Enabling Occupational Therapists to use a CBT Approach

Christine Samuel, Occupational Therapy Clinical Lead, Rheumatology

Swansea Bay University Health Board


Emotional problems such as low mood and anxiety can impact on quality of life and influence people’s coping strategies with physical conditions. CBT (Cognitive Behavioural Therapy) is the leading evidence based “talking therapy”. It focuses on how thoughts, beliefs and attitudes affect feelings and behaviour, and teaches coping skills for dealing with different problems. Improving Occupational Therapy interventions using a CBT approach, can lead to better patient outcomes.

CBT is frequently delivered via group sessions (allowing more patients to be seen). However, individual face to face sessions may be more appropriate for some patients but waiting times can be significantly longer. Trained occupational therapists, with skills to offer a CBT approach as part of the patient’s treatment plan, could be more prudent by being timelier and ensure continuity of care. Patients requiring more specialist mental health interventions are identified and referred on to the appropriate service.

Project Aims

Photo of occupational therapists attending  the training programme


The first wave of Covid 19 occurred weeks after the initial training date and resulted in the majority of the therapists being redeployed to hospital wards to assist with rehabilitation and discharge planning. Therefore, they were unable to practice the CBT skills. Many of the therapists did not return to their substantive posts until the summer of 2020.

The second training date was delayed from March to November 2020. Following this, several therapists were redeployed with the second wave of Covid 19. Despite all these delays and setbacks, therapists have been able to practice the skills but not as consistently as planned.

It was planned that all of the training would be held face to face, but due to the pandemic we had to switch to virtual training. Initially this was challenging but the feedback from the sessions was that the quality of the training was not affected.

Woman speaker attending the CBT training online

Key Outcomes

Photo of attendees attending the online training

Therapists’ feedback

“I found the use of the hot cross bun model allowed the patient to become engaged and activated. She was able to generate her own reasoning into how her emotions/thoughts was impacting her physical symptoms and then behaviour.”

“The knowledge gained during the CBT training enabled me to explore issues raised in more depth than I might have previously done so e.g. using Socratic questioning.”

Trainers’ feedback

“This group of trainees have worked so hard and been so adaptable, not letting a pandemic get in the way of their learning. They have had to adapt to a changing course, and changed delivery methods. The patients and families that have been helped and continue to be helped with these new skills are evidence of this hard work.”

Next Steps

Our Exemplar Experience

Taking part in Bevan Exemplar scheme has been a really valuable experience and one which I would recommend to others. Highlights have included the opportunity to network with professionals from different part of Wales and to attend workshops le by renowned experts.

Bevan Exemplar Showcase 2021



With Thanks

I am extremely grateful to the Bevan Legacy Fund, Neath Port Talbot Hospital for funding this training.

Also to Kathy Burn (Former CBT lead St Christopher’s Hospice TCH, and supervisor King’s College London) for leading the inspirational training.