individual support to manage any common mental health problems such as anxiety disorders and/or depression which may be linked to your relationship. If it is relationship counselling you are looking for you can access this from RELATE the relationship people on 0300 100 1234 or visit their website at http://www.relate.org.uk/

    Do you work with drugs and alcohol misuse?

    We understand at times that people use drugs and alcohol as a coping strategy for their anxiety and/or depression. However we would recommend this is reduced before commencing treatment with First Step and we would need you to be able to attend appointments without the influence of any alcohol or drugs. If you would like help to address your drug or alcohol misuse there are specific services available such as UNITY, CADAS and ADDACTION. If you feel you would like help with your drug or alcohol misuse we would recommend that you discuss this further with your GP to find the right help for you.

    Will I be coming to you for a chat?

    No. First Step offers counselling, cognitive behavioural therapy (CBT) and guided self-help. These are focussed therapies that involve learning new skills to manage and reduce your symptoms of depression, anxiety or anger.

    Can you write me a letter regarding my housing/welfare benefits/court case?

    First Step is a service which is funded to provide interventions for common mental health problems such as mild to moderate anxiety and depression and therefore lack resources to offer this as part of the service. In addition we are not an occupational health service. Your GP may be able to offer a letter of support, but they may charge for this service. Alternatively you can speak with someone at the Citizens Advice Bureau or local benefits, housing or legal advice charities. See the main links page for further information.

    Would you visit me at home?

    We are a service which mainly provides appointments at GP surgeries and other community based settings. If you are unable to attend appointments in the community due to your anxiety or depression symptoms it may be that First Step isn’t the service for you and it would be beneficial to talk to your GP about this and what other options are available to you. If you would struggle to attend appointments due to physical health and mobility issues please discuss this with your GP. Sometimes therapy be successfully delivered over the phone if you find it difficult to attend appointments due to physical health problems. Please discuss this during your assessment appointment.

    Can you treat my autism/Aspergers?

    First Step can and do work with some people who have autism or Aspergers, but this is usually around their common mental health problem such as depression or anxiety disorders.  We cannot provide treatment for autism or Aspergers.  The learning disabilities team or the autism assessment service may be more beneficial to you. You can speak to your GP about this.

    Can you prescribe or change medication?

    No, we are not medical doctors and therefore we cannot prescribe any medication for you. You can contact your GP regarding any medication queries you have.

    Will I be seen immediately?

    No. First Step is a therapy service and therefore you will be placed on a waiting list until your treatment commences.  If you do not feel that you are able to wait for an appointment, we may not be the right service for you. You can discuss this with your GP.

    Do you offer pain management support?

    First Step provides interventions for people with depression and anxiety and although this may be a result of pain we do not work on the pain specifically. We can discuss other options with you however, such as the pain management clinic, Persistent Physical Symptoms Service and you can also speak to your GP for further information.

    Will my children get taken off me if I come for therapy?

    No. Having a common mental health problem does not mean that you are not able to look after your children, and we work successfully with many parents. Staff at First Step will be required to ask you questions about you and your children’s safety and whether you require any support in looking after your children. Staff will be required to liaise with relevant agencies if we have any concerns about your children’s safety.

    Will the information go in my medical records?

    We will share relevant information with other services involved in your care, including your GP so yes, some of the information will go into your medical records.  This will normally be in the form of a letter sent to you and copied to your GP both after your assessment and following discharge. We will summarise the problems you have been experiencing and the work we have done.

    How can talking help me to "stop worrying", "manage stress", "stop being anxious" or "manage depression"?

    Talking therapies are not just about talking.  They are about making changes to the way you think and the things you do.  We can help you to make links between these and show you strategies to help to reduce your symptoms of low mood and anxiety.  We cannot do this to you, so we will ask you to do some work in between our sessions to practice.

    Do you treat bipolar, schizophrenia, personality disorder, offending behaviour?

    No. First Step offers treatment to people with mild to moderate anxiety and depression. These types of difficulties tend to be more complex requiring longer term support. If you have a current diagnosis or have concerns about any of these mental health problems, please discuss this with your GP.

    Are you part of the Community Mental Health Team?

    First step is a separate team from the Community Mental Health Assessment and Recovery Team (CMHART). The CMHART work in a multidisciplinary way offering support for severe and enduring mental health problems. First Step is a service providing brief therapy for low to moderate common mental health problems and works in a different way to the CMHART; therefore we are not able to respond in the same manner or offer the same level as support as the CMHART.

    How many sessions can you offer?

    We offer brief psychological interventions (average of 6-8 sessions) in line with best practice guidance and we do not offer long term support.

    What happens if I can’t attend my appointment?

    Please call us (04524 455055) to let us know as soon as possible so that your appointment can be offered to someone else.  It is important to attend regular appointments, and so if you cancel several appointments, your practitioner will discuss this with you as now may not be the time for this type of work. If you do not let us know that you are not able to attend, we will write to you to ask you to contact us. If we do not hear from you in 7 days we will discharge you back to your GP.

    Will I see the same practitioner every time?

    Yes, we will try and ensure you see the same practitioner unless there are unforeseen circumstances (like practitioner sickness).  In this case, we will try to ensure we let you know as soon as possible, and we will try to offer you the option to see another practitioner as soon as a space is available.  We are a stepped care service which means we have different levels of therapy available. If your practitioner feels that a different therapy or practitioner may benefit you more, they will discuss this with you.

    Do you see people over 65?

    Yes. We have no upper age limit in First Step and regularly see people over 65. There is evidence that therapy works just as well with older people than it does for those under 65.  Depression and anxiety is not just part of getting older, and we can help you to cope with changes in life.

    Do you offer workshops?

    Yes, we currently have free workshops running in different parts of the county to help you to manage your stress, anxiety, low mood and sleep problems, without having to engage with traditional therapy. For more information see our page on our Ways To Wellbeing classes.

    I need an interpreter, can I access the service?

    Yes, we can arrange foreign language interpreters and sign language interpreters.  Please discuss this when you book your appointment, or ask your GP to refer you and request this.

    I have a learning disability, can I access the service?

    Yes, we can work with people who have mild learning disabilities. Please let us know at your assessment if you have difficulties with things like reading and writing so that we can make things easier for you.

    Are you an advice agency?

    We are not an advice agency like the Citizens Advice Bureau however we can signpost you to other organisations for advice on things like finances, debt, welfare benefits etc. There is further information and links available on the main Trust links page.

    Can I be forced to undertake therapy?

    No one can force you to engage with therapy, and you can ask to be discharged at any time. If you feel you are at risk from someone who is trying to force you to attend, you should discuss this with your practitioner as soon as possible so we can ensure you are kept safe. Therapy is only effective if you want to engage in it.

    Do you offer support for 'tough times'?

    It is normal after certain life events to experience low mood or anxiety. This can include things like a break up of a relationship, a loss of a job, or a bereavement. Therapy can’t make this go away, and in some cases can get in the way of a grieving process and hinder our own coping strategies.  Usually with time, we can start to accept changes, but if not, it could be that therapy is beneficial later on. It might be useful to discuss this with your GP.

    Similarly, sometimes after a traumatic event, we might find that we experience flashbacks, nightmares or anxiety. This is normal in the first few days or weeks, but it might help to speak to your GP in this time. If these symptoms don’t pass, you might find therapy helpful.