£65 per 50-minute session

CBT for Depression

For when everything takes more effort than it should, and the things that used to help have quietly stopped happening.

Signs this might be for you

Low mood that's settled in for weeks or longer, more than just a passing bad patch
Loss of interest or pleasure in things you used to enjoy
Exhaustion that isn't explained by how much you're sleeping
Persistent self-criticism or a sense of being a burden to others
Withdrawing from friends, activities or routines without quite deciding to

Depression has a way of narrowing life down. The activities that used to give you a break, connection or a sense of achievement fall away one by one, usually without a single decision to stop, and the gap left behind gets filled with low mood, self-criticism and exhaustion. CBT for depression works on that pattern directly, because the withdrawal itself tends to actively keep the depression going, rather than simply being a symptom of it.

A core part of the work is behavioural activation, which is a structured, gradual way of rebuilding activity and contact with the things that matter to you, even before motivation returns (motivation typically follows action in depression, not the other way round, which is often a relief to hear). Alongside that, we work on the self-critical thinking patterns that depression tends to generate: the sense that you're failing, that things won't change, that you're a burden.

I take a High Intensity CBT approach here, which means structured, session-by-session work rather than open-ended talking. That doesn't mean rigid; it means we have a clear map of where we're going and check in on progress along the way, using the PHQ-9 as one of the ways we track that.

What treatment actually looks like

Assessment

We look at how depression is currently showing up: mood, sleep, energy, activity levels, and the thinking patterns that tend to accompany it.

Formulation

We build a shared understanding of the withdrawal-low mood cycle specific to your life, and agree concrete, achievable goals.

Behavioural activation and cognitive work

We rebuild activity gradually while working on self-critical and hopeless thinking patterns, adjusting pace as energy shifts.

Consolidation and relapse prevention

We build a clear plan for noticing early warning signs and responding to them, since depression has a tendency to recur without ongoing awareness.

Behavioural activation, built around your actual life

We rebuild activity gradually and specifically, not with a generic "do more nice things" list that ignores how depleted you currently are.

PHQ-9 tracked periodically

We use the PHQ-9 every few sessions as a shared way to see whether things are shifting, alongside how the sessions feel to you.

Working with self-critical thinking directly

Socratic questioning, not correction; we examine the evidence for and against self-critical thoughts together, rather than me telling you they're wrong.

Adapted pacing for low energy

Homework is calibrated to where your energy actually is, especially in early sessions, so tasks build confidence rather than becoming another thing to feel you've failed at.

Questions about depression at Pamoyo Therapy

What if I don't have the energy or motivation to do the homework?

That's expected, and it isn't a failure on your part. Depression makes tasks like this genuinely harder to start, which is exactly why we begin with small, achievable ones and build from there. If something isn't working, we adjust it together rather than treating it as evidence you're not trying.

How many sessions does CBT for depression usually take?

Most clients work within the standard 12-session programme. If depression has been long-standing, or there's significant complexity, we may agree to extend to 15 to 20 sessions. That's a conversation we keep having as we go, not something we settle once at the start.

I'm on antidepressants. Can I still do CBT?

Yes, and many clients do both alongside each other; there's good evidence for combining medication and CBT. I'm not able to prescribe or adjust medication myself, so any changes there should go through your GP or psychiatrist, but I'm glad to work alongside that care.

What happens if things get worse during therapy, or I have thoughts of harming myself?

We'll have an honest conversation about risk as part of the assessment and revisit it throughout. If you're in a mental health crisis or at immediate risk, private CBT isn't the right first port of call; I'll be clear with you about that and can point you to crisis support (999, NHS 111, or Samaritans on 116 123) alongside our work.

Will you assume my culture or faith is part of the problem?

No. Your background shapes how you experience the world, but you're the one who tells me what it means to you, not the other way round. If faith, family or community are part of what's sustaining you through this, we build on that rather than treating it as separate from the therapy.

Is there a waiting list?

No. You can typically start your assessment within a week or two of getting in touch.

Ready to talk about depression?

Book a free 15 minutes consultation. No pressure, no commitment, just a chance to ask questions and see if working together feels right.

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