CBT for Pregnancy Specific Anxiety & Tokophobia: WORKSHOP PRESENTATION ONLINE via ZOOM

Registration closes @12 noon on 06.02.24

Research has shown that it is helpful to consider pregnancy specific anxiety (PSA) as a distinct type of anxiety characterised by pregnancy related concerns. This might include worry about the health of a woman’s baby, their bond with their baby, what birth will be like, their appearance during pregnancy or after birth, their parenting abilities and / or how life might change after birth. Most women will worry to some degree about these things during pregnancy but for some their anxiety becomes significantly preoccupying and disruptive and will benefit from a psychological intervention.

Severe anxiety about childbirth or tokophobia is estimated to affect around 3% of women (Nath et al. 2021). It can result in avoidance of pregnancy, terminations of pregnancy or extreme stress during pregnancy and childbirth. This not only has implications for a woman’s health but also for her developing baby, her relationship with her baby and the wellbeing of the wider family. Whilst there is a growing evidence base that points to risk factors for both primary and secondary tokophobia, and NICE guidelines recommend psychological support to address a woman’s anxiety there is currently no working psychological model to help guide treatment.

This workshop will provide a cognitive behavioural framework for conceptualising pregnancy specific anxiety including primary tokophobia and enable participants to gain skills in using cognitive behavioural therapy (CBT) to help alleviate women’s distress. Treatment for secondary tokophobia will be discussed more fully in our workshop ‘Trauma focused CBT in the perinatal context’. We will use a combination of teaching and interactive exercises across both workshops.

Learning objectives:
• To understand what is meant by ‘pregnancy specific anxiety’ and ‘tokophobia’ and how they can affect women and birthing people on their parenting journey.
• To be able to effectively assess and conceptualise pregnancy specific anxiety and tokophobia within a CBT framework taking account of developmental factors alongside the cognitive and behavioural processes that are likely to maintain distress
• Specifically, we will consider the application of a ‘vicious flower’ and ‘theory A vs theory B’ framework in this context as a springboard into targeted intervention
• To consider the role of societal, cultural and familial scripts around pregnancy and childbirth which may compound a woman or birthing person’s anxiety.
• To use this formulation to help plan effective and realistic interventions to tackle anxiety specific to pregnancy. For example, how to work with a heightened sense of threat about pregnancy, birth and/or parenthood; difficulties tolerating uncertainty; magical thinking and emotional, cognitive and behavioural avoidance.
• To consider the importance of anxiety informed birth planning and role of the wider support and professional network in helping to alleviate a woman or birthing person’s anxiety
• To consider practical adaptations to CBT when working with anxiety in pregnancy e.g. when and how to intervene, adapting behavioural experiments and exposure exercises etc.


Cathy Green

Cathy Green trained as a Clinical Psychologist at the Institute of Psychiatry in London after completing a Wellcome Prize PhD Studentship testing a cognitive model of persecutory delusions.  She has over 19 years experience researching and applying cognitive behavioural therapy across a wide range of presentations in primary, secondary and tertiary care settings.  She has worked as a national specialist in the treatment of anxiety disorders using CBT and is fully accredited with the BABCP.  She enjoys supervising and teaching CBT therapists of all levels and backgrounds both in the UK and oversees.

Cathy currently works as Principal Clinical Psychologist within the South London and Maudsley NHS Foundation Trust’s community perinatal services. Here she supports the leadership and development of psychological care of women across four specialist perinatal mental health teams.  She has a particular interest in the treatment of anxiety disorders within the perinatal period as well as supporting women with more complex psychological needs, often in the context of early relational trauma.

Ellen Craig

Ellen gained her Doctorate in Clinical Psychology from the Institute of Psychiatry in 2008, completing her postgraduate Diploma in CBT in 2009. She then worked in London IAPT teams, developing a specialist interest in the treatment of birth trauma using Trauma-Focused CBT. Ellen worked as the perinatal lead clinician in the Hackney IAPT team for several years, developing a small group of clinicians with a specialist interest in perinatal work.  Ellen has extensive experience in the supervision and teaching of CBT to students and clinicians of all levels.  Ellen currently holds the position of Principal Perinatal Clinical Psychologist in the Hertfordshire Community Perinatal Team – a specialist, secondary-care multi-disciplinary team, where she has been since its inception four years ago. Ellen’s main theoretical background is in CBT, but she also regularly uses EMDR and DBT-informed approaches, as well as parent-infant interventions in her clinical work.

Additional Information

Cancellation & changes policy

If you cancel more than 14 days prior to your booked event, we will refund your fee minus a charge of 15% to cover our administration costs. We regret that cancellations 14 days or less before the booked event cannot be refunded or changed/transferred.

If you wish to change/transfer your booking after confirmation we will do our best to accommodate you if you notify us 14 days prior to your booked event, and if there is space to do so. However there will be an administration charge of £15 per change/transfer.


Workshops often contain clinical material. This is always anonymised as far as possible but delegates are none the less reminded to respect confidentiality.

All that is discussed in your therapy sessions will be treated as confidential, with the following exceptions.
We are required to seek supervision by our professional body (The British Psychological Society or equivalent) as a means of ensuring good practice. We will usually inform your referrer of your progress, but the details that we disclose will be discussed with you. We do have a statutory obligation to break confidentiality under rare circumstances, namely, if we believe that a client is of danger to themselves or to others (under the Mental Health Act, 2001) or if we believe that a child is at actual risk of physical or sexual abuse (The Children Act, Section 47, 1989).

If we felt that it would be helpful to request additional medical, social or legal information, we could only do this with your consent. Similarly, should another medical, social or legal professional request information from us, we would not release this without your consent.


OCTC makes every effort to ensure that this programme is delivered as advertised. However, should a presenter have to cancel, we will endeavour to find another suitable presenter. We will inform attendees as soon as is reasonably practical and, if requested, will offer a refund. In the rare event that we are unable to substitute a presenter, we may cancel a workshop and refund payments already made by attendees. OCTC will not refund travel and accommodation costs that attendees may incur.
All the workshops in this programme are carried out by highly experienced therapists and trainers. The individual presenter is responsible for the content of the workshop and any views expressed do not necessarily represent those of OCTC.
Although highly informative, none of the open workshops or workshop series confer a formal qualification or assurance of competence in CBT (or a specialist area of CBT) since we are unable to assess attendee competency within the training event. However, credit and award-bearing courses that lead to formal qualifications are offered by OCTC in conjunction with the University of Oxford. More about these courses is available on our website www.octc.uk

Levels of competence

Before booking a place on a workshop, please ensure that it is pitched at the appropriate level of competence for you. The guide to levels is as follows:


Basic workshops are for people from a variety of backgrounds, who have at least one year’s clinical experience. Cognitive behavioural knowledge is not necessary for attendance at these workshops, though in practice, a number of attendees will have some skills in the area, and are refreshing/updating their knowledge.


Intermediate workshops are directed towards people who already have knowledge of CBT, and experience in using cognitive formulations and treatment methods – for instance, they are able to identify and test automatic thoughts, and design behavioural experiments. Most participants will be using CBT as part of their clinical practice, and may still be acquiring new CBT skills.


Advanced courses are directed towards those professionals who use CBT routinely as part of their clinical practice. They have probably undertaken a significant number of training courses and/or workshops, and use a broad range of cognitive behavioural strategies to work with a range of presentations at varying levels of complexity.

Making reservations

Bookings can only be considered confirmed after we have received your online registration or application form and payment (or invoicing details, including an official purchase order document).

The registration closing date for each workshop is shown on the workshop description page.  Please note that no applications received after this deadline will be permitted.

If you are booking a workshop place for someone else, you must complete your own details in the billing field, but ENTER THE WORKSHOP PARTICIPANTS NAME/ADDRESS in the shipping field. If you wish to order items using a paper order form instead of online, you can view or download an order form in Adobe Acrobat (PDF) format. Once downloaded, print it out, fill it in, and send off with your payment [cheque made payable to OXFORD HEALTH NHS FOUNDATION TRUST] to the address on the form.


The cost of the workshops includes hot drinks on arrival, mid-morning and mid-afternoon, but not usually lunch unless stated. However, for workshops that do include lunch, if you have any special dietary requirements please let us know at the time of application.

Special needs

We welcome applications from diverse backgrounds. If you have any particular needs, please contact us
prior to booking.