Comments for en-gb 30 Sun 24 May 2015 23:47:55 GMT+1 A feed of user comments from the page found at rainbow2zy We could all try EFT The tapping therapy. You don't have to register with the government and you can tap on yourself. It may not help certain people. It is free and it is DIY therapy.I wouldn't seek help via my GP because my health records are seen by employer. The history of illness and control trials is to ensure that the aberrant is controlled. A mental health nurse told me some years ago that most mental illness was rooted in control – loss of control etc. Why does every measure have to be reported to the government?I agree we -- all benefit from having the right to chose from a variety of approaches.Why does our personnel life and difficulties need to recorded. Wed 11 Mar 2009 19:03:41 GMT+1 avalon9 So CBT works for some and does not work for others and we just hope that other therapies and therapists will be available to pick those folks up.... except that most of the funding is now going into CBT. So how is that going to work?Another aspect that has not been discussed here yet: the fact that more and more CBT-based interventions will be "manuelised" and/or computerised. What is planned is for many GP surgeries to be able to offer computer based CBT. So you turn up at your appointed time, have your on-line session and leave. No humans involved. Too messy the human stuff, really... It feels to me there is something profoundly unethical about this process. We are dealing with human stuff and yet we are cutting out the human relationship which most of us here agree is so important in a person's journey to their (self-defined) recovery. Sometimes we need to be able to just think aloud and let another human being respond to these thoughts, in a human way with the professionalism and expertise that goes with being a properly trained therapist.Such "virtual" therapies are for me one of the dangers of the throughput aspect of IAPT. Finally, of course, someone somewhere is making quite a lot of money designing and marketing this type of software. Tue 10 Mar 2009 19:21:53 GMT+1 phloll Unlike nje3006 I think the British Association for Counselling and Psychotherapy has done a marvellous job in managing an enormously difficult public exercise in quite rightly supporting the investment of new money in talking therapies while not behaving like an infantile Oliver James in threatening Alan Johnson with the Evil Eye. It would have been very easy for BACP to have damned the entire project as biased towards CBT instead of trying to work within an alliance to persuade the politicians to extend their remit to include a full range of counselling and psychotherapy intervetions. Phillip Hodson exactly expressed BACP's viewpoint - as he has before in The Times - that CBT will not work for all clients - and the other 50 per cent will need different therapies. And this has already been shown to be the case in the Doncaster pilot study - where traditional counselling is picking up the pieces. Tue 10 Mar 2009 18:08:26 GMT+1 nje3006 IC, I have had sessions with a psychotherapist, it cost £50 a session, not cheap I know but not £100 a week and not much different to private CBT (if you can't get it on the NHS) at around £40 a session. I was not encouraged to have more than 1 session per week and I attended for 10 months, it was entirely my decision to take a break which may or may not be permanent. I know some psychotherapists encourage regular breaks, some every 10 weeks or so. My dreams were discussed but we looked at them together, the analyst always reminding me that anything he said was only a suggestion, a possible interpretation only - he didn't claim to have all the answers.Most models have their supporters and detractors, I think there will always be people for whom one model did or didn't work. I agree that the view that CBT is a panacea for the NHS will be called into question as time goes on. Tue 10 Mar 2009 17:17:47 GMT+1 ingeniousCliff 28.nje3006. This is too serious to make claims like this.It does cost often £100 plus per week.Every dream IS analysed as is every nuance and the trump card is always to blame the patient even if the therapist falls asleep. A frequent occurence , see the literature.The Kleinians, Freudians and Winnicotians (the 3 major schools of psychoanalytical therapy) have been fighting to the death for years and have put little time into decent trials. It is a tragic waste of time and very wrong. It does take years, the patient becomes a pawn in a cult like power relationship and do not expect to be released with good grace until after at least 3 years. Some short term sessions can be useful but it is unregulated and when you rely on the therapist to decide how many sessions are needed the wallet or the dogma always win .CBT at least gives the patient a short term chance without abusing his or her wallet. Most mental gains are short term, that is life. But CBT has come to be seen as a panacea which is equally wrong. Tue 10 Mar 2009 15:47:31 GMT+1 Diziet_Sma I am a professional working in the mental health sector and I have had both psychotherapy and CBT. I am a social worker by training and currently work as a CBT trainer for adults with depression and anxiety.Oliver James, while customarily entertaining, gave a disappointingly and wilfully unbalanced view of CBT including just a few of those "lies" he heartily condemns in others- I'll stick with one. CBT does not absolutely not promote "postive thinking" or "lying" to oneself about social situations or personal feelings. It focusses on the crippling negative (not realistic) thinking characterised by depression and anxiety. Comparing psychotherapy and CBT is like comparing apples and pears. Psychotherapy focusses on the question "why do I feel the way I do". When you're done with finding out you feel depressed because Mummy (and it is invariably Mummy) was over- critical/cold/difficult/self obsessed you move to CBT which focusses on the "How do I manage these feelings by challenging my negative thinking and changing my behaviour". The therapies are doing 2 different things. I am amused that Oliver James recommends years of psychotherapy as a fix for what he identifies as essentially social ills given he comes from an intensively individualistic, inward looking, exclusive, upper class (and wildly expensive) therapeutic tradition. The discipline we should be looking to for ideas during this difficult time is actually social work which has a theoretical and practical heritage in community development and social change- but hey, that is even more unpopular that CBT! Tue 10 Mar 2009 12:42:57 GMT+1 nje3006 The meta-analysis shows that there is no one form of therapy that works better than any other. Different people find different models effective. The research shows the most important part of the therapy is the relationship between counsellor and client - irrespective of the model. The supporters of CBT hav been very effective in getting their evidence together and convincing the Govt that they have the answer - they don't. It works for some people, not for others. I think the Govt is being very short sighted in restricting NHS talking therapy to CBT only. Patients will miss out on a lot of good, effective counsellors. I disagree with a lot of what Oliver James said but I do think the "one size fits all" approach of the Govt will in time be shown to be ineffective for a lot of people.CBT has its supporters both in practitioners and service users. I don't think it helps the debate to denigrate other models with sweeping generalisations. I disagree with Getaway26 that psychodynamic therapy is not "scientifically validated" - there is validation for that form of therapy as there is with other forms, including CBT. It doesn't cost £300 per week, nor does it have to take many years, nor do all such practitioners "interpret every dream". I do agree with Getaway26 that it is difficult to understand why the BBC did not interview someone who was a CBT practitioner. Why not? Was it really that difficult to find someone from their professional body willing to discuss it?They seem to roll out Philip Hodson of BACP on many of these discussions. Why? He's not a CBT counsellor nor a particular supporter of the Govt IAPT proposals. In fact the BACP (of which I am a member) seems to have been singularly ineffective in getting its voice heard by Govt and here we are as a nation going ahead with a scheme which few professionals seem to agree is a good solution. Is it an indication that those working on BBC news programmes do not really understand the IAPT proposal and its implications? Tue 10 Mar 2009 10:47:46 GMT+1 CPTKILLER Therapy is OK but why not put these people back to work with decent wages. That in reality why they are depressed. Therapy is a band-aid. Work with decent pay is the solution.Remember that next time you by something made in China. Tue 10 Mar 2009 05:12:31 GMT+1 ingeniousCliff on.However most forms of psychological therapy are equally short term in their effects. CBT is at least cheaper than 3 times a week on a psychoanalytical couch in Hamstead (£50 plus a pop) harping on about transference and a bad 'breast' experience that has resulted in a paranoid fear of melons. (I am still not cured). CBT is cheap enough to support in an area where outcomes are poor across the board. It's probably better to have it than not. OOOOOOOh Melons. I wish I could stop doing that. Mon 09 Mar 2009 23:51:14 GMT+1 avalon9 righteousMuffin"Why go and train a whole load of other people"?Well for one thing, it looks and sounds good. It sounds like the Government, through health autorities, are being proactive in tackling the increasing number of people suffering from mental health issues. It looks like finally something is happening and the gullible are being fed this mush which passes for positive action.Reports abound which stress the cost of mental health to society. Cost in jobs, cost in this and in that and yet mental health services still cannot achieve the basics. Care planning is still letting people down and will possibly leave more and more people on the fringes when IAPT comes fully into force as only those deemed extremely vulnerable will be on full Care Plan. The rest could find themselves in no-man's land. I am not off the subject. This is all linked. Today contracts, often lucrative, have been signed to deliver this type of service. How can health authorities back down at this stage? Who will have the guts to take up this fight? I don't see user organisations making much of a fuss, but then some of them have been signed up to deliver CBT and IAPT.... If we are also sold out by our own kind, where do we go when we don't have the means to go private?Many of us believe in the NHS and would not want to go private. I am aware of some NHS therapists who have told their patients that once their limited sessions run out, they could have private sessions with them. What a brave new world we live in! Mon 09 Mar 2009 23:27:58 GMT+1 righteousMuffin Great let's have this debate!I believe that the public are being sold down the river in choice being taken away as to the sort of talking therapy they are able to access.In my area the new "therapists" being trained in CBT do not get a traditional "counsellor" training. I believe that this means that the relationship is NOT at the heart of the therapy. The number of sessions offered have been cut to the bone - a bit like the doctor's "you can only come with the one problem".Like others have said - a sticking plaster to mend a broken leg, OK when measured you might say the graze on your knee hurt less and it wasn't bleeding any more, but it doesn't mean you can walk on the leg.There are thousands of trained and experienced counsellors out there (who do not choose to adopt the CBT approach) who could offer much to those wanting to talk about their problems.Why go and train a whole load of other people to do the same unless there was something in it for the government - the low cost approach to looking like you're doing something? Mon 09 Mar 2009 22:27:36 GMT+1 nasigoreng Oliver James is right. CBT is attractive to the government because they think it is 'evidence based', good value for money and measurable. It is none of these things. It can be useful for some minor problems but so can a good chat with a friend. Mostly it just turns off the fire alarm because the noise is unpleasant - it does nothing to address the causes of the fire - mental disorder, (whether that is due to unemployment, bereavement, stress-overload etc). As James said, 18 months after completion of the 'treatment' there is no difference between those who received CBT and those who had nothing. That's short termism for you. Looks shiny and good in the quarterly stats but in the long term, it makes the problem worse.The government should apply quantitative easing to a range of treatments, not just those it can understand and which look good on the packet. Mon 09 Mar 2009 22:04:51 GMT+1 funnyJoedunn Avlaon9@17Excellent contribution. I know exactly where your coming from. CBT therapists are trained to avoid and steer people away from exploring their childhoods and long past histories. Often it can just be a way of clinically saying "pull yourself together".This is where I think I understand a little of what Oliver James was trying to say. I think he was trying to say that mental health problems do not exist in a vacuum. There are socioeconomic and political overtones attached to any individuals experience whether good or bad. In service receiver terms, its usually a bad experience. This is one reason why poor and disenfranchised people experience a disproportionate amount of depression and anxiety. LOVE Mon 09 Mar 2009 20:52:02 GMT+1 philtblog What an interesting discussion. I agree with sensiblepsych who gives quite a clear picture aboput CBT. FJD - it doesn't work for everyone and actually I find the various types of treament available for depression quite revealing about the condition.Firstly - most of treating depression is about treating symptoms. Secondly, some people find a logic based approach with strategies aimed at breaking negative though patterns and recognising when fears are uinjustified (like CBT) very valuavble whereas others don't want to be told what to think but benefit from a deep investigation of their psyche which unearths trauma that has left lasting scars. Drugs correct (or create) chemical imbalances and can be tremendously successful reminding us that the mind has at least some organic component.This guy who ranted about his personal political beliefs and touched briefly on psychiatry but only when it helped is political argumnts was very unhelpful to this debate and was not really challenged about any of his facts. He said CBT is about spin and teaching people to lie to themselves when it is actually about teaching people not to believe the lies (or exaggerations) that their brain tells them. What's worse is I'm sure he knows this and was pursuing his own agenda. Why was he given a platform? Get someone who cares about the topic at hand, not just someone who'll rant and be interesting if unhelpful - this isn't the News of the World. Mon 09 Mar 2009 20:22:46 GMT+1 Janehutch Oliver James must be living in cloud cuckoo land if he is seriously suggesting 3 or 4 years of 3 times weekly psychoanalysis for people suffering from mental health problems. I work as a community mental health nurse within a crisis team in the NHS. There is an 18 month waiting list for individuals who are referred to psychotherapy services and a time limited number of sessions available to those who eventually access it. CBT may not be a cure-all but it can be a useful therapeutic intervention for a good many people suffering from common mental health problems. It also has the benefit of being something that can be put into practice straightaway to help alleviate symptoms. I cannot think of anything more depressing for the depressed than being told that they will need 4 years of prohibitively expensive 'expert' analysis to achieve any relief from their suffering. Mon 09 Mar 2009 19:50:44 GMT+1 funnyJoedunn As someone who has been involved with a national mental health charity and having personally experienced CBT I have to say;1 Oliver Jame's argument is mostly right both both psychologically and politically.2 my experience of CBT is that (especially when used in conjunction with un/employment issues), it tends to rely on pre-ordained outcomes. Because Government say they are putting much resources into this, they also want to pre-ordain the outcomes. For this much resources in therapy, we want to see this many back to work or something like this. This is why in the long run, it will not work. Like lots of other dabbling in other areas of health and education, people do like to be treated as individuals and not the great lumpenproletariat. Therapy should be about an individuals health, recovery and comfort through a serious illness. Therapy should never be about implementing politically predefined employment or any other goals. We do not treat cancer suffers in this way. The other thing the government wants to just ignore, is what Oliver James cites as the 'it could be you society'. This approach gives the impression that, no matter how false and unreal or just plain deluded your dreams, you have the right to pursue fulfilling them. Just look at programs like the 'X' factor and all the so called 'life changing' money winning game shows that have been whipped up so much that psychological well being can be and is deeply affected. Its the grabbing after the unattainable where we have been brainwashed and addicted to. Government supports this philosophy by promoting rampant acquisition of material gain. Just look at the banks.CBT seeks to implant what a psychologist friend described as a 'cop in your head'. We are a prime society for this approach too with our inherited class based repression and famous English reserve. I want therapy to get rid of the cop in my head that wants to tell me I have to conform to the present evil. Just because they think it works for them... Mon 09 Mar 2009 19:23:52 GMT+1 dennisjunior1 Eddie:I think it is a wonderful and good idea....Since, it will show insight into the persons' needs...-Dennis Junior Mon 09 Mar 2009 19:16:02 GMT+1 avalon9 I am a service user of mental health services and a mental health researcher.Mental health services are being drastically transformed into IAPT services across the country with the effect of reducing choice, rather than increasing it as it is claimed at every turn, including by some oddly evangelical service users who should really know better but who are fooled by empty promises and no robust evidence to make a true judgment.The lies about IAPT need to be much more forcefully exposed. Sure enough, IAPT look on the surface cheaper to run than normal secondary mental health services. Those services will also be delivered by all kinds of people, many of them with non clinical training. If I were truly cynical, I’d say you could possibly train a monkey to deliver CBT and I would not be surprised if CBT toolkits flourish here and there to do just that; train “anyone” that is...There is also big money attached to IAPT services at the moment. Millions of pounds are being thrown in at least for the next two to three years, with private contractors often getting the contracts. Thereafter, who knows...As your correspondent rightly said, CBT suits only certain types of people. However it will be forced down our throats as not much else will be available. Fewer psychologists are now trained to deliver traditional psychotherapy (instead a lot of the training is diverted towards CBT) with the result that psychotherapy and psychoanalytic therapies are virtually no longer available through the NHS. When they are, it is usually offered only as group therapy and for a very short period of time (up to six months locally) when everyone agrees this type of work on the self takes a very long time to establish itself and start making a difference. If not only you cannot afford private therapy at £50 a session (preferably twice a week), and if don’t know how to properly chose your private therapist (amongst the many different schools of approaches), I’d say you’re doomed.There is a big push to get people back into work quickly. Hence the appeal of CBT which looks like a miracle plaster. A plaster is exactly what it is. Teaching psychologists to help patients think differently about their childhood: what a load of nonsense this is, it is still extremely superficial work. Psychotherapy on the other hand is about working in depth, about the individual, about their needs and that takes time.IAPT will be linked by the primary care trusts, who will implement them, to deliverable outcomes. This means targets and timelines. This potentially means pushing people through that system. That potentially means GPs being asked to write a script for CBT via IAPT and nothing else. Think I’m kidding? It would not surprise me.In the end this mess may end up costing society much more in financial and human terms. Since we live in a society when short-termism prevails, is it so surprising?Already we are facing a situation where people with mental health issues are increasingly facing revolving door services. It used to be revolving door hospital/ community services. Now it is revolving door in the community where individuals end up in crisis as community services disappear, are seen by crisis services, patched up through CBT or similar short term input and discharged again. Every time the person is looked at as a new patient (great for stats) when in reality they are individuals who never got proper care in the first place. Who’s fooling who? Who are the truly crazy folks playing with our lives? Our. Lives. Mon 09 Mar 2009 18:59:35 GMT+1 Tsogyal What a brilliantly funny interview! It had me roaring with laughter all the way up the A34. The shrink who was anti-CBT should have his own show - what a breath of fresh air! Also, I think he's absolutely right about CBT. It's just folk telling you to put up with injustice, oppression, etc. and not get depressed about it. I reckon Jung was right - ultimately the only real cure for depression is finding (or being found by) God. Doesn't matter which religion, but it seems to me that people without a personal faith are bound to feel depressed - why wouldn't they be? Mon 09 Mar 2009 18:53:58 GMT+1 Charlie darkd @14You're quite right.But, they're all over it... more like a rash... Mon 09 Mar 2009 18:37:56 GMT+1 darkdesign Governments can't cope with mental illness. It's can't be solved with a tablet, or an injection, or physio: it's messy.Then along comes CBT, a neat little abbreviation that sounds good on the telly, and they are all over it like a cheap suit. Mon 09 Mar 2009 18:29:59 GMT+1 Lady_Sue Without wishing to state something from the Ministry for the Bleeding Obvious: wouldn't JOBS for the unemployed be a little more useful? Mon 09 Mar 2009 18:28:04 GMT+1 steamyjoe I can only repeat the age-old wisdom that - anyone who goes to a physciatrist needs their head examined! Mon 09 Mar 2009 18:17:34 GMT+1 hazifantasi I am glad this is being discussed. I heard a minister basically explain that the extra money would be used to 'help people find a positive'.. if I had been made redundant I wouldn't touch that service with a barge reveals the basic flaw in rolling out cognitive behavioural therapy (cbt)as the cure all.CBT is valuable ..sometimes..I know,if any one tries to tell me how to think, I am out of the door. There are hundreds of qualified therapists already, if not thousands, who are really skilled and who could be a valuable addition to the health service immediately. By singling out one approach as the 'saviour' is not clever, not funny and possibly detrimental ( excuse the pun)Basically the British Association for Counselling and Psychotherapy (BACP) seems so scared of saying 'boo' to the government because the fear is they will not be included in the process of registering therapists. The fact that the majority of the BACP membership are not CBT trained would mean that BACP may cease to exist. Last summer the BBC reported on an international conference held at the University of East Anglia where three professors announced evidence that person centred therapy was as effective as cbt (as are other psychotherapeutic interventions).. why is the government being so blinkered about this and sticking to a one horse track? We are so wonderfully different..we all benefit from having the right to chose from a variety of approaches. And yes, I am a therapist. Mon 09 Mar 2009 18:17:17 GMT+1 darkdesign I have some small experience with this. CBT didn't do much for me, so my therapist wisely switched to an alternative that helped much more. CBT tries to enable an individual to use the intellect to 'prove' their fears are wrong. Facts don't always allay fears, though. That's why fears exist. Mon 09 Mar 2009 18:15:55 GMT+1 Sindy And yet again the unwieldy BBC modding apparatus prevents people who (presumably) know what they're talking about contributing to the debate in a timely fashion. Mon 09 Mar 2009 18:14:48 GMT+1 Getaway26 The opinions from Oliver James are highly partisan and contentious, and the BBC keeps getting him on because they think he knows what he's talking about. Not just an eccentric political lightweight, James is a paid up member of the psychoanalysis movement, a cartel of self-appointed psych "priests" who resent the emergence of non-elitist and empowering CBT because it threatens their livelihoods. CBT, unlike psychoanalysis (Freud and all that mythical rubbish), is scientifically validated, and it does indeed deal with deep issues, as any expert would tell you. It does not require 4 years of therapy at £300 a week to get a result, which is what psychoanalysis takes (maybe its patients recover because they're rich?), with the therapist "interpreting" every dream and memory of childhood to sell you on a preposterous golden-age notion of human "wholeness", or some such. Why doesn't the BBC get REAL CBT practitioners and experts on to explain CBT (people at the Institute of Psychiatry for example). They just prefer James because he's a nut who talks a good anti-captialist game. But psychoanalysis is to CBT what astrology is to astronomy. In the real world, it's no contest. Mon 09 Mar 2009 18:14:25 GMT+1 quiteFudgey Yesterday the government announce it was going to invest another thirteen million pounds to train health worker staff how to council victims of mental health problems as a result of the present financial climate.I would have thought the government’s official adviser on matters concerning ‘mental health’ should be given counselling him or herself coming up with such an idiotic suggesting.The simplest and quickest way to overcome peoples’ anxieties due to the government’s mismanagement of tax payer’s money, is to split the thirteen million equally amongst those people who have lost their jobs and pay off their mortgage.At least this treatment would react instantly and there are no know side effects. Mon 09 Mar 2009 18:10:35 GMT+1 drstephenpalmer Politicians and their advisors can refer to the NICE guidelines to check out what is effective. CBT has been shown in many studies to be effective for clinical depression and anxiety. Being relatively low-cost does not mean that CBT is ineffective. Mon 09 Mar 2009 18:08:21 GMT+1 newlach I would prefer that no one was depressed, but I think unhappiness is a part of life. I remember a quote that says that normal unhappiness is fine, but that it is neurotic unhappiness that is the problem. We should not go around asking people if they are unhappy. If you ask enough questions you will find more than enough unhappiness. Where people's jobs depend on others' unhappiness, the number of depressives in society is likely to increase. Mon 09 Mar 2009 18:06:17 GMT+1 brocklette 5 years ago I was depressed and suicidal. I had CBT with a wonderful therapist and now I am absolutely fine. Your expert should not so readily write off a treatment which literally saved my life, and gave me and my family a new future. Mon 09 Mar 2009 18:02:46 GMT+1 sensiblepsych I'm a trainee clinical psychologist in my first year. All our CBT teaching has stressed that we should enquire about our clients' childhood, and we've been taught to think collaboratively with clients about how their current difficulties might have a basis in things they learnt when young, or how they were influenced by their main caregivers. There are also many techniques (schema-focused therapy and imagery-based techniques to name but a few) for helping clients to think differently about what happened in their childhood. I simply do not understand why Oliver James claims that CBT does not take childhood origins of psychological distress into account, unless perhaps he himself has never been taught it properly? Mon 09 Mar 2009 18:02:04 GMT+1 Sindy It rather looks to me as if the government are doing for our mental health what they have done for education - they've plumped for a cheapish intervention, as though they're qualified to judge between different approaches, just as they imposed the literacy strategy (before the pilots has been evaluated) - as if we had elected a government which knew how to teach children to read.Let the politicians stick to their area of expertise, let the health [and other] professionals get on with theirs. Mon 09 Mar 2009 18:00:59 GMT+1 David_McNickle I'm sure they'll work it out. Mon 09 Mar 2009 17:54:56 GMT+1