We offer a range of psychological interventions for people aged 18 and above who have mild to moderate anxiety and depression.
Which patient groups are seen in this service?
We have a range of different staff working within Renew and when patients are referred to the service, we will match them with a member of staff to discuss your difficulties with. The therapist and patient will then be able to decide together which the most appropriate treatment option is for you.
The people who work in our team are:
Assistant Psychologists (APs)
Enhanced Psychological Practitioners (EPPs)
Mental Health Practitioners
Psychological Therapists
Clinical Associates in Applied Psychology (CAAPs)
Clinical/Counselling Psychologists
Patients accessing Renew may also be seen by trainees who are employed within the service. These staff are undertaking structured training with an accredited course and are under close supervision from senior staff within Renew.
Where are patients seen?
Appointments in Renew are offered by phone or online via Attend Anywhere. Following referral to the service a member of staff will call the patient for an initial triage appointment with the aim of determining the patients' difficulties, their suitability for a psychological intervention and to ascertain which intervention is most appropriate.
There are several treatment options in Renew, patients are allocated depending on their presenting difficulties to the appropriate intensity of intervention:
Guided self-help: An Enhanced Psychological Practitioner guides patients through a self-help manual via a video link. They will explain some of the ideas in the manual and help you to complete the activities
Silver Cloud: Is a programme which offers evidence based computerised cognitive behavioural interventions for a range of difficulties, including, low mood, anxiety, health anxiety, social anxiety, panic disorder. People using this programme can work through it themselves, or an assistant psychologist will arrange support appointments to help people work through the modules.
Enhanced Psychological Practice Intervention: This is a one to one intervention with an EPP which will be offered on line via video link. These interventions are usually offered to people whose difficulties are amenable to a very short term intervention. Types of difficulties which can be treated include, worry, panic, low mood and help with difficult thoughts.
Skills courses: Skills courses in Renew are generally offered over 7 to 10 weeks. They are 2 hours per week and are run by qualified staff in the service and supported by assistant psychologists. These courses are offered via video link and are an effective way to learn CBT skills. We offer skills courses which cover Anxiety, Low Mood, Healthy Self Esteem and Survive and Thrive – recovering from interpersonal trauma.
IESO:Cognitive Behavioural Therapy delivered is digitally individually to the paitent. Therapy is delivered via chat function at a regular appointed date and time. People see the same therapist on a weekly basis for evidence-based treatment. People can access this type of therapy for a range of difficulties. We often consider IESO for people who request therapy at more flexible times, like in the evenings or weekends.
One to one intervention with a CAAP or Clinical Psychologist: These interventions are delivered online via video link and work towards a clear goal identified at the start of therapy. The maximum number of sessions offered is 10 with a CAAP and 12 with a Clinical Psychologist. These sessions are offered to people who may have a combination of presenting problems or difficulties whose needs are not likely to be met within one of the other interventions.
Renew provides rapid assessment and intervention for mild to moderate anxiety or depression for people aged 18 and above.
Types of presentations commonly seen in Renew include but are not limited to; Depression, Generalised Anxiety Disorder, Health Anxiety, Panic Disorder, Post Traumatic Stress Disorder and Emotional Dysregulation. Treatments offered in Renew are time limited and are typically offered 8 to 12 sessions. Interventions offered vary in intensity and duration. These include digital guided self-help via SilverCloud, CBT skills courses and individual CBT interviews with either EPPs, Clinical Associates in Applied Psychology or Clinical Psychologists. Where Renew are not able to provide an intervention we will signpost or refer on to other appropriate organisations.
There is no multidisciplinary team in this service and so patients need to be able to tolerate the potential for a short wait between having an assessment and treatment starting. They also need to be able to tolerate the distress that can arise within sessions without a significant increase in risky behaviours.
Patients who have moderate or severe mental health problems and are seeking therapy should be referred to the Secondary Care Psychology Service.
For patients who require multidisciplinary support, for example assessment and diagnosis of mental health problems or advice on medication, then referrals should be made to BACMHS. There will continue to be psychology provision within the BACMHS which is part of the multidisciplinary treatment team. The psychology service provided within BACMHS is called CMHT psychology to distinguish it from Secondary Care Psychology.
The key criteria that psychologists will use when considering referrals to psychological services are as follows:
Age
Risk
Impact of functioning
Goals for treatment
Levels of distress
Psychological mindedness
Readiness for change
Presence of co-morbid physical or neurological problems
Significant problems with substance misuse
Recent period of psychological intervention
Substantial previous input from psychology
These criteria are described in more detail in our referral criteria guidelines.
Who to refer, who not to refer, how to refer
Who to refer
Referral criteria and routes:
18 years and over
Experiencing mild to moderate anxiety or depression
Able to commit to regular psychological therapy appointments
Referrals can be made via: GP, Health Visitor, Wellbeing Service, Midwifery, Borders Crisis Team, Community Mental Health Teams
Who not to refer
Exclusion Criteria for Psychological Services:
Co-morbid physical health or neurological problems
We do not accept referrals where the primary concern is adjustment to a physical health condition. Examples include long covid, diabetes, stroke, Huntingtons Disease, ABI etc. We also do not offer interventions where pain is the primary cause of a patient’s concerns.
We are unable to offer neuropsychological assessments for queries regarding cognitive functioning, memory problems and impacts of physical health conditions on mental health. The exception to our ability to offer neuropsychological assessments is where there is a query of a learning disability for CMHT patients.
Significant substance use that impacts on ability to engage in therapy
This is an exclusion criterion across all adult psychology services.
Although patients may have co-morbid substance use or problems with alcohol, where these are a significant coping strategy that will be exacerbated by psychological intervention then work on these issues may need to take place prior to psychological treatment commencing.
Bereavement, adjustments to life changes, e.g. job loss, relationship break-downs
We do not accept referrals where there is an adjustment to life changes taking place with no co-morbid mental health problem that requires treatment, exceptions may be complex grief responses.
Recent period of psychological intervention
In order to enable a consolidation period following a piece of work with psychology we usually recommend a break of at least six months before engaging in further psychological treatment.
Substantial previous input from psychology
When there is evidence that a patient is unlikely to make any further gains from psychology having had a number of previous psychological treatment episodes then this should be considered as an exclusion criterion. This also includes evidence that a patient is unable to maintain any gains made from therapy.
How to refer
SCI gateway
Primary care management
It’s helpful when:
Risk is indicated on the referral when it is present and any mitigations
Referrers are able to discuss with the patient what they are hoping to achieve from contact with the service, for example goals for therapy.
Patients understand that they may be referred to a range of psychological interventions within Renew.
Referrers include any previous mental health treatment or risk which may be important when triaging the referrals
Resources and links
Useful links and resources
Samaritans – this is a 24/7 listening service. People can contact them on 116 123.
Breathing Space – 0800 83 85 87 (evenings and weekends) is a free, confidential, phone service for anyone in Scotland over the age of 16, who is experiencing low mood, depression or anxiety. They can also be contacted if you are experiencing a crisis related to your mental health. www.breathingspacescotland.co.uk
Borders Carers Centre – contact for advice, information and guidance on what support is available to help you maintain your caring role. They continue to be available during COVID-19 on 01896 752431 https://www.borderscarerscentre.co.uk
NHS 24: Health information provided digitally or via the phone tel:111 or www.nhs24.scot
Living Life to the Full – Free online courses covering low mood, stress and resiliency. Work out why you feel as you do, how to tackle problems, build confidence, get going again, feel happier, stay calm, tackle upsetting thinking and more. The courses are free for individuals using them in their own lives. Access: Self-referral online for free. No need to contact GP
Distress Brief Intervention Borders
Silver Cloud – Emotional health is vital to living a balanced and productive life. These self-help programmes give you the skills to deal with everyday issues that affect your emotional health.
Daylight – Daylight is a science-backed, digital therapy for Anxiety and Worry, personalised to your needs – no prescriptions or doctors’ visits needed. Daylight was created by leading mental health experts using evidence-based techniques, in collaboration with creative storytellers such as Pixar – because we believe mental healthcare should not only be effective, but also positive and fun. Start with just a two-minute quiz to learn more about your Worry and Anxiety and how to manage it.
IESO Digital Health – Provides free, one to one therapy for people with common mental health problems such as depression and anxiety. Qualified therapists deliver live Cognitive Behaviour Therapy online through typed conversation in a secure virtual therapy room. You can access the session from anywhere you feel most comfortable and at a time to fit around your schedule, including evenings and weekends. Access to the service is quick and appointments are 30 or 60 minutes long. Your therapist will work closely with you to help you understand the links between what you do, think and feel, and can help you make changes in the way you think and the way you act which then affects the way you feel. Access: IESO individual therapy is one of the options we can discuss with you at your initial assessment appointment.
Borders Ref Help Toolkit
