Redundancy, a restructure, a sudden change of role, leaving a long held job or returning to work after a break can affect far more than a payslip. People may notice anxiety, low mood, sleep disruption, irritability, loss of confidence, indecision, shame, anger, grief or a sense that they no longer recognise their place in the world. Those reactions can be understandable in the context of uncertainty and change. They do not, on their own, establish a mental health diagnosis. Work can hold practical security, routine, identity, status, social contact and a sense of contribution. When that changes, the mind may try to solve every consequence at once. This can show up as persistent checking, replaying conversations, avoiding applications, difficulty making decisions, overworking, withdrawing from others or being unable to rest without guilt. A person may be dealing simultaneously with financial pressure, family responsibilities, a changed routine, confidence after interviews, a difficult workplace history or uncertainty about what comes next. An assessment led conversation starts with the person rather than a standard story about career change. What changed? What has become harder day to day? How are sleep, concentration, appetite, physical health and relationships affected? What support is already available? Are there symptoms that need medical attention? Is the main need emotional support, a return to work conversation, employment advice, financial advice, medical review or a combination of these? Therapy is not employment law, HR advice, redundancy consultation advice, benefits advice or financial planning. A CBT therapist cannot decide whether an employer has acted lawfully, write a grievance, assess entitlement or guarantee the result of an interview, application or workplace conversation. Those questions may need an employment adviser, union representative, solicitor, Citizens Advice, a financial adviser, an occupational health service or the relevant employer process. CBT based therapy may be considered when appropriate after assessment. It can offer space to understand the interaction between uncertainty, self criticism, avoidance, mood, worry, routines and the meaning attached to work. It can also help someone test whether a thought such as “this proves I have failed” is the only possible account of a difficult event. It does not promise a particular outcome, replace practical specialist advice or require a person to force themselves through a job search, networking event or workplace situation before they are ready. Physical symptoms should not automatically be put down to stress. Changes in sleep, appetite, energy, concentration, pain, palpitations or mood can have physical, medication related or psychological contributors. New, severe, persistent or concerning symptoms need appropriate medical advice. Urgent help is needed if someone feels unable to stay safe, has thoughts of suicide or self harm, is experiencing psychosis or has a sudden marked change in mental state. For related information, see anxiety support at lyceumclinic.co.uk/therapy/anxiety/, depression support at lyceumclinic.co.uk/therapy/depression/ and the guide to imposter feelings and CBT at lyceumclinic.co.uk/guides/imposter syndrome cbt guide/. You can enquire about current appointment arrangements and whether CBT based therapy may be suitable for your circumstances.