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'Reputation is an idle and most false imposition; oft got without merit, and lost without deserving.' Othello Act 2, Scene 3 Case Study: Cognitive and Behavioural Psychotherapy for Distressing Thoughts in Work Introduction The Community Treatment Service (CTS) in Pwllheli is a team of 5 nurses and a social worker offering intensive support, therapies and can provide out-of-hours support for patients open to Care Managers from the Community Mental Health Team and the North West Wales NHS Trust GP Counselling Service. Her General Practitioner referred Ellen to the GP Counselling Service. A brief telephone call described Ellen as suffering from work related stress and anxiety. The only further information given was her telephone number and address so that an appointment could be made at the local GP Health Centre. This is indicative of the extent of pre-contact information given about patients referred and other information about her is obtained after initial assessment sessions. Ellen is 43 years old...

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