For GPs and Referring Practitioners

Presenting Concerns

GPs often encounter these patients presenting with anxiety, relationship distress, or low mood where the underlying driver is relational, not always obvious from a standard mental state exam alone. Common presentations include:

• Relationship-related anxiety: excessive reassurance-seeking, difficulty trusting a partner, anxiety symptoms that intensify specifically around relationship uncertainty or conflict

• Interpersonal/social difficulty: chronic overthinking of social interactions, difficulty asserting needs, a pattern of over-functioning in friendships or family relationships that the patient describes as exhausting

• Perfectionism and chronic self-criticism as coping: patients who present as high-functioning but report significant internal distress, often with a history of prior CBT that addressed symptoms without resolving the underlying pattern

These presentations are frequently chronic and relational in origin rather than acute, which can make them harder to categorise on a standard referral, patients may not spontaneously report them unless directly asked about relationship functioning.

Who This Service Suits

I work with adult women (including trans women, intersex women and feminine-aligned non-binary people) whose primary difficulty is anxiety within close relationships. This is usually chronic rather than acute, and often sits alongside high day-to-day functioning. Patients who may be a good fit include those who:

• Experience persistent worry, reassurance-seeking or hypervigilance in romantic relationships, friendships or family relationships

• Present as capable and high-functioning but describe an exhausting effort to keep relationships secure, avoid rejection or be "enough"

• Have had previous CBT or counselling that helped with symptoms but left the underlying relational pattern in place

• Are interested in understanding how earlier relationships and experiences shape how they connect with others now, and are able to engage in regular weekly or fortnightly sessions.

• Are seeking longer-term work. I typically recommend a minimum of 10 sessions, and ideally 15 or more where the patient has capacity, given that Medicare rebates cover up to 10 per calendar year

When to Refer Elsewhere

This service may not be the right fit if the primary concern is:

• Acute risk, active crisis or recent suicidal behaviour that requires urgent assessment or a higher level of care. I'm not a crisis service. For urgent concerns, please contact your local crisis assessment team, Lifeline (13 11 14) or emergency services (000)

• Psychosis, mania or other conditions requiring psychiatric management as the primary treatment

• Substance dependence or an eating disorder needing medical monitoring or specialist care

• Relationship or couples work, or work with children, adolescents or men. I see adult women individually only.

• A primary need for trauma-focused treatment where relationship anxiety is secondary. Please get in touch to discuss

If you're unsure whether a patient is suitable, feel free to contact me before referring. My initial 15-minute phone consultation is also a chance to check fit, and if a different kind of support would suit the patient better, I'll say so and help find one where I can.