Does the phrase, “you are such a perfectionist” sounds familiar?

Judging achievements by our high internal standards drive high performance and deliver results in academic, home and work environments. The challenge we all face is ensuring these standards, and our desire to do things perfectly remains adaptive and helpful.

In times of pressure, these standards can become unrelenting as we continue to strive for achievement in meeting the next project, deadline or set of targets. When faced with competing demands, perfectionistic standards can work against us leading to psychological distress.

CBT (Cognitive Behavioural Therapy) works by understanding the process of clinical perfectionism and its function in maintaining stress, anxiety and mood difficulties. CBT provides techniques for developing cognitive flexibility and honing more adaptive, sustainable standards while still achieving high performance and reducing psychological distress.

By Shamira Graham, Director of Clinical and Business Operations at Efficacy

Getting exercise is good for our mental well being as well as our physical health – so the Business Healthy Challenge is a great way of toning up our minds as well as our bodies!

Much research has demonstrated that physical exercise can boost our mood as endorphins or “happy” chemicals are released by exercising. It is also a great way getting a sense of achievement and often pleasure if we are doing an activity we enjoy, which further enhances our good mood. A balance of activities for achievement and pleasure is a key ingredient of resilience and good mental wellbeing.

But exercise is also good at helping us manage stress and anxiety issues. Sometimes when we get anxious, we can get locked in a vicious cycle noticing the physical symptoms that may lead us to feel more anxious as our hearts race or we struggle to catch our breath. When we do aerobic exercise, we get the same physical responses, which can help to normalise them. It also reduces our stress levels, increasing our chances of addressing our problems more constructively.

Efficacy helps individual and corporate clients improve resilience and mental wellbeing through evidence-based psychological therapies and coaching.

Written by Tanya Wolff, Clinical Lead – Efficacy

Research includes:
Faculty of Public Health (2010). “Concepts of Mental and Social Wellbeing.”
[11] Alfermann, D. & Stoll, O. (2000). Effects of Physical Exercise on Self-Concept and Wellbeing. International Journal of Sport Psychology, 31, 47–65.
[12] Salmon, P. (2001). Effects of Physical Activity on Anxiety, Depression, and Sensitivity to Stress: A Unifying Theory. Clinical Psychology Review, 21 (1), 33–61.
[13] Zschucke, E., Gaudlitz, K. & Strohle, A. (2013). Exercise and Physical Activity in Mental Disorders: Clinical and Experimental Evidence. J Prev Med Public Health, 46 (1), 512–521.
[14] Alexandratos, K., Barnett, F. & Thomas, Y. (2012). The impact of exercise on the mental health and quality of life of people with severe mental illness: a critical review. British Journal of Occupational Therapy, 75 (2), 48–60.
[15] Penedo, F.J. & Dahn, J.R. (2005). Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current Opinion in Psychiatry. 18 (2), 189–193.
[16] Kanning, M. & Schlicht, W. (2010). Be Active and Become Happy: An Ecological Momentary Assessment of Physical Activity and Mood. Journal of Sport & Exercise Psychology, 32 (2), 253–261.
[17] Reed, J. & Buck, S. (2009). The effect of regular aerobic exercise on positive-activated affect: A meta-analysis. Psychology of Sport and Exercise, 10 (6), 581–594.
[23] Lindwall, M. & Aşçı, F.H. (2014). Physical Activity and Self-Esteem. In: A. Clow & S. Edmunds (eds.). Physical activity and mental health. Champaign, IL: Human Kinetics.
[32] Conn, V.S. (2010). Anxiety outcomes after physical activity interventions: meta-analysis findings. Nursing Research, 59 (3), 224–231.
[33] Asmundson, G.J.G., Fetzner, M.G., DeBoer, L.B., Powers, M.B., Otto, M.W. & Smits, J.A.J. (2013). Let’s get physical: a contemporary review of the anxiolytic effects of exercise for anxiety and its disorders. Depression and Anxiety, 30 (4), 362–373.

This is a great testimonial from one of our clients and how taking action can help you.

Hi Mirco,

I hope this email finds you well.

This is just a little note to say thank you.

I recently took part in the London Landmarks Half Marathon… and completed it in a very respectable 2hours 50mins.

After our CBT sessions had finished last year, I decided I wanted to challenge myself with something I had never done before and found scary, and that would take some dedication (as this is something I tended to avoid). I raised money for Mind charity and asked for sponsors, as I knew this would motivate me to keep going when I felt the training get difficult.

There were many occasions when my anxiety became overwhelming, and at times I truly believed I wouldn’t be able to finish the run, or ever turn up on the day. However, I went back to all the notes and strategies we had made throughout my sessions, and they helped me so much.

I now have a medal not just for running 13 miles but to remind me how far I’ve come compared to when I first came to see you.

Without your help, I don’t think I would even have signed up for anything this challenging, thank you.

Kindest Regards, (we respect the requested anonymity)

Good afternoon,

I just wanted to say that it was an absolute pleasure working with
Tiina Sormus during my sessions. I feel like I gelled very well with her and
she has helped me a great deal.

Just wanted to pass on the message,

Many thanks for everything, (we respect the requested anonymity)

By Shamira Graham

Whilst gender reassignment procedures of cross-sex hormones and sex-reassignment surgery are certainly useful options for people with a fixed gender identity of the to the opposite gender to that of their sex at birth; there are people who have other less fixed, less binary gender identity conditions for whom gender reassignment may not be helpful. There are also people with gender identity conditions who choose not to pursue physical gender reassignment. For these people, a specialist form of psychotherapy for issues relating to gender may be useful. Such patients may include those with autogynephilia, those with non-binary gender identification, and those with intermittent fluctuation between gender dysphoria and transvestism.

But What is gender dysphoria? How does it affect people? What do terms like intersex, cisgender and transsexualism mean? Dr Az Hakeem who heads up our Psychiatric Team has published his book ‘Trans’, the first of its kind presenting an easy-to-read, jargon-free guide to help anyone understand the terminology, the concept and the day-to-day reality of gender dysphoria and related concepts.

Attached a snippet from the beginning of the book.


If you are interested to read more excerpts from the book, you can find it on
Amazon via this link http://bit.ly/DrAzHakeem

About Dr Az Hakeem

Job-related anxiety is a common mental health issue we treat. In today’s world, there is immense pressure on employees, managers and leaders where job security and performance are two common reasons we hear encounter.

This testimonial outlines job anxiety and how we work to treat it and enable our clients not to come back to us if that makes sense?

(The client wanted to stay anonymous but if you should need any reassurance from us just get in touch)

“I came to do CBT with Lee at Efficacy because I had been experiencing high levels of anxiety, mostly related to my job. I had tried talking therapy (counselling) before, which had been helpful in some ways, but it felt like my anxiety had taken over and that I had no way out. I was somewhat sceptical about CBT at first, perhaps because I had told myself there was no way out. However, Lee skillfully explained how learning how to assess and challenge negative thought patterns could help me unlock feeling calm and like myself again.

Gradually, once I was able to give myself the time to put into practice what I was learning, the techniques I picked up in CBT started to take effect. CBT gave me tools to understand the interrelationships between my anxious thoughts, feelings, and behaviours. While it was not a quick or easy process, I started to feel some positive changes. Over time, practising the techniques have become more like second nature. That’s not to say I don’t still experience waves of panic or anxiety: I do, but I know I have the tools to assess what is happening and to work through those reactions. I also learnt a lot about myself during the process, all of which was incredibly valuable. Lee is excellent at reading people and seems to have a profound understanding of how to tap into the individual’s view of things, to teach them how to help themselves.

Now, a couple of years later, I can safely say that the things I learnt in CBT continue to work wonders for me. They allow me not only to manage the occasional waves of worry but also to thrive in a way I was not able to previously. I wholeheartedly recommend seeking support from Lee and the team at Efficacy. ”

Thanks again for everything.

‘I am very happy to say that I now have my mouse phobia under control. During the treatment Poonam was very patient, supportive and encouraging. It was the perfect environment to slowly and safely deal with the phobia.

I would most definitely recommend!’



March 2017

After years of living with anxiety , panic disorder  and horribly anxious feelings surrounding my social anxieties, I was running on empty about the tools to cope with anything. I knew I desperately needed help so I decided to take action – even though I seriously doubted that anything or anyone could help me. I began to research CBT online and came across Efficacy who recommended that I have a consultation with Shamira 

Making the decision to seek help was easy as I was very prepared for it not to work. However, after the initial consultation I felt a glimmer of hope and gradually began to invest as much time as I could into the methods and tasks I was set.

The first meetings with Shamira gave me confidence and re assurance as she understood how dreadful and debilitating anxiety could be. I began to put everything into it because I implicitly trusted this person and the techniques and strategies that were laid out. I also desperately wanted my life to change and was now prepared to do what I needed to make this happen.

By allowing myself to believe I could get better I was slowly but surely able to start taking the control back and for the first time in my life I felt mentally strong and much more able to cope.

The road to freedom from anxiety hasn’t been an easy one, there have been many highs and lows and some serious challenges and it’s still very much a work in progress but Shamira is always able to help me navigate through and help me find ways of dealing with the problems I’m faced with.

I would recommend Efficacy and CBT to anyone who is living with anxiety and can’t see a way out. I’ve been a scared and anxious person living in the shadow of anxiety and now I feel I’m back in control and more importantly have a deeper understanding of why this has happened to me and how to manage it.

Anonymous, Feb 2017 

‘Having undertaken CBT at a challenging point in my life I can say with confidence that it has significantly altered how I approach difficult situations.

It has provided me with tools to manage aspects of my life more positively and with greater autonomy. The experience was both enlightening and empowering. I received excellent support from Shamira who was not only kind and approachable but exigent and effective.’

Anonymous, February 2017