Register for Outlook South West

Please complete this form if you would like help from our service. Our NHS-funded therapies are for people aged 16+ who are registered with a GP Practice in Cornwall & the Isles of Scilly.
When you submit this form, one of our therapists will review your details and invite you by email or letter to start your treatment.
If we need any further information from you to complete your registration, we will contact you within 5 working days.
If you are a GP or health professional referring a patient, please complete the form and we will contact the patient within 5 working days.

Personal Details

We may email questionnaires to you during your treatment. These are used to review your progress. They are sent and received securely.

GP Details

Referral Information

Please be aware that we are not an emergency service. If you feel that you are in crisis or in need of urgent support, please contact your GP or the Community Mental Health Team on 0845 207 7711.
Out of hours crisis numbers:
- Home treatment Team(s) 5.15pm - 8.45am East: 0845 2303901 West: 0845 2303902
- Nightlink: Freephone 0808 8000 306
- Samaritans: Freephone 116 123
- NHS Direct: 111
- Valued Lives: 01209 901438 (7 days a week 1pm-4am)

Assessment Questionnaires

Please answer every question in the below questionnaires - this should take about 10 minutes to complete and are an essential part of your assessment for treatment. The questionnaires will help us identify symptoms of low mood and/or anxiety.

PHQ-9

Over the last 2 weeks, how often have you been bothered by any of the following problems?*
PHQ-9 is adapted from PRIME MD TODAY, developed by Drs Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues, with an educational grant from Pfizer Inc. For research information, contact Dr Spitzer at rls8@columbia.edu. Use of the PHQ-9 may only be made in accordance with the Terms of Use available at http://www.pfizer.com. Copyright 1999 Pfizer Inc. All rights reserved. PRIME MD TODAY is a trademark of Pfizer Inc.

GAD-7

Over the last 2 weeks, how often have you been bothered by any of the following problems?*
The GAD-7 originates from Spitzer RL, Kroenke K, Williams JB, et al; A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. GAD-7 © Pfizer Inc. all rights reserved; used with permission.

Work & Social Adjustment

People's problems sometimes affect their ability to do certain day-to-day tasks in their lives. To rate your problems look at each section and determine on the scale provided how much your problem impairs your ability to carry out the activity.
Ref: Mundt, J. C., I. M. Marks, et al. (2002). "The Work and Social Adjustment Scale: a simple measure of impairment in functioning." Br J Psychiatry 180: 461-4.

Phobia Scales

Choose a number from the scale below to show how much you would avoid each of the situations or objects.
The IAPT Phobia Scale is reproduced from the IAPT Toolkit which is ©Crown copyright. Reproduced under the terms of the Open Government Licence which can be found at http://www.nationalarchives.gov.uk/doc/open-government-licence/version/1/open-government-licence.htm

Further Information

Thank you for completing all of the above details. One of our therapists will review your information within the next 5 working days and let you know, by email or letter, which treatment will be most suited for your needs.
This could be one of our wellbeing courses or our online therapy programme.
We recommend our wellbeing courses as they provide a good introduction and foundation to CBT (the treatment of choice within our service) and provide you with an understanding of depression and anxiety. Often people find them so useful that they don't require any further input with us, but if you do then we can review this after your course. Some of our courses available are:
Stress Buster:
Focuses on learning about stress and understanding its effects on the way we think, feel and behave. It is an educational CBT based course designed to arm you with the knowledge and skills to cope with stress effectively.
Mindfulness:
Combines mindfulness meditation practices with elements of CBT and teaches us to be more flexible in our response to the stresses of life, to be less driven and distressed by our thoughts and emotions, and to appreciate each moment of life more fully. Daily home practice is a very important part of the course and materials are given to each participant to support this.
Live Well:
Based on an exciting new psychological approach called: Acceptance and Commitment Therapy (or ACT for short). It aims to give people the psychological skills to cope with difficult thoughts and feelings. It will also help you identify and focus on what is truly important and meaningful in your life. It helps you create your 'best life' according to those core values and can help with problems like low mood and worry. It is also helpful for people who have low self-esteem and low self-confidence.
Finding Yourself Again:
Open to mums with a child aged under 3 with crèche facilities provided at some venues. Many mums find that life with a baby or toddler can be extremely challenging, and that the new demands and responsibilities, together with broken sleep, can sometimes leave you feeling overwhelmed, low in mood, irritable or anxious. This course helps to manage these thoughts and feelings in a supportive environment.
Low Mood and Worry:
Based on CBT principles and delivers an evidenced based treatment for anxiety and/or depression. It is an interactive course and incorporates education as well as CBT skills practice; this mixed approach is recommended in order for you to receive the full benefit of CBT. The course is designed and effective as a stand-alone treatment and can also be used as an introduction for further CBT treatment after course completion.
Online Therapy Programmes:
Our online therapy service has been designed to help with problems of anxiety, stress or depression. You can complete modules chosen by your OSW therapist at your own pace, wherever and whenever it suits you.
We also offer specific online programmes for patients suffering with long term medical conditions - COPD, Heart Disease, Chronic Pain, and Diabetes.
Please indicate below if you have a particular preference for one of our wellbeing courses and/or online programmes. If you do not select a preference, we will offer you the most suitable course or programme for your difficulties at this time:
In some cases we may recommend one-to-one therapy, although you may need to wait for this option.
We will send you an email or letter confirming that you have been placed on our waiting list for one-to-one therapy and you will receive an appointment by post or email to start your treatment as soon as we have an appointment for you.
We offer appointments throughout the County and your appointment will be booked based on the areas that you can attend as below.
By selecting an area you could be booked at one of these sites for your treatment:
Penzance:
OSW Penzance (Long Rock), Penwith Centre, Hayle Community Centre, Stennack GP Surgery, Penzance GP surgeries
Camborne/Redruth:
OSW Redruth, Camborne Community Centre, Pool Health Centre
Falmouth:
OSW Falmouth, Falmouth Health Centre, Westover GP Surgery
Helston:
OSW Helston, Mullion GP Surgery
Truro:
OSW Truro, St Agnes GP Surgery, Carnon Downs GP Surgery
Newquay:
OSW Newquay, Newquay Health Centre, Narrowcliff GP Surgery
St Austell:
OSW St Austell, Merlin Centre St Austell, Clays GP Practice
Bodmin/Wadebridge/Camelford:
OSW Lostwithiel, OSW Bodmin, OSW Camelford, Wadebridge Town Hall
Launceston:
OSW Launceston
Liskeard/Looe:
OSW Liskeard, OSW Looe
Saltash/Callington:
OSW Saltash, Callington Community Clinic
Torpoint:
CHAT Torpoint
Bude:
Neetside Community Centre
Isles of Scilly:
St Marys Health Centre
Telephone treatment - OSW also offer therapy by telephone
We will always try to find an appointment that matches your preferences. However, this is not always possible and the appointment we send maybe the nearest we have that is both available and suitable for your needs.
Please be aware that if you cancel or miss 2 appointments throughout your care with OSW, you will be discharged and will need to re-refer when you are able to attend appointments.

Use of Information

By submitting this online referral form, you are agreeing to share your data with the NHS. For more information on how we collect, store and use your data – please see www.outlooksw.co.uk/use-personal-information