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Co-morbidity occurs when a patient meets criteria (using the DSM-V or ICD-11) for a diagnosis of two or more mental disorders simultaneously (Clark et al., 2017). It is common in mental health populations, with over 70 per cent entering the IAPT programme experiencing two or more mental health difficulties (Hepgul et al., 2016). Where co-morbidity is identified during assessment, the LICBT practitioner is required to use guidelines (e.g. NICE, 2011b) and consult service protocols to determine the main provisional diagnosis before reaching a clinical decision regarding treatment to offer (Table 4.2).

Table 4.2