CNWL Talking Therapies

Maintaining
wellbeing
Workbook
 My appointments:

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My main learning points:

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My weekly challenge:

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Crisis numbers:
Out of Hours Urgent
Advice Line: 0800
0234 650
Samaritans: 116 123
 What does ‘maintaining wellbeing’
mean?
Well done for working through one or more of the
self-help guides and completing them. Now that you
have introduced positive changes into your life
(using the cognitive-behavioural techniques and
strategies) it is important to reflect and plan for the
future. This will ensure that the level of wellbeing
you are currently experiencing is maintained in a
healthy way and that you continue to make
progress.

Step 1: Summarising my difficulties

What triggers my problems?

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What keeps my problems going?

This could involve factors such as thoughts, behaviours, specific
situations or stresses.
Step 2: What have I Learnt

Now is a good opportunity to have a think about what you

have learned from the work you have done. Have a think
about some of the techniques or strategies in the self-help
guides that you have found useful and successful so you
can refer back to them in the future. Also think about some
of the things you have enjoyed doing or have found to have
the biggest impact on you feeling better.

What have I learned?

What did I enjoy?

What was useful?

What tools do I have?

Step 3: What have I found difficult

When we use Cognitive Behaviour Therapy it is likely that

the Journey is not always easy or smooth and there may
have been some areas that you have struggled with or
obstacles you have met. This is quite natural and it’s
helpful to think about these so we can continue to work on
them or consider the reasons for them. Make a list below
of anything you have found difficult or challenging. Can
you think why this might be?
 What have I found difficult?

What obstacles have there been?

Do I want to continue to work on any of these?

Step 4: Spotting and Tackling my Early Warning

Signs

It can be useful to think about the early warning signs that

will signal the start of the difficulties we experience. Try to
think of them in relation to your thoughts, emotions,
behaviours and physical sensations. Recognising them and
recording them is important for dealing with situations in the
future. An example might be withdrawing from social
situations or feeling unable to cope. There is space to
record your early warning signs on the next page.
In order to keep well, one useful skill can be to spot our
early warning signs and know how we can tackle them if
they come along. Below is a traffic light system where
Green is ‘early’ warning signs’, Amber is ‘Medium’ warning
signs and Red is ‘Late’ warning signs.
Green – my early warning signs are:

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I can tackle this by:

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Amber – my mid warning signs are:

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I can tackle this by:

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 Red – my later warning signs are:

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I can tackle this by:

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Step 5: How will I stay well and deal with set

backs

Most people experience situations or periods of life

where things feel much more difficult and stressful.
This is a normal part of living within a world where
we cannot always control what happens to and
around us.

During the early stages of our recovery, it can often

feel very difficult if we notice signs of the difficulties
creeping back in.

In order to increase our confidence with the new

skills and strategies we have learnt to manage
these difficulties, it is important to keep practicing
these regularly, to maintain all of the progress that
you have started to make.
Now you have a toolkit filled with useful evidence
based CBT techniques – Take some time to list those
that you have found helpful over the course of
treatment and would like to continue using to maintain
your progress.

My CBT Toolkit
 Step 6: Review time

It can be helpful to set aside some time on a regular

basis to review your progress - to take note of all of
your achievements, to problem solve any difficulties
that may arise, and to adjust your goals
accordingly.

Just as you have committed to regular treatment

sessions, it can be helpful to plan in some protected
time for a regular review so that this doesn’t get lost
in the comings and goings of day to day life.

My review time:

Day: .................................................................

Time: ................................................................

Questions to ask

 What has gone well?

 What hasn’t gone so well?
 What can I learn from this?
 Have I noticed any warning signs?
 What am I going to do over the next few weeks?
 Step 7: My goals

It is important for us to set goals in order to feel that we

have something to work towards and ensure that we are
making progress. An effective goal is one that is specific,
measurable, achievable, realistic and within a time-
frame. These are sometimes known as ‘SMART’ goals

At the start of your journey you set yourself some goals,

go back and revisit these goals and ask yourself the
following questions:
 Have I achieved them?
 How do I know?
 Do I need to carry on working on them?

In order for us to continue to make progress and practice

what we have learned so that we keep well, we need to
continue to use goals.

Fill in the table below making sure that you remember to

factor in what the goal is, how you are going to know
when you’ve achieved it, whether it is achievable and
when it has to be completed by.
 My short-term goals (in the next week)

1
2
3
My medium-term goals (in the next 6 weeks)

1
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3
My long-term goals (in the next 6-12 months)

1
2
3

Helpful resources
Self-help module packs: www.cci.health.wa.gov.au
Living Life to the Full: www.llttf.com
Relaxation resources: http://wellbeing-glasgow.org.uk/
Mental Health Self Help Guides : www.ntw.nhs.uk/pic/selfhelp/
 Continuing to make changes
Now that you have come this far it’s important to
continue with the progress you have made and here are
some tips to help you do that:
 Watch out for problem times
 Plan a regular review, although you may not have
an appointment with your PWP you can make an
appointment with yourself and think about how
things are for you, whether your mood is better or
worse, any changes you need to make, any
strategies you may need to put back in place.
 Make an emergency plan – what are you going to
do if things start to become difficult or go wrong.
What will your plan look like and how will you put
it in place.

Practice makes perfect

The more that you practice the techniques and
strategies you have learnt, the more you will be able to
cope and master your difficulties. You may prefer certain
techniques to others which is perfectly acceptable and
as you become expert at applying them, you will know
what works for you and what doesn’t in different
situations. Remember that it takes time and effort to
learn these techniques and they have been proven to
help individuals to manage and overcome symptoms of
anxiety and depression.

Overcoming setbacks

Experiencing setbacks is part of everyday life for

everyone. Good days and bad days are a feature of our
daily lives and it is important that we focus on coping
with them and not overreacting if things don’t go as
planned. It is extremely common for people to
experience fluctuations in their recovery which means
that you might feel as if you have reached a plateau, are
slipping backwards or are progressing faster than you
thought.

Overall, remember that a gradual improvement in your

ability to manage your symptoms is what you are
working towards. If you experience a setback, this is not
a failure but a normal part of the recovery process. Try to
view setbacks as learning opportunities which you can
use to help devise a new plan of how to tackle the
problem if it arises again.

Keeping track of your progress

Continue to use the self-help guides to refer back to and
fill in the diaries and record sheets to monitor your
progress. Reward yourself if you have succeeded with a
technique as if you were encouraging someone else to
learn a new skill. Don’t dwell on past difficulties, but
focus on what you have achieved, how much you have
progressed over time and the targets you are working
towards to overcoming your difficulties.

Helpful hints:
Remember the link between thoughts, behaviours,
emotions and physical sensations and how this
relates to you and the difficulties you are experiencing.
By learning to control your behaviours and thoughts, this
will have a positive impact on your mood and physical
symptoms.
Seek help from professionals or friends if you need
advice or support with something. Ensure you are
getting the right amount of sleep that you need. Try
not to get over-tired or take on too much.