How our service can help you
The Centre for Anxiety Disorders and Trauma (CADAT) is an outpatient psychological therapy service. CADAT provides assessment and cognitive behaviour therapy (CBT) locally and nationally for specific anxiety disorders and depersonalisation disorder.
Our service spans across primary, secondary, tertiary and highly specialist (Tier 4) care. We are unable to accept direct referrals from GPs registered within Lambeth, Southwark and Lewisham. We are also unable to accept direct referrals from other SLaM services with the exception of referrals to our Highly Specialised Services for severe OCD and BDD (see below).
CADAT forms a small part of each of Lambeth, Southwark and Lewisham’s Talking Therapy Services (aka IAPT) but referrals should be made direct to them for primary care. Secondary care referrals should be made direct to the appropriate CCG’s Funding Panel. GPs registered within Greenwich, Bexley and Bromley can refer direct and we will seek authorisation from your CCG. We are unable to accept direct referrals from Croydon and they should be referred to the Croydon Talking Therapies regardless of complexity.
GPs from outside our catchment area can also make referrals to our clinic directly using Patient Choice, with the exception of Depersonalisation referrals. Depersonalisation referrals can only be made via our National service stream and we always have to seek authorisation from the appropriate Clinical Commissioning Group in advance of being able to add the patient’s name to our assessment waiting list.
PAX (Parents with Anxiety Disorders)
CADAT-PAX is a subservice of CADAT dedicated to parents experiencing anxiety disorders, including PTSD, during pregnancy or with children below age 3. PAX therapists can offer fast-tracked assessments and intensive treatments not provided elsewhere in South London and Maudsley or in the country. Referral pathways are as above.
Highly Specialised Service for severe OCD and BDD
CADAT holds a highly specialised service (HSS) contract, which is centrally funded by NHS England to provide treatment for people with OCD and BDD for whom numerous previous treatments have been unsuccessful. This particular contract is at no additional cost to clinical commissioning groups (CCGs). Please see attached for more detailed information
The Survivors of Terrorism Support Service (SoTSS)
Dr Blake Stobie, Dr Tom Parsloe, Dr Alexandra Keyes and Dr Kathryn Price are working in partnership with two charities (Victim Support and The Peace Foundation) on a Home Office commissioned project aimed at supporting individuals affected by terrorism in the UK. SoTSS offers screening, psychological assessment and onward referral for evidence based psychological treatment at local services. It also offers training to professionals from other services or organisations who may be required to support survivors of terrorism in the course of their work.
Telephone: 0800 090 2371
E-mail: SurvivorsOfTerrorism@slam.nhs.uk
- Service Borough Covers: National (Adult services) Treatment type: Outpatient
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Contact the service
Site Location: Maudsley Hospital Email: CADAT@slam.nhs.uk Phone Number: 020 3228 2101 - Disabled Access: No
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Address:
99 Denmark Hill
Maudsley Hospital
Denmark Hill,London, SE5 8AZ -
Business Hours/Visiting Hours:
9am – 5pm (with occasional evening clinics)
- Conditions: Addictions, Anxiety, Attention deficit hyperactivity disorder (ADHD), Autism, Bipolar disorder, Body dysmorphic disorder (BDD), Childhood degenerative disorders, Conduct disorder, Dementia, Depression, Dissociative disorders, Eating disorders, Learning disabilities, Neuropsychiatry, Obsessive compulsive disorder (OCD), Perinatal disorders, Persistent physical symptoms, Personality disorders, Post-traumatic stress disorder (PTSD), Psychosexual, Psychosis, Self-harm
Other essential information
Interventions
- We provide validated cognitive behaviour therapy. Many of our treatments have been developed at our clinic, including trauma-focused cognitive behavioural therapy (CBT) for post-traumatic stress disorder (PTSD)
- We have expertise in treating anxiety disorders through specialising in this area.
- We offer assessments and if indicated CBT treatment for specific anxiety disorders and depersonalisation disorder are the main problem
- Additionally, depersonalisation patients may be offered a one-off telephone psychiatric consultation if indicated and we may recommend onward referral to our neuropsychiatry colleagues where appropriate for more complex presentations
- CBT treatments can be provided in a traditional weekly session format, or in some cases, in a more intensive format in which most of the treatment occurs within a single week
- We predominantly offer relatively short-term courses (usually 12 to up to 20 sessions) of outpatient Cognitive Behaviour Therapy, for the specific anxiety disorders that our clinic specialises in treating.
- We offer EMDR in some instances only for PTSD, and not for other anxiety disorder treatments. The reason for this is that this is in line with the evidence base and NICE guidelines, which we adhere to.
- We can only provide specialist advice on medication for patients being assessed under our highly specialised service (HSS) for treatment refractory obsessive compulsive disorder (OCD) and body dysmorphic disorder (BDD). We are unable to provide advice on medication for patients being assessed under our national and patient choice service streams.
- Treatment packages are usually 12 to 20 weeks of hour-long therapy sessions. In some instances, more intensive outpatient packages can be offered
- Depersonalisation treatment packages are usually up to 16 weeks of hour-long therapy sessions
Eligibility criteria
Eligibility criteria
- 18 years and over.
- Main presenting problem is an anxiety disorder of the type treated by the clinic: obsessive compulsive disorder, body dysmorphic disorder, post-traumatic stress disorder, depersonalisation disorder, social anxiety, emetophobia, panic disorder, health anxiety and various other specific phobias.
- Referrals taken from NHS primary, secondary, tertiary, highly specialist (Tier 4) care, as well as Patient Choice (GP) referrals.
- Willing to attend regular sessions and travel to the Maudsley for outpatient appointments. Initial assessment appointments are only carried out at our clinic in person. For treatment appointments, we are able to offer online/video call sessions only in cases where we think this will be a suitable treatment format. We do not offer online/video call sessions for more severe anxiety problems, or for types of anxiety where meeting in person is an important component of the treatment (e.g., agoraphobia). In cases where this will not be possible, our recommendation would be that people access services more local to them.
- For online/video call sessions, we ask clients to have their camera on for all assessment and treatment sessions. We know that treatment is most effective where both the therapist and client can fully interact to most closely mimic face to face. We are aware that for some people this may be initially difficult to manage, in particular where conditions such as body dysmorphic disorder or social anxiety are the main problems. In treatment for these conditions, active use of the camera and being able to see our clients is important, so this is a requirement of treatment. Where this would be difficult to manage, you may wish to request face to face sessions through our service instead, or we can discuss how to access alternative services in your local area. If you have any questions about this please do call us prior to your assessment, or discuss with your assessing or treating therapist.
- Willing to complete regular questionnaires to monitor progress.
- If taking psychotropic medication, the person should be on a stable dose prior to starting treatment.
- Not receiving, on waiting list for, or seeking cosmetic or appearance-altering procedures related to BDD.
- For PTSD referrals, the person must present with clear intrusive memories/flashbacks/re-experiencing symptoms related to a specific traumatic event or events. They must be willing to talk about traumatic experiences without risk of being destabilised or going into crisis, and able to work safely within a short- to medium-term intervention.
- We can treat specific anxiety disorders occurring in the context of co-occurring neurodevelopmental conditions (e.g., ADHD, autism), where the anxiety disorder is the main presenting problem requiring treatment, and the neurodevelopmental condition does not require . As we are not a specialist neurodevelopmental service, we are unable to offer treatment focussed on ASD/ADHD or related difficulties (e.g., repetitive behaviours accounted for by autism).
- We can only see patients who are currently living in the UK whilst having therapy sessions and are unable to treat people if they are living abroad for any part of their planned treatment with us.
Exclusion
- Direct referrals from other SLAM services (with the exception of referrals to our Highly Specialised Service for OCD and BDD: we regret for funding reasons we are not able to accept referrals directly from other SLAM services. In these cases, the referrals will need to be made by a patient’s local mental health team or GP.
- Direct referrals from GPs in Lambeth, Southwark, Lewisham and Croydon. In these cases please complete our referral form.
- Private referrals.
- Non UK residents, or not currently residing in the UK.
- Current psychosis or bipolar disorder requiring treatment.
- Current alcohol or drug dependence requiring treatment in its own right.
- Current severe depression requiring treatment in its own right, in particular ongoing self-harm or immediate suicide risk.
- Complex PTSD which requires treatment in its own right.
- Personality disorder, emotional regulation or enduring personality characteristics which require treatment in their own right.
- Individuals with current or historical risk of violence towards others
- Individuals requiring inpatient care.
- Unstable housing or housing issues requiring assistance as a point of priority, or current inpatient status.
- For PTSD referrals, people who are likely not sufficiently stable to engage in trauma-focused treatment due to factors including social problems, severe physical health problems, or significant mental health problems (including recent inpatient or crisis admissions or likely crisis admissions while waiting for therapy) or level of dissociation. People who are not willing or able to talk about past trauma and do not want to engage in exposure-based (e.g. re-living or processing) treatment.
- Poorly managed medical or psychological comorbidity which is currently associated with an increase in mortality risk, and which needs to be addressed in the first instance before psychological treatment for anxiety can be attempted e.g. BMI of below 17.5, electrolyte imbalance, ongoing medical investigations or indication of a need for medical investigation in the first instance.
- Not motivated or willing to attend therapy sessions or to have Cognitive Behaviour Therapy.
- Due to the number of home visits required, we can only accept referrals for hoarding disorder from within our local boroughs. We are unable to accept hoarding referrals where the travel time by public transport would be greater than 30 mins from our clinic at the Maudsley Hospital.
- Moderate or severe learning disability.
- Dissociation, including dissociative identity disorder (DID).
- Where alcohol or drug use is at problematic levels, clients must have a minimum period of 6 months of abstinence from their problematic substance prior to treatment at CADAT, where they are receiving support from their local alcohol service during this time.
- As a specialist anxiety treatment clinic, we only offer relatively brief courses of outpatient CBT. This means that we are not in a position to offer treatment for conditions requiring long term interventions, as this is not part of our treatment offer or specialism.
- Referrals requesting assessment and treatment for skin picking.
Outcomes
We use all the recommended national improving access to psychological therapies (IAPT) outcome measures, as well as specific anxiety disorder measures related to each patient’s diagnosis, to track the progress of patients over the course of their treatments with us.
73% of the patients who received treatment through our clinic in 2018 to 2019 made reliable improvement in their anxiety symptomatology by the end of their treatment with us, and 63% of patients were classified as having made a clinical recovery in terms of their anxiety. 22% of patients did not make reliable improvements with their anxiety symptomatology, and 5% of patients experienced a deterioration in their anxiety symptomatology by the end of treatment.
For almost all of the anxiety disorders treated across our clinic, the change in our patients’ pre to post specific anxiety disorder specific ratings showed a large reduction in symptomatology. This is very important, because specific anxiety measures give a much better indication of whether the specific presenting anxiety disorders have been effectively treated, relative to general measures of anxiety levels, which may indicate that a patient’s general levels of anxiety have decreased, but not whether the anxiety disorder has been effectively treated.
Care Options
Referrals
Please complete our online referral form by clicking on the link below and submitting here
Information regarding our current waiting times for “National”, “Patient Choice” and “Depersonalisation” referrals
Please note that our waiting list times are not static, and also differ across the 9 service streams we have into the clinic, and consequently it is difficult to accurately notify referrers and clients of these prior to a referral being made, without this information being requested from us directly. However, the following are rough waiting time estimates for “National”, “Patient Choice” and Depersonalisation referrals. Our admin staff would also be happy to help if you have any additional questions. Please email us on CADAT@slam.nhs.uk or telephone during clinic hours Monday to Friday 09.00-16.30 on 020 3228 2101.
Triaging: This is when referrals received are passed to our clinicians to check if they would be appropriate for our service and may also involve having to liaise further with referrers for additional information. Due to this and the number of referrals received, triaging may take up to 6 weeks.
Assessment appointments: We aim to arrange these within 12 weeks of receipt of an authorised referral.
Treatment appointments: We aim to arrange these within 12 months of receipt of the original referral.
Our experts
Dr Blake Stobie: Read more here
Prof David Veale: Read more here
Dr Sharon Chambers: Read more here
Emily Hall Read more here
Dr Claudia Hallet: Read more here
Dr Colette Hirsch: Read more here
Idyli Kamaterou: Read more here
Dr Alexandra Keyes Read more here
Dr Alessandra Iervolino: Read more here
Dr Tom Parsloe: Read more here
Dr Katy Price: Read more here
Katja Schulze: Read more here
Dr Khodayar Shariyarmolki: Read more here
Diane Shields: Read more here
Tracey Taylor: Read more here
Dr Rachel White: Read more here
Ms Josefine Lange Read more here
Sarah Pickles Read more here
Resources
The Service User handbook can be accessed here
