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Cognitive Behavioural Therapy

Cognitive Behavioural Therapy (CBT) is a talking therapy that is used in the management of mental health. Occupational Health provides referrals to our CBT Psychotherapist via self or management referrals. Our service supports work-related and other issues and helps with common mental health-related problems such as anxiety, low mood and depression, work-based stress, low self-esteem, dealing with trauma, bereavement and loss, sleep issues and loss of confidence. These might be on-going issues that are causing distress or resulting from work or life events or issues including relationship problems, physical illness, loss, change or trauma. The service is available to all staff and PhD students at the University of St Andrews.

The CBT service in Occupational Health is intended as a short to medium term intervention. Typically you will be offered six sessions initially with an option to review after five sessions. At present our service provides support via Microsoft Teams and through phone consultations.

Q: What can I expect from a therapy session?

A: Therapy sessions are 50 minutes long. During the session you will typically agree with the therapist what you would like to cover and what your goals of therapy are. It is up to you what you disclose or choose not to disclose. Sometimes the therapist will provide tools and exercises as a framework for the session; other times it is more free-flow talking. Sometimes you might agree with the therapist to do some work outside of the session such as writing something, trying something new or recording thoughts and feelings.

Q: Is it confidential?

A: Everything you say during the session is treated by the therapist as confidential. The content of the discussion will not be repeated outside of the session and no reports are made back to your manager or colleagues about what you discuss. The therapist keeps a note of attendances and this is recorded in your Occupational Health record. The therapist also keeps clinical notes, which are confidential.

Q: What are the limits of confidentiality?

A: If you disclose to the therapist that you are at risk of serious harm, or another person is at risk of serious harm then the therapist will make your (or the other person’s) safety the focus and priority. The therapist will, in this case, help you to prepare a safety plan and reserves the right to alert third parties.

Q: Does CBT work? How does it work?

A: There is a body of evidence and research showing CBT to be effective in treating, managing and alleviating the distress of many mental health problems. CBT is, however, not a magic cure. It is a collaborative approach that involves the therapist and the client working together to understand and tackle distress. It works by helping the client to help themselves – by understanding and addressing patterns of their own thoughts and behaviour; their environment and relationships in order to feel, manage and cope better.

Q: Is CBT a sticking plaster?

A: The tools, techniques and approaches that you learn through CBT can have lasting impact and can often be applied to future situations and problems. However, they do need to be practiced. If you think of CBT as the equivalent of physical personal training – a personal trainer will give you the tools, techniques and approaches to help you get fit and stay fit but you need to keep using them in order to stay fit. Similarly, the on-going effectiveness of CBT requires a commitment to keep practicing.

Q: Could I take medication instead?

A: Some clients attending CBT sessions also take medication prescribed by their GP or specialist. CBT works to address underlying thoughts, behaviours and feelings and to manage and alleviate distress as it is occurring in the here and now. Clients often find that CBT approaches help them to feel more in control and able to deal with aspects of their life. You should discuss any plans to change your medication with your GP or specialist.

Q: Can I come back if something else happens, or I need further support?

A: Yes, you can refer back again to the service if you feel you could benefit from further support either with a recurring or new issue.

Q: Can you recommend any self-help tools I can use instead?


A: The University of St Andrews provides access to a self-directed online system called Silvercloud. You can use this for self-help purposes. Silvercloud provides a range of self-help programmes for mental health and well-being. The programmes are based on Cognitive Behavioural Therapy (CBT) approaches and cover issues such as anxiety, sleep, depression and coping with COVID. The programmes are free for use by staff of the University of St Andrews. You need to sign up, using your email address, to get access. Click here to sign up.