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One thousand graduate primary care mental health workers (GMHWs) were introduced to practices throughout England this year. Their role is to increase primary care capacity within National Health Trust areas by providing safe and effective therapeutic interventions. A key objective is to reduce the number of clients needing referrals to secondary care by treating mild to moderate mental health problems in the general practitioner (GP) surgery. Training for GMHWs consists of a one-year postgraduate certificate in mental health in primary care. This was introduced in January 2004. The first graduates will complete the course in January 2005. As part of training the graduates have been placed in GP surgeries to carry out one-to-one therapeutic interventions.This paper examines the challenges faced by a graduate, trained on the Plymouth University programme, in taking up this new role. It provides an insight into one graduate’s approach to the task of promoting the benefits and supporting role of a GMHW to all those in the GP practice. This includes a presentation of the strategies used to gain GP and other support in setting up a successful self-help clinic. The paper provides details of the main stages in setting up the clinic and focuses on the collaborative processes, client profiles, therapeutic work and success indicators used, such as referral rates and GP feedback. A case study of a client is also included to illustrate key aspects of the approaches used. In total this account and analysis provides a progress report and insight into one of the most important roles held by the GMHW.