I am still appalled by the lack of information available to people who find themselves with a mental illness. Sure, there are lots of leaflets, books etc that tell you how to get better, but most people tell me they need to know where their base is first before they can even contemplate trying to improve.
A diagnosis from your GP can be a shock. All the doubting questions race through the mind, personal recriminations follow and then we are left in a void, not knowing where to turn and questions are left unanswered. The fact that mental health does not take as high a priority in the NHS as physical illnesses, is a a travesty, one that few governments really want to tackle. The fact that waiting lists now stretch to twelve months in a lot of areas is testament to that. The whole idea behind IAPT (Improving Access to Psychological Therapies) was to offer a wide range of therapies, but NICE needs evidence-based results and they decided CBT (cognitive behavioural therapy) would fit the bill. But it doesn't.
I read in a recent copy of my regulator's Therapy Today magazine that at long last, significant data is being sought for counselling vis-a-vis CBT. It is years overdue although some data from a few years back showed that counselling is just as effective as CBT in dealing with depression and anxiety.
But you, the patient probably wonder, quite rightly, what is the best therapy for you. Does your GP offer that information? Does the consultant they refer you to offer that information? Does anyone?
Given the confusion, I thought I'd offer some questions that you can print off and take to your GP or mental health worker. Of course, if you feel there are other questions, feel free to add them and please, drop me a line as I want to work with you on this.
So, here are those questions.
- Are you suggesting medication or therapy or a combination of both?
- What therapy are you suggesting I have? ***(see note below)
- How long will I need to wait for this therapy?
- Will the therapy be one-to-one or group work?
- Will the therapy be time focused (a set number of sessions) or open-ended?
- Will the sessions be weekly?
- Will the sessions be face-to-face or over the telephone?
- What happens at the end of the therapy sessions?
*** The general options here are CBT, Counselling, Psychotherapy.
CBT is ONE theory out of all those available and normally requires quite a bit of input from you. It deals with the specific problem you have and rarely takes into account much of your past life.
Counselling is eclectic, that's to say you will have a counsellor who can call on many theories to help you. Counselling is often a slightly longer process (more sessions to you and me) although be aware, some health units do limit the number of sessions. It will deal with your whole life, not just a specific issue in the here and now.
Psychotherapy is like counselling, normally open-ended and may well go a little deeper and invariably is longer term work. Again, like counselling, it is eclectic and deals with your whole life.
It's important to know what you are being offered because you will know what feels more comfortable for you.
CBT can be very effective but it is a therapy that has become confined to questionnaires, tick-box answers and the like as that way, the evidence of success, or otherwise, can be gauged. From my work at Sutton Hill surgery, a lot of patients did not like the 'tick-box' system and felt the need to be able to talk freely and without constraints - such as in counselling.
I want this website to be a place you can come to to ask questions about your treatment, so by all means, drop me a line if you wish and/or share your experiences, good and bad. You can do it anonymously if you wish.
Don't be left puzzled by the lack of information out there.
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