version 15/11/2010
Mood Disorders Centre AccEPT Primary Care Psychological Therapies Service
Accessing Evidence-based Psychological Therapies: See www.centres.ex.ac.uk/mood/clinic
Referral form for group treatment for PTSD in individuals with depression
ACCEPT offers evidence-based and developing therapies to people experiencing severe and/or recurrent
depression as their primary presentation.
We are currently running a group treatment aimed at people who have survived psychological trauma and
experience PTSD and depression. Therefore, between January and March /early April 2015 we will be accepting
referrals for a limited number of places in this therapy group.
The group treatment combines elements of Cognitive Behavioural Therapy (CBT) and Interpersonal
Therapy (IPT). Both treatments are recommended by the NICE guidelines and we are adapting them for a group
setting and for individuals who experience PTSD in the context of (recurrent) depression.
The group will commence in mid April 2015 and run for approximately 5 months on a Wednesday morning.
Sessions will be on a weekly basis, with occasional “breaks” during which time participants will speak individually to
one of the therapists.
Your client may be appropriate for the group if he / she:
 Is aged 18 or over
 Has had a history of psychological trauma (e.g. such as being a victim of violent physical or sexual assault,
surviving a severe accident or natural disaster, being diagnosed with a life threatening illness, experiencing
the sudden death of a loved one, experiencing combat stress or political imprisonment)
 Had in the past month either:
o nightmares about it or thought about it when they did not want to, or
o tried hard not to think about it or avoided situations that reminded you of it, or
o were constantly on guard, watchful, or easily startled, or
o felt numb or detached from others, activities, or your surroundings?
The group is not suitable for people who:
 Have current substance dependence
 A primary diagnosis of a psychotic illness
 Have organic brain damage
 Engage in behaviour posing risk to self, staff or other patients which cannot be managed within the clinic
setting
 Are currently involved in psychotherapy or counselling
If you would like further information or to discuss whether the group might be suitable for your clients, please
contact the lead clinical supervisor, Dr Anke Karl, on 01392 725271or email: a.karl@exeter.ac.uk
All referrals will be assessed within 6 weeks of referral. A decision of whether this therapy would be
appropriate will be made in discussion with the person at the end of the assessment.
This group therapy is being run in addition to the standard therapies that we offer for people with severe or
recurrent depression. For information on these or to access the standard AccEPT referral form please see:
http://www.exeter.ac.uk/mooddisorders/acceptclinic/
Name
Male / Female
Address
DoB
Referrer
Date of referral
GP
GP Practice Name and address
Tel No:
Mobile no:
Please return form to:
Intake Coordinator ACCEPT Primary Care Psychological Treatment Service Mood Disorders Centre
School of Psychology University of Exeter Perry Road Exeter Devon EX4 4QG
Telephone; 01392 723493 email: mdc-accept@exeter.ac.uk www.centres.ex.ac.uk/mood
version 15/11/2010
Please provide as much information as possible including presenting problems, relevant psychological history, current
situation and clinical measures. If preferred attach referral letter.
Previously referred to AccEPT Yes
No
PHQ9 Score
GAD7 Score
Please return form to:
Intake Coordinator ACCEPT Primary Care Psychological Treatment Service Mood Disorders Centre
School of Psychology University of Exeter Perry Road Exeter Devon EX4 4QG
Telephone; 01392 723493 email: mdc-accept@exeter.ac.uk www.centres.ex.ac.uk/mood