How does CBT for Long-Term Conditions work? page thumbnail

By Rajnish Virk

Hello all, I am a Cognitive Behavioural Therapist within Telford Wellbeing Service.  I’m going to tell you about a day in my life of working with clients who have anxiety and depression caused by long term health conditions – things such as fibromyalgia, respiratory conditions and arthritis, among others.  The people I work with have given me permission to share these pictures.

My day starts off with gettinga large waterbottle to my venue and setting up my desk. I place my emotional health questionnaire out for the client to do with tissues, as session can become emotional. I also set up my lap top, client notes etc. and water (it’s always good to have decent water intake for the brain to function well!). Once I am set up I check my notes about the client to update on what we will be working on in the session, and get any extra worksheets we need to work on out. Getting a good session plan in place is vital for CBT, and preparation is key. 

Then I see my first patient and so the day begins. 

a formI work with clients on techniques about how to better manage and have control over their health issues. We will raise awareness and normalise what they are going through, then we will practice techniques on how to manage these, via either cognitive work or behavioural work. Then near the end of the session we will set homework based on what has been discussed, and another appointment is booked to follow-up.

a mindmap in a notebookThis was some exploratory work I did with a client in relation to helping her understand what her health means to her and why she is finding it hard to accept. Once we identified her thoughts we were able to start to work on challenging these thoughts and the behaviours they created.

a worksheetThis is a vicious cycle I completed with a client to help them see how their physical health is affecting their mood and behaviour. Vicious cycles show that the more we get stuck in these patterns of thinking or behaviours, the more they are reinforced. We call this part of Cognitive Behavioural Therapy “Psychoeducation”.

Working with long term condition clients is very rewarding, as you get to see a client move from negative experiences in their life, which they believed they would never be able to get a handle on, to managing and looking at things in a different way. It also highlights how sometimes little changes such as self-care or viewing their health in a more helpful light can make healthy shifts in their mood state.  Living with Long-Term conditions can be incredibly hard at times, however that is what can be challenging and rewarding when working with clients who are in difficulty, and seeing them improve their lives. 


Rajnish Virk

Telford & Wrekin IAPT Contact Details

Phone numbers, fax and email


Telford & Wrekin IAPT,

Fuller House
Hall Court

Opening times:
Monday to Friday, 9am - 5pm (some evening appointments are available)

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