The following guidelines may be useful:

1. Referral is better early than late.
   • Best of all is to identify the problems BEFORE staff absent themselves from work - many people have to feel really quite bad to reach the point of going off. To do this requires training of supervisory (promoted) staff.
   • It is better to refer after a week or two off work than after a month or two off - these problems are much more likely to be amenable to successful treatment early.
   • The problems, for both the individual and organisation, of prolonged absence are more likely to be avoided.
   
   
2. The first manifestations, especially with males, may be "somatic" (physical) rather than overtly "psychological".
   • For example, what are really panic attacks may seem to be "heart attacks" - with emergency admission to hospital followed by various negative investigations.
   • Spotting the psychological problems early also requires training of supervisory (promoted) staff.
   
   
3. Confidentiality must be assured and understood.

   To ensure staff are willing to be referred, it is important that they know just what may go into their records. Stress still carries a "stigma" for some people.

   We would generally agree with employer and with the person referred that we will:

   • Give outline information to the employer as to the nature of the problem and discuss any adjustment of duties with the employer that might help.
   • We would not divulge extensive personal information and would discuss with the person referred just what information may be passed on.
   • We get the patient's agreement before writing to any other parties (GP, medical specialists, etc).

1. We carry out an initial assessment and make a treatment plan
   • After the initial assessment, we should know the nature of problem and the number of sessions likely to be needed.
   • This is often about 6 sessions - by then progress or lack of progress should be evident. If more would be helpful, we revert in advance to the referrer for agreement.
   
   
2. The treatment approach is, broadly, a cognitive-behavioural approach.
   • Handouts are used to reinforce understanding and help with "homework" during treatment.
   
   
3. We favour a reasonably early return to work - for those who have gone off.
   • In returning to work, it often helps if employers can be flexible in terms of nature of duties for an initial period.
   • If you have an interest in this service please contact us.