1. 1) Self referral form 
  2. Completed

Stockport Child Self Help Self-Referral Form

Welcome to the Stockport Psychological Wellbeing Service.

We provide support to Children and Young people (CYP) aged 11-18 who are registered with a Stockport G.P.

Please note, we require consent from the client to process the referral, if the client has not given you permission to submit this referral, do not submit the referral. If a client is under 16 years old we need consent from the caregiver, if the caregiver has not given you permission to submit this referral, do not submit this referral.

Our online interactive eTherapy Service is here to help with how thoughts have an impact on feelings, physical symptoms and behaviours. It teaches techniques and strategies to help young people to cope better with negative thoughts, feelings, low mood andanxiety, as well as building on wellbeing and resiliency. Our eTherapy programme can take between four to eight weeks to complete and the young person will be supported weekly by an eTherapy coordinator by either face to face and/or telephone support while they complete the course.

If, for any reason, our service isn’t right for you, we will make sure that you see the right professional for your situation and get the support you need with the community.

To help us put you in touch with the team who can give you the support you need, please complete the form below.

Please note: this service is not a crisis service and will not be suitable for you if you are at immediate or imminent risk to yourself or others.

If you feel that you are in distress, for example if you feel at risk of harming yourself or others then we would urge you to contact any of the following organisations who are able to offer support:

  • NHS (non-emergency) 111 (24hrs)
  • Samaritans (Helpline)116 123 (24hrs)

Alternatively, please contact your GP. Or if in crisis, attend your local A&E department

(you may wish to call an ambulance on 999)

If you want to find more about how we use your information, please see this page to see our terms and conditions: https://www.selfhelpservices.org.uk/Privacy/

The Stockport Psychological Wellbeing Service is delivered by Selfhelp who work in Partnership with Stockport Women’s Centre, Beacon Counselling and Pennine Care NHS Foundation Trust.

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Young Person's Details
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We will try to contact you by telephone unless otherwise advised. If possible please provide a mobile number in addition to a landline.
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I am a Parent / Carer and am making this referral on behalf of a young person. My contact details are:
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*Please note, we require consent of the caregiver for anyone under 16 years of age to process the referral

How can we get in touch with you? (Parent/Carer making referral)
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Your GP Details
We are required to notify your GP that you are accessing our service. Please provide permission for us to write to your GP with this information.
Unfortunately if your GP is not listed in the drop down we are unable to offer you support via our service. Please search NHS choices for your local IAPT provider.
Please note that if you do not give permission for us to contact your G.P., this may impact the type of support we can offer.
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Presenting Problem
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To help us to continue delivering quality care, from time-to-time trainee practitioners are required to shadow our qualified practitioners during live appointments.
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Please note: should you provide consent now, you can change your mind at any point before or during your appointment.

About you
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Contact Telephone: 0161 480 2020

Contact Email: stockporttalkingtherapies@thebiglifegroup.com