Cognitive Behaviour Therapy (CBT) is an approach that has been found to be helpful in treating depression and other mental health difficulties.
Mindfulness-Based Cognitive Therapy (MBCT) is a group-based course for people with a history of recurring depression.
Find out which treatments the National Institutes of Clinical Excellence currently recommends for depression.

AccEPT Clinic

The AccEPT (Accessing Evidence-based Psychological Therapies) Clinic specializes in delivering and developing new treatments for depression. Cognitive Behaviour Therapy (CBT) is an approach that has been found to be helpful in treating depression and other mental health difficulties. In the AccEPT service we offer several different forms of CBT, with a particular emphasis on new and promising versions.

When people are depressed, the way they see themselves and the way that they perceive situations can change. This change can lead to thinking and behaving in unhelpful ways and often leads to symptoms and distress persisting in a vicious circle. CBT can be used to break this circle.

In CBT the therapist works with the person to help them begin to identify and then change these unhelpful patterns of thinking and / or behaviour. By doing this, the result can be a significant improvement in how the person feels and lives their day to day life.

Therapy within the clinic is offered by a number of trained psychological therapy practitioners who are from a variety of professional backgrounds. Our practitioners all have specialist skills in the development, training and delivery of their approach.

You can find out more about CBT and how it works via the British Association for Behavioural Cognitive Psychotherapies website.

You can find out which treatments the National Institute for Clinical Excellence currently recommends for depression here. There are separate guidelines for depression, depression that co-occurs with chronic physical health problems, bipolar disorder and post-partum depression.

Assessment in the AccEPT Clinic

After an initial referral has been made to the clinic by a GP or other Mental Health Professional, If it is appropriate clients will be invited in for an assessment at the clinic discussion to discuss their main difficulties and any relevant history to decide on the best treatment option available to them.

Treatments in the AccEPT Clinic

The clinic is continuously developing and evaluating innovative treatments. As a result of this, the specific therapies offered by the clinic may change over time. Currently, we are offering the following therapies:

Group Behavioural Activation (BA) Therapy for Current Depression

We know that people become depressed for all sorts of reasons, but that once they are depressed, there are particular factors that can keep depression going. BA therapy seeks to change one of these factors.

Often people who are depressed have a pattern of acting and reacting to situations in ways that may keep their depression going. In the BA group we look at our patterns of acting and reacting and consider how this might make depression better or worse.

Then we look at ways to change these patterns, and how to engage in activities that feel meaningful and help depression to lift.

Later on in the group, we look at a particular pattern of thinking called 'rumination'. Rumination is when we keep thinking something over and over without moving on. It is usually something that we are unhappy or uncomfortable about. We look at how rumination happens and how it contributes to depressive illness, and we consider some alternatives ways of thinking and behaving.

In terms of practice, our BA groups involve weekly meetings for 10 weeks. The BA groups include about 10 people plus two facilitators. Group sessions are quite like workshops: We go through set material each week, and group members take home handout summaries of each session.

During group meetings there is large-group discussion and also discussion in small groups and in pairs. Each week group members are asked to practice new skills at home.

The BA group is different from some other group therapies because it is quite structured, and has a very ‘here and now’ focus. That is, it looks at group members’ difficulties in their day-to-day lives.

Rumination-focused Cognitive Behavioural Therapy Group (RfCBT) for relapse prevention and residual symptoms

Our rumination-focused group is designed to help people who have suffered from depression in the past reduce the likelihood of experiencing depression again. By “rumination” we mean repetitive thinking, where people go over and over things in their minds without really arriving at any way forward. Rumination is a normal behaviour and can be helpful if it helps people to arrive at solution to a problem or a plan. However, more often in depression it leads people to getting stuck and is associated with worsening distress. Ruminating for long periods prevents people from being able to move forward in a meaningful way. In this way, rumination can play a major role in maintaining depression and it can also contributing factor to it recurring.

The group aims to provide group members with an understanding about the role of rumination and how it can keep people vulnerable to relapsing in depression. It is more of a skill-based course, rather than a traditional therapy group. In our group the emphasis is upon learning new ways of responding to situations. Our group aims to provide group members with the knowledge and opportunity to try out and practice different approaches. 

During the course of the group we will look at triggers and early warning signs for distress and rumination so that group members can become more aware of their own individual pattern of lead up to rumination. By spotting the signs early on, people are more able to intervene in the process and hopefully will become able to prevent the negative spiral of rumination and low mood. We look at a range of techniques and skills that can be more helpful alternatives to rumination.  However, developing alternatives can be difficult. Rumination can become an established habit in depression and it takes practice to make lasting changes to how we respond.

There will be up to 10 people in the group with two group leaders and an assistant. The group will meet for 8 weeks, each meeting lasting 2 hours.  Everyone attending the group will have had some experience of depression. Group members will be given opportunity to meet as a group for an orientation session prior to starting the group so they can meet one another, discuss practicalities and go through some of this information.  We also ask group members to consider a personal goal that they would like to achieve by attending the group.

Mindfulness-based Cognitive Therapy (MBCT) for Recurrent Depression

MBCT has evolved from MBSR.  It includes information about depression as well as cognitive therapy-based exercises linking thinking and its resulting impact on feeling.  The group-based course is suitable for people with a history of recurrent depression (3 or more previous episodes of depression), who are currently well, wishing to learn tools and techniques focusing on prevention and learning how to take care of themselves.  People who have gone through an MBCT course say it can halt the downward spiral into depression.  They also describe how the course helped them to develop a more accepting relationship to bodily sensations, feelings and thoughts.  Finally, people say they value meeting other people in the group with whom they have a lot in common.

The course consists of an individual orientation session followed by eight weekly two and a ¼ hour sessions and follow-up sessions several months later. 

Participating in the mindfulness courses requires an on-going commitment.  Clients will be asked to attend all classes, and to practice daily home assignments for approximately 40 minutes per day.

You can find out more about MBCT and mindfulness approaches via these websites:

Mindfulness-based Stress Reduction (MBSR) for Stress associated with Other Conditions

MBSR is an 8 week course based on a form of mediation known as mindfulness for people who have medical conditions including chronic illness or pain.  In the context of health, mindfulness is way for patients to experientially learn to take better care of themselves by exploring and understanding the relationship between mind and body.  MBSR is suitable for people who are motivated to engage in learning tools and techniques to activate their inner resources for living with illness/pain.  The MBSR course is a well-established approach which has shown to help reduce symptoms across a wide range of medical diagnoses including chronic health conditions.

MBSR is also suitable for people wishing to learn techniques to manage stress who have experienced less than three episodes of depression previously and are currently well.

The course consists of a group orientation session followed by eight weekly two and a ¼ hour sessions and follow-up sessions several months later.

Participating in the mindfulness courses requires an on-going commitment.  Clients will be asked to attend all classes, and to practice daily home assignments for approximately 40 minutes per day.

The attached flyers provide more information about MBSR for GPs/referrers and patients:      

 Mindfulness Patient Q&A leaflet .

 Mindfulness GP Q&A leaflet . .

Behavioural Couples' Therapy

Behavioural Couples’ Therapy is a mode of therapy that has been found to be particularly helpful in treating depression when the person with the diagnosis of depression is in an ongoing partnership. In couples with high relationship satisfaction, for instance, employing their strengths while also modifying any less helpful interactions can powerfully address depression.  However, when relationship distress and dissatisfaction are present  this mode of therapy addresses the couple distress as well as the depression. Such distress itself   can influence and intensify the course of depression and also decrease the closeness and support that can help in its amelioration. By the same token, by helping the couple reverse their interactional cycle of distress the downward cycle of depression can be reversed.

  • Behavioural couples’ therapy works on changing the patterns of acting and thinking that occur between partners that may be reinforcing ideas and habits that are, themselves, contributing to the formation and maintenance of depression. We therefore analyze and rehearse new ways of communicating between partners. We work on devising collaborative problem solving.  We also teach skills for decreasing emotional reactivity to each other, as well as increasing mutual understanding.
  •  The sessions will teach skills in how to manage conflict within the couple; of how to listen to each other more effectively and how to communicate to each other with greater clarity and security.
  •  Concomitantly the sessions concentrate on educating both members of the couple in skills for recognizing vulnerable points between them that contribute to the downward spiral into depression; on teaching the couple how to activate positive interactional skills they have gained through the sessions; and on rehearsing, consolidating, and preparing for maintenance of these newly acquired positive behaviours.
  •  Changing the repertoire of interactional behaviours within the couple from those that contribute to  the downward spiral into depression into an upward one that draws on supportiveness and maintenance of positive experiences also entails work on changing cognitions around each other and respective behaviours
  •  Sessions typically include between six to twenty sessions, with built-in reviews every four to six sessions. Sessions last approximately an hour each

Perinatal Therapy – Group Interpersonal therapy for postnatal depression and Online Supported CBT for antenatal depression and postnatal depression

We offer a cognitive behavioural therapy programme for women experiencing depression antenatally and postnatally (up to one year post birth). This is an online CBT programme developed in conjunction with Netmums.

We understand how difficult accessing therapy can be for mothers with the demands of childcare and busy lives, therefore an online programme can offer flexibility and be completed at a mother’s own pace.

Following a face to face assessment women are provided with log in details to a secure website whereby they can complete a therapy programme. To assist women in overcoming their feeling of depression we offer a weekly telephone therapy support session for 12 sessions over a 17 week period, to ensure women get the most from the programme.

We also offer group therapy for postnatal depression, based on interpersonal psychotherapy.  The postnatal depression group runs for 10 weeks and aims to support and encourage women to overcome and manage their feelings of depression by placing an emphasis on their relationships. Interpersonal Psychotherapy is an effective and NICE recommended treatment for postnatal depression, it works by focusing on the development of strategies to reduce the symptoms of depression, improve relationships and strengthen social support networks.

The group consists of between 6-10 women and aims to be a supportive environment where women can share and gain skills in managing their depression.

Referrals

The AccEPT Clinic takes referrals from within the Exeter, Mid Devon and East Devon regions. Referrals from North Devon can also be made for the MBCT and MBSR groups.  Referrals are made via GPs and the local Well-Being and Access Service.

If you are a potential referrer to the AccEPT Clinic (i.e. a GP or Mental Health Professional) and would like more information you can email MDC-accept@exeter.ac.uk or telephone 01392 723493.

Download the client Referral form .

Download the client Referral form_North Devon . (MBCT and MBSR).