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Thread: Cbt - worked or not?

  1. #21
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    Jul 2013
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    Re: Cbt - worked or not?

    Quote Originally Posted by MyNameIsTerry View Post
    Another issue is probably that GP's can't even determine the style of therapy required so just shove everyone in the CBT bracket and let people get diagnosed and referred to the correct forms of therapy as they advance through the levels.

    I wonder if you can get a referral to a psychologist where the correct form of therapy can be determined? I was offered this but then once assessed the waiting list for any treatment is a minimum 12 months. Some areas don't even have the Level 4 though so god knows what happens to them...they most likely just suffer with no help and a GP that just dishes out the pills and doesn't try to help them.
    From what my GP told me they have no choice when referring for counselling; any referral automatically goes though to the IAPT service. IME the IAPT service is crap and they only offer CBT or short counselling sessions if you have been bereaved or something, but nothing more intensive than that. I was assessed by them 3 times and they bounced me back, admitting they couldn't help me as I had 'too many issues' for their service and was sceptical about yet more CBT.

    The GP explained that to access group psychotherapy that runs in the city or other higher tiers of care you have to go via "secondary services". I'm not sure exactly what that is but I think it means being referred to a psychiatrist, or MH team. The GP seems to think this is inappropriate in my case. Presumably I'm not unwell enough to be moved up the ladder to tier 3/4 or whatever it is.

    So my only option is to win the lottery and pay for private therapy I guess. Or have a total breakdown and run around the city naked speaking to imaginary people?

    Apologies for ranting off topic. The NHS MH services are just so disappointing and only getting worse. Does the government not realize how much money it would save on benefits and NHS in the LONG RUN if they funded better and more extensive MH care. Everything is about short term thinking - give people 6 weeks of CBT, get them back to work ASAP and never mind if they are ill again in 3 months.

  2. #22
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    Re: Cbt - worked or not?

    Quote Originally Posted by yenool View Post
    From what my GP told me they have no choice when referring for counselling; any referral automatically goes though to the IAPT service. IME the IAPT service is crap and they only offer CBT or short counselling sessions if you have been bereaved or something, but nothing more intensive than that. I was assessed by them 3 times and they bounced me back, admitting they couldn't help me as I had 'too many issues' for their service and was sceptical about yet more CBT.

    The GP explained that to access group psychotherapy that runs in the city or other higher tiers of care you have to go via "secondary services". I'm not sure exactly what that is but I think it means being referred to a psychiatrist, or MH team. The GP seems to think this is inappropriate in my case. Presumably I'm not unwell enough to be moved up the ladder to tier 3/4 or whatever it is.

    So my only option is to win the lottery and pay for private therapy I guess. Or have a total breakdown and run around the city naked speaking to imaginary people?

    Apologies for ranting off topic. The NHS MH services are just so disappointing and only getting worse. Does the government not realize how much money it would save on benefits and NHS in the LONG RUN if they funded better and more extensive MH care. Everything is about short term thinking - give people 6 weeks of CBT, get them back to work ASAP and never mind if they are ill again in 3 months.
    I totally agree. The NHS whinge on about how much they spend, the politicians poke holes in it by saying they are underspending yet no one seems to display the attitude that its not about this years annual budget but a long term strategy that gets it from 1 in 4 over the next 20 years to something much less. Its so easy to become a number in this system.

    I feel much the same, I accessed Level 2 and they advanced me into Level 3 as they delivered both in my city. Once completed, they advised my GP to put me through to Level 4 due to the complexity of issues and from asking him some specific questions throughout my therapy I determined that he never read any of their reports that were sent to him! He doesn't want me to access Level 4 with his reasoning "that type of therapy can often open up new issues" which is ludicrous as he implying that these qualified psychologists leave you even worse off! I decided to intepret this as "I will get charged for a referral and I don't want to pay for it" and the result has been that have not been back now in 15 months. They just sign the repeat presciptions.

    I actually spoke to the Level 4 people and they were fine with it all but just said it would be a 12 month wait. So, I know my GP is blocking me.

    The IAPT route is fine for those witth less complex problems. Even CBT is relatively short.

    One of the members on here, DeadManWalking, has a thread on either the Depression or OCD boards where he went to his GP and he was given contact info for MIND who are covering services in his area. They have assessed him as needing nothing less than Level 3 and put him in group sessions. I was told I couldn't access Level 3 until I had Level 2 as its "policy". So, the IAPT route is affected by all the mess that the local care trusts cause with the differences between treatments based on region. Its basically a bit of a lottery.

    So, I've joined this website and access another self help charity. Anything else for me now will be private. Then we have to try to find a reputable therapist in an unregulated sector which doesn't help.

    I think I am more open to other forms of therapy now though and would probably try those before I head back to psychotherapy.

    Its just sad that MH gets marginalised. Break your leg and you're booked in with a physiotherapist very quickly, break your mind and, well...

  3. #23

    Re: Cbt - worked or not?

    Ive been re=referred to cbt , having already had 14 sessions. It does help me to a level, but I need something more intense, and more than once a week.
    I was told I couldn't go to the next level up as that's only for people that are really on the edge / suicidal. Well Im currently spending nearly all my day feeling anxious or worrying about why my body is in a state of tension / racing thru my blood.
    Its as if there is a great big void between the 2 levels , certainly here in Worcestershire anyway.

    CBT may be a great help to people with low / mild Anxiety , but its questionable how much a 1 hour session once a week can help somebody with long standing severe Anxiety.

    I have a meeting with the Pyschiatric team in a week, but I think they will just prescribe a different medicine and tell me to keep doing CBT. But will keep you all posted.

  4. #24

    Re: Cbt - worked or not?

    Quote Originally Posted by mr benn View Post
    I have a meeting with the Pyschiatric team in a week, but I think they will just prescribe a different medicine and tell me to keep doing CBT. But will keep you all posted.
    What a great prediction. The 'team' turned out to be a girl (mid 20s ) , who gave the impression i was just another number in her boring day. She listened to me for 20 mins, then wandered off to confer with the senior member . There answer - just take some different drugs as well as the ones your on. When I asked why bother taking the ones Im on s theyve had no effect for 5 monhts, she just said they recommend the 2 in tandem...doh.
    I asked for more than one hour cbt , and she said thats all they can do. Like others say, it seems theres this big gulf between cbt , and those on the suicide risk . They need to address how stop people going from one to the other.

    As a footnote, my new CBT lady seems a little more different and agressive, which is suiting me. Sometimes I come out of a session thinking Ive learned nothing , which is dis-heartening, but I guess theyre gathering information for next time occasionally.

  5. #25
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    Re: Cbt - worked or not?

    Quote Originally Posted by mr benn View Post
    What a great prediction. The 'team' turned out to be a girl (mid 20s ) , who gave the impression i was just another number in her boring day. She listened to me for 20 mins, then wandered off to confer with the senior member . There answer - just take some different drugs as well as the ones your on. When I asked why bother taking the ones Im on s theyve had no effect for 5 monhts, she just said they recommend the 2 in tandem...doh.
    I asked for more than one hour cbt , and she said thats all they can do. Like others say, it seems theres this big gulf between cbt , and those on the suicide risk . They need to address how stop people going from one to the other.

    As a footnote, my new CBT lady seems a little more different and agressive, which is suiting me. Sometimes I come out of a session thinking Ive learned nothing , which is dis-heartening, but I guess theyre gathering information for next time occasionally.
    So was it actually a doctor you spoke to? I'm sorry to hear it didn't go so well for you.

    I have an appointment soon to see a psychiatrist or "one of their team" and I am pinning my hopes on it at the moment. I hope I get to see someone 'high up' as my GP is experienced and good with MH, so I can't see the point seeing a junior person less qualified than my GP.

    I really wanted to be referred for psychotherapy but when the appointment came through this is what it was for, so I have no choice.

    I would like to know how they define suicidal as well because I have felt constantly feel restless, demotivated, sad, suicidal and violent intrusive thoughts for years. I haven't killed myself yet but the option is always floating around temptingly.

  6. #26
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    Re: Cbt - worked or not?

    Quote Originally Posted by yenool View Post
    So was it actually a doctor you spoke to? I'm sorry to hear it didn't go so well for you.

    I have an appointment soon to see a psychiatrist or "one of their team" and I am pinning my hopes on it at the moment. I hope I get to see someone 'high up' as my GP is experienced and good with MH, so I can't see the point seeing a junior person less qualified than my GP.

    I really wanted to be referred for psychotherapy but when the appointment came through this is what it was for, so I have no choice.

    I would like to know how they define suicidal as well because I have felt constantly feel restless, demotivated, sad, suicidal and violent intrusive thoughts for years. I haven't killed myself yet but the option is always floating around temptingly.
    Its going to be more complex than this but when I had CBT I had to fill in various monitoring questionairres and there was one for this which had a question "do you ever feel like life isn't worth living" which was obviously going to get a Yes but then it was followed up with "have you made plans to end your life" which always got a No. There was a freeform box to state why & what kept you going plus some more Yes/No's about harm. I think if you checked Yes to the planning it would be a red flag straight away. I also had a scale 0-10 of mostly likely to take such an action and would always mark it as 0.

    There was a recent case of a guy near my area that did go ahead with it shortly after he was desperate enough to get to his GP, then referred off and then told he would be waiting again. 10 days later he walked in front of a train. The service stated he was low risk on the basis he marked this likeliness question as a 3 but the coroner ruled they should have done more. His wife said it was them telling him he had to wait longer for help that caused this and it does sound likely as up to the point of seeing his GP he was only talking along the lines of how he wished it would end...and we've all been there!

    So, I think its initially based on these standard IAPT forms but the therapist must have additional guidance for what to look out for.

  7. #27
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    Aug 2014
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    Re: Cbt - worked or not?

    I had a few sessions of cbt with inclusion matters. Before it really got started they decided it's social anxiety that i have and i've been referred on to another therapist but another long wait. I tried paid cbt but didn't really connect with them very well. Might try another, at least this way can carry it on as long as i need to, just need to find the right one! i think it might of helped shame it stopped so soon :(

  8. #28
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    Re: Cbt - worked or not?

    Quote Originally Posted by jol88 View Post
    I had a few sessions of cbt with inclusion matters. Before it really got started they decided it's social anxiety that i have and i've been referred on to another therapist but another long wait. I tried paid cbt but didn't really connect with them very well. Might try another, at least this way can carry it on as long as i need to, just need to find the right one! i think it might of helped shame it stopped so soon :(
    Thats a real shame. They should have nailed that in the first session where they determine what is needed. I had some similiar issues due to errors in referral by my GP to my local charity who cover CBT services and it took me complaining about being bounced around to get my wait time reduced. I too stated I would go private if needed but they found me a place in the end.

    If you go private, I was always told by therapists that the BACP register is the place to look. From there, its easy to Google them to find their websites and see what they offer and whether it will work for you. I emailed one of them to ask about whether they could help me and had a good response but luckily the charity came through for me.

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