Friday, 20 March 2020

CBT During Covid

Coping With Isolation

Over the coming weeks and months, many of us will be asked to self-isolate or be instructed to stay at home if we have been infected by the Coronavirus. This will place us under significant pressure and change many of our normal coping mechanisms. So for example, if we are used to engaging in social activities such as  sports, events, bars, shopping, contact with close friends and family, we will need to develop a new approach to maintaining good psychological health to get through the isolation period.

At Think CBT we have developed a simple framework to help people plan, structure their time and act in a way that makes the period of isolation more bearable. 

This approach is called the “PACE” framework. The PACE framework draws on tried and tested CBT methods to help maintain good emotional and psychological health. You can download a free copy of the PACE Framework at PACE or by visiting our Resources page at

PACE is a simple acronym that stands for Physical, Achievement, Connection and Enjoyment.

Each of these areas are directly linked to the upkeep of different biological and emotional processes in the human body and nervous system.

Physical – This involves diet, exercise and sleep patterns.

Achievement – This is what we do to get a sense of purpose, completion or  satisfaction.

Connection – This involves our key relationships, feelings of closeness, community or  bonding.

Enjoyment -This includes the things we do for fun, for interest or pleasure.

During the period of isolation, it is important that we plan and structure our time to address each of these areas. We  should be aware of the risks of falling into patterns of unstructured and passive behaviour. Taking an unplanned or reactive approach during long periods of isolation can lead to problems with anxiety and depressed mood, which in turn can have a significant impact on our physical health. 

In-depth studies into the affects of isolation in prison or detainment populations have shown the profound affect that a loss of structure, engagement and purpose can have on psychological health and well-being.

So how do we apply the PACE framework?

Let’s take each of the four areas in turn and outline what this involves:

Physical Time – It’s important that we maintain good diet, sleep and exercise patterns.

Diet: Diet means planning and sticking to a well-balanced, varied and nutritious diet during the period of isolation. So without stock-piling, we can buy or have fresh food delivered. We can plan a weekly menu and really stretch our imaginations to try recipes that we don’t normally have the time to prepare through work or other commitments. The key to this is planning and sticking with the weekly menu. 

If you are living alone, this can involve contacting friends or checking out recipes online or on channels such as YouTube.

If you are isolated with other family members, this can be planning and preparing food together.

The important thing is to have a plan and stick with it.

Exercise: Exercise is crucially important. Mr Motivator said on the radio just this week that your home is your gym. You should make the time and space to undertake regular exercise or gentle stretching movements to physically activate the body. You can find countless online home based exercise plans by simply entering exercise at home into your search engine. 

It’s also important to remember that isolation does not mean staying at home. You should try to walk, run or take exercise outside in daylight, always taking care to maintain physical distance from other people to avoid the risk of infection.

Sleep: A healthy sleep pattern is key to good emotional balance and we know that sleep is often the first thing to suffer when we experience periods of stress. There are some strict rules about practising good sleep hygiene and bedtime rules to improve the chances of a good night’s sleep. Some key points are stick to a regular wakeful and sleep timetable, keep the bedroom clear of screens and other distractions and only go to bed when you are tired. There is a special type of Cognitive Behavioural Therapy for Insomnia called CBT-I and you can learn more about this by visiting

Achievement Time – This involves planning and  allocating time to undertake activities that give you a sense of completion or satisfaction. This can range from work-related tasks for those people working from home or school, but it can also involve domestic tasks such as tidying, cleaning, gardening, home improvements or odd jobs around the house. Make a list of those jobs that you never seem to have time to complete and use the PACE exercise which you can download from to schedule these activities.

For those of us looking after younger children, this may also involve some support for home schooling. Again, having a structured plan for schoolwork time is crucially important.

Connection Time – This is an important human need to engage and connect with other people. If you are living alone, you should reach out to friends or acquaintances, join online groups or make contact with some of the social organisations that work to eliminate loneliness. Some of the organisations that can help include:

UK Youth, The Silver Line, The Way Foundation, The British Red Cross, Age UK.

If you are isolated with other family members, you can schedule time to sit together, play games, eat together, talk through your feelings, concerns and offer support. 

Physical human contact is a highly important aspect of this, so take the time to cuddle up and exchange hugs on a regular basis. The Danish have a specific phrase called “Hygge” (pronounced hooga) where they take the time to connect, particularly when the weather is cold and inhospitable. Again the key to this is planning and scheduling daily “hooga” time, so that you spend quality time with your partner or family members without other distractions.

Enjoyment Time – This involves just doing things that are fun, interesting, fulfilling or exciting. For many people this period of isolation could be an opportunity to learn a new skill, take up a hobby, learn some key phrases in a different language, to read books that you don’t normally have the time to engage in, to watch that box-set with a good bar of chocolate or to relax in a hot bath. Make a list of the things that you really enjoy doing and schedule something enjoyable each day. This doesn’t have to be a momentous thing and could just involve a brief moment of relaxation. 

Enjoyment always has more impact when it is linked to a sense of reward for having the personal discipline to stick to your weekly plan for Physical Time, Achievement Time and Connection Time. 

You may find that some activities cross the boundaries between Physical Time, Achievement Time, Connection Time and Enjoyment Time. This doesn’t really matter provided the activities are planned in advance and applied with good self-discipline.

To find out more about the PACE approach, you can visit the Think CBT website at 

Finally, if you need specific support and feel that you might benefit from working with a professionally accredited CBT expert, you can organise online video or telephone CBT on 01732 808626 or via

Our CBT experts can provide professional guidance and support for the full range of anxiety conditions and depressive disorders. We know that the Coronovirus will be particularly challenging for people with a pre-existing anxiety condition or problem with depressed mood. Don’t suffer in silence.

We have made special provision for online Cognitive Behavioural Therapy and the research evidence shows that it can be as effective as face-to-face work. We don’t just use messenging or email contact like some other online services. Our online sessions are conducted via a video connection where the CBT materials and exercises are shared on-screen as we work with our clients. This is a fully interactive experience and we use exactly the same approaches that we use with our clients when working together in the same room.

Our online CBT page explains how the online CBT process works and provides access to free online psychological assessments. If you want to find out more about online Cognitive Behavioural Therapy, visit

Disclaimer: the information in this article reflects the opinions of Think CBT and does not represent the position of any other professional / membership body.

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