Cognitive Behavioural Therapy

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A structured, evidence-based talking therapy that explores the relationship between thoughts, feelings, and behaviours. CBT helps people identify and challenge unhelpful patterns of thinking and develop more balanced responses. It is one of the most widely used and researched psychological treatments for anxiety, depression, and PTSD — all of which are common in cardiac arrest survivors and co-survivors. CBT is available through NHS Talking Therapies (formerly IAPT) and can be delivered in person, by telephone, or online.

Glossary: Health Anxiety
Excessive worry about having or developing a serious illness, disproportionate to any symptoms or findings. Common after cardiac arrest and in ICD patients. Can involve repeatedly checking the body or device, fear of palpitations, and frequent A&E visits. CBT is an effective treatment.
Glossary: Fear of Recurrence
Fear that a cardiac arrest or dangerous arrhythmia will happen again. One of the most common psychological difficulties after cardiac arrest and ICD implantation. Can cause avoidance, hypervigilance, and reduced quality of life. Psychological support and peer support can help. Also common in co-survivors.
Glossary: Flashback
Vivid, involuntary re-experiencing of a traumatic event as if it is happening in the present. A hallmark PTSD symptom. For survivors and co-survivors, triggers may include hospital settings, alarms, or physical sensations. Treatable with EMDR or trauma-focused CBT.
Glossary: Avoidance
Behaviours that prevent contact with people, places, or activities linked to trauma or fear. Provides short-term relief but reinforces anxiety long term. Common after cardiac arrest — may include avoiding exercise, hospitals, or the location of the arrest. Addressing avoidance is central to CBT.
Glossary: Anticipatory Anxiety
Worry or fear focused on a future event or situation. Common after cardiac arrest — for example, dread before a clinic appointment, anxiety about being apart from the survivor, or fear of returning to the location of the arrest. Tends to widen over time if untreated. CBT and graded exposure are effective.

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