The role and training of graduate primary care mental health workers (GMHWs) are being developed to enable them to contribute effectively to the provision of primary care mental health services. An important role for GMHWs is to provide direct, safe and effective evidence-based interventions. Concern has been expressed about the level and type of client work possible for these newly qualified graduates with no previous training and no professional group to ensure regulation. This paper describes a framework for safe and effective client work, provided by GMHWs during their training, for clients with anxiety and depression. The approach of facilitated self-help using the cognitive behavioural therapy model, is illustrated with four case studies. The client work was provided as part of a training programme, which enabled the development of generic therapeutic skills and skills specific to facilitated self-help. This equipped the GMHWs with the skills to provide more accessible primary care interventions in the future.