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Referral Criteria

What we help with

TalkingSpace Plus is an Improving Access to Psychological Therapies (IAPT) service part of Oxford Health NHS Foundation Trust.

We offer evidence-based psychological treatments to people experiencing common mental health problems such as depression or anxiety disorders, using a stepped care model.  

We also work with people who are experiencing difficulties or struggling to manage Long Term Health Condition(s).

Who we don't support

TalkingSpace Plus is unable to meet the needs of people who have severe and enduring mental health problems like Schizophrenia, Bipolar Disorder, Personality Disorders or Psychosis. 

Click here to see the Conditions we treat.

Accessing TalkingSpace Plus

In accordance to NICE Guidelines, most people accessing TalkingSpace Plus will be offered individual or group Cognitive Behavioural Therapy but we also routinely offer other psychological interventions such as Counselling for Depression, Mindfulness for Depression, Interpersonal Therapy (IPT), Behavioural Couples Therapy, Insomnia Support and Eye-Movement Desensitisation and Reprocessing Therapy (EMDR).

Any adult who is registered with a Oxfordshire GP surgery, can be referred to the service. We are able to accept referrals for 16-18 year olds who have been referred by CAMHS Spa.

Stepped Care Model

  • Identification; assessment; psychoeducation; active monitoring by primary health care professionals.
  • Depression, GAD, Insomnia, OCD, Health Anxiety, Social Anxiety, Panic Disorder, Agoraphobia, Specific Phobia.
  • Mild to moderate symptoms and/or where no previous CBT based treatment has been tried.
  • PTSD (single incidence), Depression, GAD, OCD, Health Anxiety, Social Anxiety, Panic Disorder, Agoraphobia, Specific Phobia.
  • Those that have not responded to step 2 interventions, and/or severe presentations with marked functional impairment.

Step 4 Psychological Services:

  • Complexity; several or frequent recurrences; multiple traumas; childhood abuse.
  • Poor response to other treatment, has had a treatment of CBT in the past (if appropriate).
  • Significant and sustained impact on daily functioning or relationships with others. 
  • History or continuing risk of moderate to severe harm to self or others.
  • Several mental health diagnoses or several different areas of difficulty.
  • Duration is greater than 12 months.

Adult Mental Healthcare Team (AMHT):

If a client is presenting with a high level of risk and/or requires a psychiatric assessment:

  • EMERGENCY – to be seen within 4 hours
  • URGENT – to be seen within 7 days (inclusive of weekends)
  • ROUTINE – to be seen within 28 days, for mental health assessment, psychiatric diagnoses or medication review.

IAPT Questionnaires

To measure depression symptoms, score ranges: 

0 – 4: normal

5 – 9: mild

10 – 14: moderate

15 – 19: moderately severe

20 – 27: severe

A score of 9 or above would be determined as in caseness for depressive symptoms.

To measure generalised anxiety symptoms, score ranges: 

0 – 4: normal

5 – 9: mild

10 – 14: moderate

15 – 21: severe

A score of 7 or above would be determined as in caseness for anxiety symptoms.

An additional measure can also be used to assess for GAD, the Penn State Worry questionnaire (short version) a score of 45 or above would indicate caseness. 

IAPT phobia scale for assessing avoidance due to fear of outlined situations (panic attacks, social situations, or specific situations such as driving, flying, heights, confined spaces, vomit, blood, animals, etc.)

0 – would not avoid

2 – slightly avoid

4 – definitely avoid

6 – markedly avoid

8 – always avoid

Work and social adjustment scale, assessing the impact on different areas of day-to-day activities due to experienced difficulties. This includes work, home management, social leisure activities, private leisure activities, family and relationships.

0 – would not avoid

2 – slightly avoid

4 – definitely avoid

6 – markedly avoid

8 – always avoid

Obsessive Compulsive Inventory, to measure symptoms of OCD, using the distress scale:

0 – not at all

1 – a little

2 – moderately

3 – a lot 

4 – extremely

A score of 40 or above would indicate symptoms of OCD. 

Health Anxiety Inventory (short version), to measure symptoms of health anxiety. Each question consists of 4 statements, with the patient choosing which statement best fits with their feelings over the last week. 

A score of 18 or above would indicate symptoms of health anxiety. 

Social Phobia Inventory, to measure symptoms of social anxiety, using the following scale:

0 – not at all bothered

1 – a little bothered

2 – moderately bothered

3 – bothered a lot

4 – extremely bothered

A score of 19 or above would indicate symptoms of social anxiety. 

Mobility Inventory, to measure symptoms of agoraphobia, using the following scale:

1 – never avoid

2 – rarely avoid

3 – avoid about half of the time

4 – avoid most of the time

5 – avoid always

A score of 60 or above would indicate symptoms of agoraphobia. 

Panic Disorder Severity Scale, to measure symptoms of panic disorder, using the following scale:

0 – none

1 – mild

2 – moderate

3 – severe

4 – extreme

A score of 8 or above would indicate symptoms of panic disorder. 

Impact of Events Scale – Revised (IES-R), to measure for symptoms of PTSD, using the following scale:

0 – not at all bothered / distressed 

1 – a little 

2 – moderately

3 – quite a bit 

4 – extremely bothered / distressed

A score of 33 or above would indicate symptoms of PTSD. 

Problems with alcohol or drug use

  • The client can attend sessions and is motivated to limit their drug or alcohol use. This is demonstrated by control of their drug or alcohol use and / or when it is limited to clearly circumscribed contexts.
  • The client is stable, i.e. using medication as prescribed and not using additional non-prescribed medication or illicit drugs. This would include clients on opioid substitution programmes (usually methadone or buprenorphine). No one should be excluded from IAPT services because they are being prescribed substitute medication.
  • The client has a history of drug or alcohol use but is now abstinent.
  • The client is dependent on illicit drugs or alcohol and not in contact with a treatment service. These clients would be likely to benefit from referral to a drug and alcohol treatment agency for specialist assessment and a care plan that targets their substance use http://wellbeing.turning-point.co.uk/oxfordshire/
  • The client is in treatment with a drug or alcohol treatment service but unable to make changes in their substance use because of mental health issues. In such cases, standard key working in the addictions service would continue to work on these issues until some stability is achieved.
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