Online CBT for depression - NHS service

More people using it because there aren't enough human practitioners to deal with the need.

I suppose it may be a Good Thing, but vampire is right when she says there aren't enough human practitioners to deal with the need for talking therapies. The internet is a useful tool but it doesn't replace the empathy, support and appropriate challenge that comes from psychotherapy with an experienced, skilled practitioner.

I am not sure that having a human being there makes much difference. I went for the first part of a CBT assessment today and, pleasant though the lady was, she was turned sideways from me most of the time, because she was tapping away at the computer keyboard. Much of that time she was ticking boxes on questionnaires, as I answered the questions that she fired at me. "How many times a day do you feel x,y,z?/ when did you last feel like killing yourself?/ rate x,y,z from 1 to 10 etc, etc/ do you consider you have ever been emotionally or sexually abused?" - then she was totting up scores on these various inventories to decide whether I warranted treatment.

The questions were mechanistic and were in no way a response to what I was saying - not that I got the chance to say much except "Yes/No, every day, moderately etc." in response to the closed options that I was being given.

I told her I was on an antidepressant and she could not spell it - and said anyway she knew nothing about them!

Her designation on the bottom of her letter was "High Intensity Worker" - I almost expected to find she was an ant!

When I was on the other side of the desk (so to speak) during my career, I used to try and engage with the person by facing them, smiling, giving them encouragement etc. - I would ask if they minded if I jotted one or two things down. We would engage in normal human intercourse, with the conversation ebbing and flowing between us. I would then write it all up after they had left.

How things have changed. A robot or a computer could have done what she did.

That's appalling, mishap. We need to be acknowledged by MH workers even if they are only filling out a form. I bet this is a new idea to save money. Instead of having a MH professional completing the form they have a member of the office staff as, to them, it's just a form filling exercise.

Among his many complaints about the place I have to go to, DH said that the member of the office staff who opened the doors (it's an airlock) never acknowledged us. She simply came out of the office, pressed the button and went back. Since then I have to admit the office staff have been much nicer. They wait, say 'hello' and smile. It only takes 30 seconds but it makes such a difference. I wish they could teach it to the MH professionals who work there.

And on the subject of airlocks. What idiot decided that all MH facilities in this region needed airlocks? I can understand it at the hospital where there are people on wards but not everywhere. I feel so trapped by airlocks.

Mishap it sound like she just had to get the facts down. An actual therapist wouldn't be like that. Give them a chance!

Actually, they probably wouldn't want you thinking too much about your answer. Perhaps it needed to be quick-fire.

She IS the therapist!!

OMG. Though unfortunately I can't say I'm surprised.

My psychoanalyst and CPN both told me that trust between us isn't necessary and wonder why I find it hard to cooperate with them. They also seem to have problems remembering my name, DH name and other basic facts. I suggested they put a crib sheet on the front of my file but they said it wasn't necessary and I shouldn't get so upset just because they got my name or DH's name wrong. After all they deal with lots of people. I pointed out that although that was true at that particular moment they were dealing with me and surely it was only polite to call me by the correct name. I've even had letters sent with the wrong name on. The get my surname right but get my Christian name wrong.

That's terrible Mishap. I would have thought they would realise how low people felt when they got to the stage of seeking help and could be a bit more human about it. I realise she has a job to do but for goodness sake!

I won't give up on it - I will go to the next appointment. I just thought it was sad that it has all become so mechanistic. It truly could have been dine by sending me a link to a computer programme.

Oh heck! I thought she was just some preliminary person who took details down. Oh well. Don't give up. She might improve. But be ready to stand up to her if necessary. Remember, this is not a Freebie. You have paid your national insurance for enough years. You are entitled to a little respect. And to a good measure of professionalism. Be strong.

Thanks jing.

The original thread was about CBT online and the way that it is now delivered face to face is so divorced from human communication that it might just as well be online as far as I can see.

I will persevere because I am determined to get well and all the research indicates that a combination of drugs and taking therapies gets the best results.

It's sad that you have to persevere alone. The best therapy I have had has been when there has been a mutual respect between myself and my therapist.

Mishap that is dreadful - gives us some idea why therapists get a bad name. Hang on in there and as jings said be ready to question if necessary. Good luck

Mishap, someone close to me had a similar experience several years ago. The follow up appointment was with a different practitioner, who was half an hour late. The patient didn't go back.

Part of the problem is the government decided CBT is a quick fix for most people. I agree it can work well with some issues, but it isn't a quick fix for longer standing difficulties imo.

I do hope things improve and I agree with vampirequeen, the best therapy is when there is mutual respect between the therapist and the person receiving therapy

The service that I have been tapped into has some silly name - can't remember exactly what - something along the lines of Talk2you. They are financed by the NHS and are the only counselling service available in this area - and they only offer CBT, nothing else.

I wish there was a "quick fix" for me!

I do feel concerned that CBT is the only therapy on offer, as help should ideally be tailored to the individual.

In this area they've decided that DBT is the way to go so, of course, people like me who don't fit into that programme are left in limbo. Under the old system we were treated as individuals with our own needs. I suppose it saves money to lump us altogether.

Anyone on twitter who would like to complain about this, you can do so tomorrow at 9 p.m. on a twitter storm organised by the NHA.

nhap.us7.list-manage.com/track/click?u=937c3e62bc24fa37708920cc9&id=626e51ccf5&e=716bee6853

Mishap I think you will feel a lot better in yourself once your physical pain has got better. I hope that gets dealt with soon, or that time passing helps it. I've had a bit of a back for a couple of days, and it can really bring you down.

I think the government are doing all they can. They can't make money out of thin air.

That's what governments do, jingl. They decide how much money to tax people and to spend on services. They do not have any money themselves. They decide it's better spent on Trident than the NHS, or on tax breaks for people who will vote for them rather than on benefits. for people who will not.
I think your statement is rather naive.

Mishap, a close friend was given the usual 6 CBT sessions, told the therapist he didn't feel it was enough and there were deeper issues he needed to work on. His GP referred him to clinical psychology and he's having excellent long term psychotherapy with a properly trained and supervised therapist. This is an option for all of us, though there is often a waiting list

CBT is usually short-term and solution-focused and doesn't really hit the spot (as far as I'm concerned anyway). But then I subsequently had a year of psychodynamic therapy - pfffft! I waited longer for this because I asked to have someone senior and more experienced. What a waste of time. Sessions consisted of her looking intently at me until I broke the silence with whatever occurred to me. I talked for England but nothing was resolved, there was no guildance, advice or help on coping with overwhelming feelings, anxiety or depression, just a bit of reflective listening. A waste of time, and in fact it made me feel far worse because I just went round in circles all the time - metaphorically speaking, of course. I'd avoid psychodynamic therapy like the plague if I were you. For me, there was no choice: it was that or nothing.
The trouble is that mental health provision is poorly funded, so there are only a few therapies on offer and patients have to take it or leave it, whether or not they are appropriate for them or not. It's like trying to fit a square peg in the proverbial round hole, but if the therapy doesn't help, then it's not their 'fault', of course - you simply haven't 'engaged' with it properly!

Oh, and durhamjen, I completely agree. Of course Trident is more important than mental health provision, which isn't sexy anyway, so who cares? No, jingl, I don't have the same faith in government as you do. Mental health has always been at the bottom of the funding pile, and it's probably going to get a lot worse.