My CBT on the NHS any thoughts? experiences?

[Paul30]

Hi,

I've suffered anxiety, agoraphobia and social phobia for around ten years.
Since last year I've been attending cbt on the NHS and I'm beginning to think either the therapists arn't qualified enough to treat people with long term/deep rooted problems, or maybe cbt is just not for me? I've noticed the appointments are infrequent to: they are every few weeks ish.

It seems the sessions are just based on some pre drafted work sheet. The first handful of sessions are about writing down your feelings when in certain situations, scoring them from 1-10 and establishing your fears. Well I've established my fears along time ago; recently I have found my own ways to get out, in my own time, without pushing myself to far.

I went again yesterday after a long brake because basically the therapist had run out of ideas: I failed to complete some of the tasks, then the ideas just dried up. The task set yesterday was to create a weekly planning schedule in which I plan events outside of the house for the week ahead; its easier to just cut and paste it:D.


"Instructions: For each hour of the week, fill in what you plan to do and how much pleasure and mastery you think you will experience. To rate pleasure, use
a scale where 0 = “no pleasure” and 10 = “the most pleasure you can imagine,” with 5 indicating a moderate amount of pleasure. For example, if you predict
that you will derive a pleasure rating of 6 if you exercise at 8 A.M. on Monday, then write “exercise, 6” in the box for Monday at 8 A.M. To rate mastery
(the feeling of effectiveness or accomplishment you get from an activity), use a similar 0–10 scale, and write the rating as the second number after the activity(e.g., “exercise, 6/8”)."


Ok so the thing is I have to do these tasks even if I feel like crap. Generally when I've had a bad nights sleep I feel pretty dam awful and not upto doing much: yesterday was one of those days.

I dragged myself to a martial arts class last night(after going out in the day to) that I've been going to on and off for a while now and it pushed me over the top. I was forgetting simple things, my mind went blank, eyes blurry,I came out looking like the grim reaper as pale as a ghost, and about the only positive I took from it is that I didn't walk out, god knows how. The thing is now I feel like crap about it and it has shaken the confidence I had built up in going there in my own time.

I had waited 18 months for cbt. I have now manged to find funds which have enabled me to book a private phycologist later next month and I'm wondering if my place would be better given to someone else who is waiting. What do you recon guys/girls is cbt to much in my face and not suited to me? Or is it simply over hyped? Would anyone else like to post their experiences? or does anyone have any thoughts?

Cheers Paul.

[wendywoo]

Hiya Paul

i had the same feelings as you about the nhs...i suffered a breakdown along with panic attacks which left me close to suicde.

went to doc and he gave me meds and said he was referring me to talk to someone,when asked how long i had to wait he said 18mnths +...i went mad i knew i couldnt wait that long so went private it cos me £50 per hour but i tell u what i would do it all again..i have never asked for anything off nhs

[freakedout]

Hi Paul,

I am not a big believer in CBT to be honest, I think it is superficial and if you have deep rooted issues these tend to be disregarded with CBT. It is more of a problems solving approach which pretty much ignores the past etc.. I realise that treatment on the NHS has its limitations, I was fortunate to have CBT but like you find that it is not particularly individualised and I guess the therapists sing from the same hymn sheet for everyone.

I asked my psychologist if I had CBT 15 yrs ago when I started having panic attacks, before I started being agoraphobic, would I be more likely to respond well but he said not necessarily. My beliefs are too ingrained, I dont believe that by changing my thoughts my behaviour and mood will change that much. I can go out but rarely on my own. I can push myself to face an anxiety provoking situation and I do quite often but no matter how many times I put myself in these situations I still feel hideous. I tell myself "it will pass" "I am going to be OK" "I never choked to death before so I will not choke to death now" etc.. etc.. but I still feel panicky, I still get the urge to escape, I still burst into tears and feel like I will poop my pants.

If I could afford private I would grab the opportunity and ask for an assessment. CBT is not for everyone but I think for the NHS it seems to be the most cost effective treatment as it is relatively short term and there is evidence in favour of it. Perhaps you should continue with the CBT until you have seen your private therapist, discuss it with him/her and decide whether it is useful to continue. Good luck with your decision.

[PITITA]

Interesting how everyone seems to favour private therapy as opposed to the NHS. In my experience the NHS was much better in the fact that I didn't have the feeling I am wasting my money away. Before the NHS I have tried hypnotherapy (£90/session and I had 10 of them and apart from feeling relaxed for the time spent in the room I had no change in my issues) then I went to another private therapist for £80/hour and did Biofeedback and talk therapy combined...I blew about 2K on it as I was seeing that therapist for about a year weekly. I can't tell you how disheartened and depressed I feolt when I saw all that money gone and still be left with my issues and atthat time it seemed to be getting worse and I always felt that my therapist never quite got me. That was the last time I ever paid for therapy!

Went back to the GP asking for meds as I was always in fear and dread etc and I just couldn't cope, so came away with meds and an appointment to see the clinical psychologist at the GP practice and this lady has pretty much saved my life! She put no pressure on me with time frame and she took her time to get a clear picture of me, my issues and my background and together we worked so hard at achieveing well-being which came about gradually in about a year's time and there were hurdles. When I left her she IMMIDIATELY put me in touch with a CBT therapist through the NHS and within 2 months I was working away with changing thoughts, beliefs...etc.

With the CBT I did sometimes feel that I wasn't making progress at all or it was way too "weak" to tackle my issues, but somehow I learnt to kind of manage my own issues anyway, so it didn't bother me as much. It requires a lot of effort to identify the negative thoughts and keep turning them around and come up with a new balanced thought, but the more you do it the more automatic it will become and when you have deeply ingrained beliefs it will take time to change those, but it is not impossible.

If I were you I'd still stick to the CBT for a little longer because maybe in a few weeks time you might just find a little shift/change or learn something (it is always little things) that will help you tackle your poblems more effectively.

[Mich1111]

When I had my last bout of anxiety/panic attacks 12 years ago I was sent for CBT - when I finally got to see someone after a few sessions they told me they were leaving and that no replacement was being found - I was told there was no point in going on the waiting list again as it was too long. Everytime I went to have my medication monitored it was by a different psychiatrist - mostly trainees. In the end I was referred to another counsellor who on my first appointment said I dunno why they sent you its my last day today!!!

I am currently suffering another bout panic attacks/anxiety/depression this time its far worse than before. My doctor told me there was a new CBT programme set up based on mainly short term help. I had my assessment 2 weeks ago. It was with a trainee, she read from a script, ticked a few boxes then said it seems you have a panic disorder and maybe some bad anxiety disorder too - REALLY IS THAT NOT WHY I'M HERE!!!!!
She said she would go away, they analyse the sheet she was working with and then when there is a space for me they will get in touch. They couldnt tell me when this would be.

With other health issues etc I've had in the past, I can not fault the NHS they have been brilliant - but there is a distinct lack of help in the anxiety area. :-(

[miss_moose]

I've not had good experiences with nhs cbt either.

the first one i saw was horrible, she would just push me way too hard. I hadn't left the house in months at that point but it was all reletively new to me so i didnt understand panic attacks or agoraphobia, i just knew that everytime i had to leave the house i would cry and shake and feel sick, and i just couldnt do it.
Anyway this CBT woman, made me go for a walk right to the end of the street, then when i got back she made me go again, and again.... It was awful.

The next one i went to was abit nicer but she didnt seem to have a clue. Every session was "tell me about one of your dreams (as in sleep dreams)", i mean whats that got to do with getting better.
Then she would spend forever just "thinking".

In the end i just gave up on nhs, ive found private ones much nicer because they actually seem more passionate about their job and alot of them have been through panic attacks ect

[xfilme]

I am having CBT through the NHS. 6 years ago i was referred and I was told the waiting list was a year long. This time I was referred and had a call from them 3 days later to ask me to come in and start. I can honestly say, that despite 2 years on anti depressants, 6 weeks hypnotherapy, counselling, bereavement counselling and regular visits with a psychiatrist, the lady who deals with my CBT does more for me in 50 minutes than all other treatments have done in the last 7 years.

CBT is not for everyone. I attended to get help with my health anxiety, but I have always managed to apply CBT to all other worrying parts of my life with great effect, so maybe I was just more easily influenced by this form of therapy.

I think a lot of people tend to assume CBT is some kind of a cure that will solve all their problems, but it does demand a lot of self discipline for it to be effective. The person attending the CBT has to do almost ALL the work themselves as the counsellor is just there to give you the tools and tell you how to use them.

I consider CBT more like taking a machine apart and learning how to rebuild it yourself. It is a means of looking forward instead of analysing the past.

Have any of you that didnt get along with the CBT found any other kind of counselling more effective? as for me, CBT is the only therapy I respond well to, as I am a very self anylitical person and all of my counsellors bar the CBT one have at some point told me that they didnt feel they could help me because I have a tendency to counsel myself, therefore they have no further suggestions as I have everything covered already.

Do you all read a lot on your disorders? I found self help books and studying my disorder helped me to understand the cause and effect and identify my own triggers which is highly supportive of the CBT techniques as you already start with an awareness of how Cognitive Behavioral Therapy works and is applied.

[honeybun]

I had CBT on the NHS but my real problems had only been around for around a year. i was also quite lucky that i lived in newham at the time which apparently has the best facilities for it in london. As my anxiety wasnt bad enough to stop me working/leaving the house etc i just had sessions over the phone once a week for about 6 weeks after work, which suited me as i didnt have to take time off work.

I didnt really work at it as much as i should have, as it felt too much like studying which i was never good at. and the woman who was my therapist mostly just got on my nerves because she sounded like a primary school teacher telling a 5 yr old how good they have been. I couldnt take her seriously, all she seemed to say was 'fantastic' and 'well done' all the time and she sometimes seemed more nervous than me.

what did help for me was looking back over the week and realising what i had managed to do. when i wasnt being told to do this, i would just forget that i had managed to make progress, like going to meet a group of friends etc. so some aspects of it did help but i dont think i would want to do it again on the NHS.

[kathee]

cbt on the nhs changed my life, it taught me how to challenge unwanted and irrational thoughts which then influenced my behaviour, it showed me how all the depression and anxiety started off with the thought process ... for me it was the "give a man a fish and you give him a meal, teach him how to fish and you feed him for life" kind of experience, i worked hard to identify and challenge thoughts which were destructive and it is a lesson once learned can be used forever. good luck everyone with what ever therapy works for you x

[Paul30]

Hi all,

Thank you for all the responses. Since I last wrote I have been to see a private phycologist and, from only a couple of sessions, I can already see a vast difference from the level of treatment that was supplied by the NHS.

I have much more confidence in the therapist, as she has a PHD and two degrees in relevant fields. The sessions have much more structure and I can already see the direction in which it is going. The therapist has a much better way of presenting the CBT; and it was made clear that I wouldn't be pushed over the edge, unlike the CBT on the NHS. I already know, Apparently, most of my problems stem from a 'social phobia' that I developed in my teenage years, which I masked by getting myself into allsorts of trouble: This is the main reason why Iam agoraphobic now.

If anyone is interested? I can update this post as my treatment progresses.

Thank's again for all the comments.

[medsec27]

I think with any therapy - it's the luck of the draw as to which therapist you get. I am under the care of maternal mental health for anxiety and panic attacks and through them, I managed to get CBT on the NHS as a priority as I am pregnant and they didn't want to treat me with medication until later in the pregnancy. I was very dubious about it and when I first met John, my CBT therapist, I thought that there was no way this was going to work. But I started seeing him 2-3 times a week and he has helped me to see things so differently. I have had anxiety for over 20 years and never had proper help apart from private counselling. He is even coming out to see me next week to do a home visit. As I said, it all depends on who you get I think. My friend's son is having CBT and the difference in the level of help we are receiving is huge. I can't thank the NHS staff involved enough for all the help I have received for my anxiety while I have been pregnant. There seems to be a distinct lack of funds available to treat people with anxiety properly according to my therapist and psychiatrist, so I realise I have been incredibly lucky. It isn't for everyone, but it has definitely made a difference to me. The only thing is it is very hard work and requires a lot of strength and willpower, something I thought I never had, but then sometimes you can amaze yourself with what you can do.