Psychological Skills Service

• A trauma informed formulation that helps make sense of difficulties in the context of what happened to you, how you made sense.
• Different types/ level of group and individual interventions. These aim to offer different intensities and different therapeutic approaches (phased approach/ rebuilding the brain from the bottom up)
• Transdiagnostic therapies. We provide therapy that helps you with the difficulty you have rather than categorise/ exclude by diagnosis.
• Supervision, training and teaching to staff in and outside CPFT on request

What is a formulation?

When you are referred to our service you will initially get an email asking you to opt in to a formulation appointment. 

A psychological formulation attempts to make sense of your present difficulties in the context of your life history, recent events, and understandable survival strategies you have adopted that may help in the short-term but maintain your difficulties in the long term. It also acknowledges your strengths that can help you to address your difficulties.

Before your formulation you will be sent a link with three questionnaires  which have been chosen to think about the wider stressors and your quality of life and help us plan interventions that will be most helpful.

A psychological formulation tries to make some sense of why you are struggling and inform the specific approach or intervention that is going to be most beneficial to you right now. We spend some time really trying to understand your difficulties and how they affect you. This means asking you what these difficulties look like day to day and when they are manageable or at their worst.

We will try and understand why these difficulties developed. What has happened to you and how might this have affected you (taking into account your own temperament, cognitive and emotional style and age). We think about how you have coped/ survived until now and how these strategies have helped you but may have limited you.
We also think about recent events/ pressures that may have meant that the resources you had are not enough for what you are trying to cope with right now. 

It also acknowledges your strengths that can help you to address your difficulties. We also ask you to think about where you want to get to (your goals) and what you have tried before. Knowing your goals tells us where you want to get to which helps us choose the right intervention. Knowing what hasn’t worked stops us from recommending something unhelpful. We might recommend an intervention from our service or from another service that offers a different approach that we think could be helpful. Depending on the service we can make a referral or explain how you might do this.

Interventions in PSS

1. Therapeutic support work  is targeted at the following areas:

Finding out if you need more support  – this may involve a short screening appointment to explore your current needs and readiness for therapy. We’ll work with you to create a personalised “passport for therapy” and help you access any immediate support services that could stabilise things before starting psychological work

Supporting you to get the most out of trauma-focused group therapy   – if you’re attending a trauma group, support work can help you engage more fully. This might include meeting between sessions to practice skills, revisit key ideas, and adapt materials so they feel more relevant and manageable for you

Supporting you in the coping with senses group  – if you’re part of this group, support work can help reinforce the strategies you’re learning. We’ll offer extra sessions to practise sensory regulation techniques and provide adapted resources if needed, especially if you find it hard to take in or apply the group content.

Helping you reclaim your life through meaningful activity and connection  – we’ll support you to identify activities that matter to you and set achievable goals. Using approaches like behavioural activation and graded exposure, we’ll help you gradually reconnect with life, build confidence, and manage emotional distress using tools like distress tolerance and problem-solving.

Getting practical help with social stressors  – if things like housing, finances, or work are getting in the way, we can help you explore and access services that offer support. We’ll also work with you to build skills for managing stress and overcoming avoidance, so you feel more able to take steps forward.

This support is designed to help you build your psychological and sensory toolkit, overcome barriers to therapy, and feel safer and more stable – whether you're preparing for therapy, attending groups, or stepping down from more intensive support.

2. Brief psychological therapy

Rationale

Many people feel distressed when they can't make sense of their difficulties especially the “why” and “why now.” This confusion can make it hard to know what might help. 

Complex trauma  refers to repeated adverse experiences during childhood – especially when caregivers are unavailable to provide safety and comfort. These experiences differ from person to person, depending on how their brain responds to stress and overwhelm. 

Complex trauma in childhood affects brain development.This can lead to being stuck in “threat mode”, a fragmented or negative sense of worth and identity, difficulties in emotional regulation, sensory and cognitive processing and strong negative views about self and others. Because trauma interacts with many personal and environmental factors, its effects vary widely. While some people meet criteria for diagnoses like CPTSD, many do not.

Many people present with confusing/ less obvious symptoms – like unexplained physical reactions, critical inner voices, intense emotional responses, or relationship patterns where their needs are overlooked.

S urvivors often develop coping strategies that were necessary at the time but now contribute to emotional suppression, hypersensitivity, and overworking. Because trauma often involves caregivers, it also impacts how people relate to others, shaping negative relationship templates.  

When people can’t make sense of their experiences, it often leads to shame, confusion, and withdrawal. This is especially true when their childhood didn’t involve overt abuse but included emotional neglect, conditional love, or a lack of belonging – experiences we now understand to be deeply harmful.

What is involved (2 parts)? 

This therapy is typically offered over up to 10 sessions, and is divided into two main parts:

Sense making (around 4 sessions)  
In this first phase, you and your therapist will work together to explore how your current difficulties may be connected to past experiences, especially those that were overwhelming or traumatic. Many people find that the ways they learned to cope in the past – strategies that helped them survive – are now causing distress or no longer working well.

This part of therapy has two main purposes:

• To help you make sense of your current struggles, by understanding how your past has shaped your thoughts, feelings, and behaviours.
• To figure out what kind of therapeutic approach will best support you now, based on your needs and circumstances.  Therapists may draw on Cognitive behavioural therapy,

We also use this time to gently explore whether you feel ready to begin making changes and think about what kind of therapeutic approach might be right for you. It has to be a therapy that fits with how you think and that you have the space and energy for.

Talking about how your past has affected you, recognising patterns you’ve been stuck in, and trying new ways of responding can bring up big emotions. It’s important that you feel able to manage these emotional reactions and that you’re not overwhelmed by external stressors in your life.

Making sure this is the right time for therapy

Even if you’re highly motivated, we want to make sure the timing and type of therapy are right for you. During the four sessions we will explore different ideas and strategies to see how they work for you.  We will also get you to try and put some of these into practice and keep a record of how this went and/ or other things we think could be helpful to look more closely at. At the end of these four sessions we can talk about what approach might be best for you

Sometimes, this phase alone can bring clarity, validation, and a sense of relief. For others, it lays the foundation for the next stage of therapy. 

Review and next steps 

 At the end of the making sense period, we’ll review your experience and ability to use the strategies in and out of sessions, your goals and scores on outcome measures and use this to talk about what comes next. This might include continuing with a similar approach and making more active changes, further support, referrals to other services, or signposting to helpful community resources.

Making changes (up to 8 sessions) 

If you and your therapist decide to continue, this phase focuses on actively making changes in your life. This might include:

• Challenging long-held beliefs about yourself.
• Trying new behaviours or ways of relating to others.
• Building relationships or engaging in activities that matter to you.
• Responding differently to situations that previously felt overwhelming.

These changes can stir up strong emotions, which is why the sense-making phase is so important in preparing you for this work. You’ll set goals that focus on what you can do, rather than just how you want to feel, and you’ll practice new skills between sessions to help you move toward a life that feels more aligned with your values. 

Review and next steps

At the end of BPT, we’ll review your progress and talk about what comes next. This might include further support, referrals to other services, or signposting to helpful community resources.

3. The Understanding and coping with trauma group  is an eight-week online programme designed to help individuals make sense of the impact of trauma and develop practical, compassionate coping strategies. Each session focuses on building awareness of trauma responses, learning grounding and emotional regulation techniques, and exploring tools such as the window of tolerance, reality orientation, and compassionate self-practices. The group provides a safe and supportive environment with clear boundaries, complemented by individual pre- and post-group appointments to personalise goals and ensure continuity of care. By the end of the programme, participants will have a tailored recovery plan and a toolkit of strategies to support ongoing healing and resilience.

4. The coping through my senses group  is a face to face group aims to help you build sensory awareness of yourself, others, and the environment, increase self control.  You will learn to understand your senses and which of those might be hypersensitive or hypo sensitive.  You will learn how to use this awareness to increase energy or help you feel calmer and more focused (depending on what you need at the time). This will help you improve your ability to pay attention to activities you want to, complete activities and mean you are better able to problem solve

5. Individual occupational therapy – you will meet with one of our occupational therapists who will help you complete an assessment of your sensory profile and develop an understanding of your specific sensory processing difficulties. You will then learn some strategies to manage difficulties in sensory modulation.

6. The Group Schema Therapy Programme  is designed for people whose current difficulties stem from adverse childhood or attachment experiences. It focuses on identifying and changing deeply ingrained patterns of thinking, feeling, and behaving – known as schemas – that developed when core emotional needs were unmet in early life. These schemas, while once protective, often become rigid and maladaptive in adulthood, contributing to issues such as anxiety, depression, emotional dysregulation, and relationship problems.

The programme consists of 24 weekly online group sessions, complemented by individual sessions focusing on formulation and reinforcement of experiential strategies. GST combines cognitive, behavioural, and emotion-focused techniques to help participants understand their schemas, connect with unmet needs, and develop healthier coping strategies. Through experiential exercises like imagery and role play, the group setting provides a safe space to explore how schemas are triggered in relationships and to practice new ways of relating. The ultimate goal is to strengthen the “Healthy Adult” mode – enabling participants to meet their emotional needs, build balanced relationships, and make conscious choices for their wellbeing.

7. Trauma processing therapy – this is individual therapy focused on the reprocessing of trauma memories that are directly linked to the intrusive symptoms you have as part of CPTSD.You and your therapist will identify specific memories that you think are stuck and need to be reprocessed.These will be the memories related to the flashbacks, nightmares or problems you have which are understood as the past feeling like it is in the present.You will not be processing all your trauma memories just the ones that appear to be stuck and impacting on you now.You and your therapist will initially contract for 12 sessions.Using questionnaires and monitoring between and before sessions you and your therapist will continue to measure how helpful the therapy is in targeting your difficulties.These measures are really important to understand anything that is getting in the way and what is working. 

Trauma processing requires you to relive memories using different techniques. To ensure that you can benefit from the therapy and be able to flexibly visit the past and return to the present you will have needed to have completed the trauma stabilization group before starting this therapy (see above).  The group provides you with psychoeducation and resources that essential for looking at memories of developmental trauma.

How do I refer?

All referrals from outside of CPFT come via the GP and our primary care mental health service

See information on how to refer below: 
Information for referrers.docx [docx] 69KB 
Guidelines for referrers for referrals for CPTSD.docx [docx] 868KB
PSS - a brief overview.docx [docx] 28KB

Referrals from within CPFT (see table attached here) 

Most referrals are received electronically through S1. We do not take referrals by emails. We are aware that some of our referrers do not have S1. If this is the case please contact pssadmin@cpft.nhs.uk

Please see below document on how to make a referral on System 1. PSS - Making an Electronic Referral on SystmOne.docx [docx] 329KB

Assessment and monitoring

Watch an introduction to the CPTSD Guidelines here.
Overview of guidelines on CPTSD 2024 3 (1).pptx [pptx] 3MB
Differentiating between ALT TT and PSS 2.docx [docx] 964KB

Watch a film about differentiating between ACT, CFT, DBT and Schema : 
Differentiating between ACT, CFT, CBT, schema and DBT 1 (1).pptx [pptx] 2MB

Assessing a client’s suitability for CT-PTSD: Assessment video
 

 

 

Will I be seen online or in person?

Please note: PSS is both an online and face to face service. For some therapies there will be an option, for others it will only be available either online or face to face.

Where to park and are there parking charges?

Limited free parking at Chesterton Medical Centre. Peterborough clients should use the public car parks, or phone ahead for parking advice.

Is there access and support for patients and visitors with a disability?

Please ring the team before your appointment to discuss any requirements.

How to cancel your appointment

Please call and leave a message 01733 746811.

 

 

The effects of developmental trauma PSS poster.pdf [pdf] 1MB
PSS simplified powerpoint.pptx [pptx] 1MB
Occupational therapy and Sensory approaches in PSS.pptx [pptx] 4MB

Trauma body workshop part 1- What do we mean by trauma and how does it effect us.pptx [pptx] 8MB
Trauma body workshop part 2 - Understanding the link between trauma and chronic pain.pptx [pptx] 20MB
Trauma body workshop part 3 - Understanding the link between trauma and chronic fatigue.pptx [pptx] 10MB
Trauma body workshop part 4- Understanding the relationship between trauma and FND.pdf [pdf] 2MB
Trauma body workshop part 5- Other physical problems linked to trauma.pdf [pdf] 847KB
Trauma body workshop part 6 Top down approaches to treatment and where to find them.pptx [pptx] 17MB
Trauma body workshop part 7- Bottom up approaches and references.pdf [pdf] 4MB

Trauma Body workshop - film 1
Trauma Body workshop - film 2
Trauma Body workshop - film 3
Trauma Body workshop - film 4

Watch a series of films and podcasts produced by the service about dealing with trauma.

Session 1: Understanding trauma
Session 1 audio: 54321 grounding
Session 2: The impact of trauma
Session 2 audio: Soothing rhythm breathing
Session 3: Managing nightmares and flashbacks
Session 3 audio: Safe place imagery
Session 4: Cultivating a compassionate self exercise
Session 4: Multiple selves
Session 5: Multiple selves: Reflective Exercise Part 1
Session 5: Multiple selves: Reflective Exercise Part 2
Session 6: Reframing thoughts compassionately
Session 6 audio: Progressive muscle relaxation
Session 7: Understanding attachment styles in the context of trauma

PSS - a brief overview.docx [docx] 28KB
Schema Group.pdf [pdf] 446KB
The group schema therapy programme 2025 information for service users 1.docx [docx] 38KB
The effects of developmental trauma PSS poster.pdf [pdf] 1MB
Understanding and Coping with Trauma Group (1).pdf [pdf] 1003KB
Support Work.pdf [pdf] 1MB
Trauma Body Workshop.pdf [pdf] 288KB
Trauma processing leaflet[pdf] 569KB
PSS simplified powerpoint.pptx [pptx] 1MB
The effects of developmental trauma PSS poster.pdf [pdf] 1MB

A carer is anyone, including children and adults who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid.

At Cambridgeshire and Peterborough NHS Foundation Trust, we value the often life-long support carers provide and recognise them as equal care partners. We want to offer as much guidance and reassurance as possible, to help you in your caring role. You can find general information and support for adult carers, young carers and parent carers by following this link.