The BTF model

The BTF model is an educational tool for health professionals to help them support their breathless patients.

The model shows the normal emotional and behavioural responses to breathlessness, and demonstrates how these can form vicious cycles that inadvertently worsen the symptom.

Making sense…

Conceptualising breathlessness in this way can help make sense of the symptom by:

  • explaining how the severity of breathlessness can be out of keeping with the severity of the underlying long-term condition(s).
  • revealing how breathlessness can persist or worsen even when the initial trigger, such as a chest infection, has settled.

Management focus…

This approach facilitates personalised management of the breathlessness by:

  • providing a rationale for intervention by breaking vicious cycles, for example by practising a breathing technique to break the ‘breathing’ vicious cycle.
  • helping clinicians choose non-pharmacological interventions that can break the vicious cycle that is most relevant to an individual patient.


People are empowered to self-manage and take control as:

  • this approach shows that it is still possible to improve breathlessness, even when the underlying condition cannot be improved.
  • a small change to break a cycle has the potential to make a big difference, by generating a cycle of improvement.

More information about the BTF model and its use can be found in the publications section.