I don't know what models this guy is using, but according to the article this is being trialled in the Jobcentre. That can only be with one goal: to roll it out further
Your opinions of co-location of IAPT staff in Jobcentres
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wulwirth
New Member
Took the words from my mouth
Strange reading after the previous reference to CBT at job centers.
existentialist
Tired and unemotional
I am well aware that BACP does not hold a monopoly on accreditation and governance of the profession - but it is, for better or worse, generally seen within the counselling field as the default template for ethical practice, etc. And I don't doubt that the training of IAPT staff is, for the level of training required, admirable. But - as has been pointed out further upthread - IAPT was set up with a fairly narrowly-focused goal, and my main concern is that I wonder how many practitioners are able or willing to accept when the work needs to go beyond that goal, or is failing because it is not an appropriate intervention for that particular client. An article in a recent copy of the BACP's house journal relates the experiences of someone who was seeing an IAPT practitioner, and was being quite clearly told that if the therapy wasn't working, it was the client's fault. That is the sort of statement which a therapist, working within an ethical framework such as the BACP's, would not dream of making, and it doesn't seem to be a unique occurrence.
Let me make myself very clear - I don't think CBT is inferior to other therapies, or that its practitioners are inherently inferior to the practitioners of other therapies. I don't think there is anything inherently wrong with IAPT, or the way in which the people who are trained to deliver it, either.
But I do think there is a grave risk that people who commission therapies, and sometimes even the practitioners themselves, can misapply them - someone who understands only one modality is always going to be somewhat more at risk of the old "if all you've got is a hammer, everything looks like a nail" problem, and that becomes a particular danger when an organisation employing such people is contracted to perform a specific task to achieve a goal they have defined.
Really, this whole thread is about the misapplication of perfectly valid therapeutic approaches by lay organisations such as the DWP, and what we need to do as practitioners to ensure that people aren't harmed, and professions undermined, by inappropriate use of them by such organisations.
wulwirth
New Member
The words CBT/CCBT are controversial and the main problem money, so the government pledge £21m for DWP usage at job centers, surely problems are far wider than job centers, they appear to be throwing lots of money at it, although from media it is a massive worldwide problem, not easily solved.
UK GP's allocated from memory around £1 Billion... https://lindahansard.wordpress.com/...rk-with-job-centres-following-1bn-investment/
http://www.youngminds.org.uk/news/b...for_job_centre_mental_health_treatment_scheme
USA https://www.wecounsel.com/americas-...6309567&utm_medium=social&utm_source=linkedin
We appear to be in a bit of a mess.
existentialist
Tired and unemotional
CBT, and even computerised CBT, don't need to be controversial. There is nothing inherently wrong with either.
The problem comes when they start to be used as tools to implement policy that is a lot more about political motivation than client well-being. At that point, they get caught in between the ethical values that need to exist within any therapy, and the political imperatives that are driving - and funding - them.
wulwirth
New Member
We are all brainwashed in society regardless IMO, possible to make people believe most thing if said enough time, government ethic is money, they do not care if we live or die, but have to appear so, to keep face and stay in power!
Power Money live together we are pawns in a bigger game IMHO.
Alternative therapy seems the way forwards, pills are addictive and do not cure depression and related problems, been there and done it.
Best...
Power Money live together we are pawns in a bigger game IMHO.
Alternative therapy seems the way forwards, pills are addictive and do not cure depression and related problems, been there and done it.
Best...
existentialist
Tired and unemotional
I don't tend to think of the work I do as "alternative" therapy...I think there is an over-reliance on medications and "technical" solutions, but it is not so much that they are "addictive" (most antidepressants are anything but), but that the benefits don't outweigh the drawbacks as much as many in the medico-psychological establishment would like to think.
People want definitive answers, they want to believe that the relationship between x and y is simple, but where our minds are concerned, it can never be simple. It can be logical, analysable (to some degree), causal, and all those things, but it is always complex. Which means that definitive answers are hard to get.
The diagnosing, labelling, and prescribing that the medical model tends to go in for reduces that complexity to a more finite collection of "symptoms" which they then aim to have treatments for. Sometimes, that will hit the target perfectly, but most doctors will admit that that's more about luck than just judgement. More often, it doesn't quite address the problem, and more complex - and therefore less simplistic - approaches are required. These approaches are hard to quantify, and not just difficult to measure, but prone to being quite badly disrupted by carrying out such measurements. Outcomes are not predictable - the easy cases probably don't get this far, so success rates may even appear to be comparatively low, in the same way that a surgeon who works on "last ditch" high-risk cases might show a death rate that's worse than the average. In both cases, though, what's important is that someone who has been considered "incurable" (or at least untreatable) by the simple methods has the possibility of achieving a recovery by more complex ones.
I am saying this in response to you, wulwirth, because I think it's important to recognise that, just because something isn't mainstream, that doesn't make it "alternative". Or any less valid.
People want definitive answers, they want to believe that the relationship between x and y is simple, but where our minds are concerned, it can never be simple. It can be logical, analysable (to some degree), causal, and all those things, but it is always complex. Which means that definitive answers are hard to get.
The diagnosing, labelling, and prescribing that the medical model tends to go in for reduces that complexity to a more finite collection of "symptoms" which they then aim to have treatments for. Sometimes, that will hit the target perfectly, but most doctors will admit that that's more about luck than just judgement. More often, it doesn't quite address the problem, and more complex - and therefore less simplistic - approaches are required. These approaches are hard to quantify, and not just difficult to measure, but prone to being quite badly disrupted by carrying out such measurements. Outcomes are not predictable - the easy cases probably don't get this far, so success rates may even appear to be comparatively low, in the same way that a surgeon who works on "last ditch" high-risk cases might show a death rate that's worse than the average. In both cases, though, what's important is that someone who has been considered "incurable" (or at least untreatable) by the simple methods has the possibility of achieving a recovery by more complex ones.
I am saying this in response to you, wulwirth, because I think it's important to recognise that, just because something isn't mainstream, that doesn't make it "alternative". Or any less valid.
wulwirth
New Member
I do know that BTB has undergone numerous trials and is Nice registered for NHS usage as an alternative with other CCBT programs, I would say, is a reasonable alternative to addictive pills that fail people and make them reliant, suppose those have there part to play, with worldwide mental problem.
chainsawjob
Kipping in the dunes
I wonder how rare this is though? I have had it said to me by an NHS therapist whilst doing CAT, and so have other people I've known. It shouldn't be said. Took me a while to stop blaming myself and realise CAT wasn't the right approach for the problems I had. CBT/CBT-lite in jobcentres risks adding more self-blame to the problems of people already experiencing depression or other mental health issues, or even those who aren't (feels a very obvious point to make).
This organisation may be of interest, I like what they say about the psychological effects of austerity.
https://psychagainstausterity.wordpress.com
existentialist
Tired and unemotional
I suspect it's not that rare, and I am sure it probably goes on - possibly unconsciously - across the counselling world.
But one of my other "hats" is training counsellors. I take them at the start of a three year course and bash them into shape ready to hit the main diploma course in years 2 & 3
. And one of the constant themes that I maintain through the year (and I know it's continued onwards) is that of building self-awareness, which is critical in minimising those unguarded or prejudiced thoughts we all have, and preventing them from turning into words or actions. Even if everything the client does makes us feel like they're not putting in the effort, it is not for us to tell them that. Certainly not in so many words, because that's just punitive and critical, and most people can get plenty of that elsewhere. We might speculate as to what resistance the client has to change that is making it so hard for them to achieve, but we'd be doing that from the perspective of finding a way of overcoming it, not of fingerpointing at the client because they hadn't done it "our way".Frankly, if a counsellor says to a client "the therapy's not working because you're not doing it right", the answer has to be "well, if you were any good as a therapist, that wouldn't have to matter". Because it shouldn't, to the therapist. Except, of course, if the therapist is working in some kind of results-driven goal-focused manualised therapy process where the client going off-script immediately takes the process into uncharted waters, and Must Therefore Be Wrong.
Plumdaff
joy in people
I have to say that whilst I think that they are overused, not least because of a dearth of other options, and that they are of very limited use for most people with mild to moderate depression and anxiety it's complete nonsense that antidepressants are addictive. They can be very helpful for people, and when I was very low they were a literal lifesaver, and I'd never say someone should or shouldn't take them.
Coming in again as a devil's advocate, I don't really see why being outcomes driven is so terrible most of the time. The point, surely, is to lower suffering, otherwise the question should be why do it? Now of course you can consider how you measure, what you measure and why but frankly I think every clinician should want to know whether their intervention has made a difference.
With a CBT or other cognitive approaches there's often a strong focus on what happens outside the sessions and putting into practice what's discussed. Put bluntly if nothing happens outside the sessions it probably isn't worth doing CBT or another cognitive approach. Discussing that, discussing the reasons why, and finding the best approach for an individual can be done with varying levels of skill and tact.
Ultimately it's what the person wants to achieve from therapy,what their goal is you might say
. I regularly send people to counselling colleagues if that approach is going to work better for them. The issue is that a there's not enough therapy full stop b there's not enough options and c too many therapists become zealots for their modality.
Coming in again as a devil's advocate, I don't really see why being outcomes driven is so terrible most of the time. The point, surely, is to lower suffering, otherwise the question should be why do it? Now of course you can consider how you measure, what you measure and why but frankly I think every clinician should want to know whether their intervention has made a difference.
With a CBT or other cognitive approaches there's often a strong focus on what happens outside the sessions and putting into practice what's discussed. Put bluntly if nothing happens outside the sessions it probably isn't worth doing CBT or another cognitive approach. Discussing that, discussing the reasons why, and finding the best approach for an individual can be done with varying levels of skill and tact.
Ultimately it's what the person wants to achieve from therapy,what their goal is you might say
. I regularly send people to counselling colleagues if that approach is going to work better for them. The issue is that a there's not enough therapy full stop b there's not enough options and c too many therapists become zealots for their modality.
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existentialist
Tired and unemotional
Likewise, here. I am (professionally) agnostic about the pills themselves, but less so about the tendency to reach for them at the first instance.
I've been on ADs where they have been very beneficial, and on another occasion where they haven't.
The "addictive" thing probably comes from the advice that it is a bad idea to stop taken them abruptly - some people can find, if they do, that they experience "head shocks" or other mood problems, so the advice is usually to taper them off. I've certainly never had any difficulties with discontinuing them, and to the best of my knowledge, no client I have ever worked with has had anything remotely like withdrawal symptoms either.
Looby
Well-Known Member
I've had CBT three times in the past 4/5 years, with the same therapist each time.
It has helped to a degree, certainly with particular negative thought patterns and recognising/managing anxiety symptoms but I'm still really fucked up. I still have a lot of crap hanging over me that I've never dealt with and never had time to properly talk about in therapy.
That was all that was on offer though unless I was referred to the CMHT which I think I'd have had to have attempted suicide to qualify for.
After the third course of treatment, I had a long chat with my therapist about the future. He said I could come back to the service for further treatment if needed but he didn't think it would be particularly useful as I'd been given the CBT tools and he had very little else he could do with me apart from go through them all again.
He wasn't being mean, we had a really good relationship, but I think he recognised the limitations of what he could do in 15-20 sessions when there was so much historical shit to wade through.
So now I'm stuck. Recent events have stirred up some stuff and I think I need help. I can't afford private psychotherapy, I don't think CBT is appropriate so I'm left with trying to get counselling from a very busy and very underfunded charity.
I'm really fearful of this IAPT/DWP thing as it's so obvious how this will be used against claimants. It's all too easy to feel like a failure if treatment 'doesn't work' without that being confirmed by the cunty DWP and risk having benefits cut.
Anyway, my point was that whilst CBT clearly has benefits and can work very quickly and effectively for many people, there are limitations that I can see as a service user. These aren't ever addressed because CBT is all that's on offer so there's no point talking about those limitations or possible alternative methods.
It has helped to a degree, certainly with particular negative thought patterns and recognising/managing anxiety symptoms but I'm still really fucked up. I still have a lot of crap hanging over me that I've never dealt with and never had time to properly talk about in therapy.
That was all that was on offer though unless I was referred to the CMHT which I think I'd have had to have attempted suicide to qualify for.
After the third course of treatment, I had a long chat with my therapist about the future. He said I could come back to the service for further treatment if needed but he didn't think it would be particularly useful as I'd been given the CBT tools and he had very little else he could do with me apart from go through them all again.
He wasn't being mean, we had a really good relationship, but I think he recognised the limitations of what he could do in 15-20 sessions when there was so much historical shit to wade through.
So now I'm stuck. Recent events have stirred up some stuff and I think I need help. I can't afford private psychotherapy, I don't think CBT is appropriate so I'm left with trying to get counselling from a very busy and very underfunded charity.
I'm really fearful of this IAPT/DWP thing as it's so obvious how this will be used against claimants. It's all too easy to feel like a failure if treatment 'doesn't work' without that being confirmed by the cunty DWP and risk having benefits cut.
Anyway, my point was that whilst CBT clearly has benefits and can work very quickly and effectively for many people, there are limitations that I can see as a service user. These aren't ever addressed because CBT is all that's on offer so there's no point talking about those limitations or possible alternative methods.
existentialist
Tired and unemotional
There are therapists and agencies which will see people for reduced fees - obviously, the less you can afford, the fewer options there will be, but it is worth exploring the possibilities. A charity for whom I work offers low-cost counselling with its graduated students while they work up enough hours to complete their qualifications: we have to be a little more careful with assessment, as some clients' presentations aren't suitable for a comparatively inexperienced counsellor, but for many people it can be an opportunity to do some really useful work at little cost. It may be worth finding out if there are any organisations in your area that do something similar - although to be fair most training establishments tend to have their students go to outside agencies for placements rather than providing them internally, the way we do.
Other options - you may already have exhausted these - are various charities (and don't assume there's just one). Sometimes church groups run counselling services, but that doesn't mean the counselling will necessarily be "holy". And it's probably worth looking up on http://www.itsgoodtotalk.org.uk/therapists to see which therapists offer a sliding scale of fees, in case there's someone near you.
And don't assume you need a psychotherapist - it may simply be that a reasonably experienced non-CBT counsellor is just the job.
As for your concerns about the DWP IAPT thing - yes, I think this is a worrying development, but I feel that it should be possible to navigate it without being compromised. My view would be that, much as people do with these get-you-back-to-work agencies, if you stick to your guns and know your rights, you can probably bollix up the system quite nicely: for a start, you should be entitled to insist on confidentiality and that your client information is not shared at all with any other agency, let alone DWP. That in itself will probably put the skids under a therapy referral quite nicely, as the system is probably entirely geared up to them being able to browbeat you into agreeing to waive your right to confidentiality.
Another option, if you do end up being forced into seeing one of their therapists is to reiterate your desire for confidentiality to the therapist - again, they should not disclose anything without your specific permission, and if they do, it is likely that you will be able to make a complaint to their professional body...so make sure that you have got the therapist's name, registration number, name of professional body, etc. at the first session. And, of course, if you have any concerns that your desire for confidentiality might not be being respected, you have the option of attending the session, but refusing to share any information - that way, if they then report back to DWP that you are doing this, they have immediately outed themselves as being willing to breach confidentiality. Whichever way it pans out, I'd be really surprised if DWP is going to be able to put something legal in place that obliges you to attend a therapy process wherein your confidentiality is not maintained, so they'd be on a sticky wicket.
If I were in that position, I'd probably try a third strategy - a kind of "scorched earth" approach where I would hit the therapist with every trauma, horror, emotional meltdown and early life happenings I could think of, and let them try to pick the bones out of that. I suspect they'd "refer on" (ie., get rid of you) extremely quickly. Not very therapeutic, but it would get the job done.
Other options - you may already have exhausted these - are various charities (and don't assume there's just one). Sometimes church groups run counselling services, but that doesn't mean the counselling will necessarily be "holy". And it's probably worth looking up on http://www.itsgoodtotalk.org.uk/therapists to see which therapists offer a sliding scale of fees, in case there's someone near you.
And don't assume you need a psychotherapist - it may simply be that a reasonably experienced non-CBT counsellor is just the job.
As for your concerns about the DWP IAPT thing - yes, I think this is a worrying development, but I feel that it should be possible to navigate it without being compromised. My view would be that, much as people do with these get-you-back-to-work agencies, if you stick to your guns and know your rights, you can probably bollix up the system quite nicely: for a start, you should be entitled to insist on confidentiality and that your client information is not shared at all with any other agency, let alone DWP. That in itself will probably put the skids under a therapy referral quite nicely, as the system is probably entirely geared up to them being able to browbeat you into agreeing to waive your right to confidentiality.
Another option, if you do end up being forced into seeing one of their therapists is to reiterate your desire for confidentiality to the therapist - again, they should not disclose anything without your specific permission, and if they do, it is likely that you will be able to make a complaint to their professional body...so make sure that you have got the therapist's name, registration number, name of professional body, etc. at the first session. And, of course, if you have any concerns that your desire for confidentiality might not be being respected, you have the option of attending the session, but refusing to share any information - that way, if they then report back to DWP that you are doing this, they have immediately outed themselves as being willing to breach confidentiality. Whichever way it pans out, I'd be really surprised if DWP is going to be able to put something legal in place that obliges you to attend a therapy process wherein your confidentiality is not maintained, so they'd be on a sticky wicket.
If I were in that position, I'd probably try a third strategy - a kind of "scorched earth" approach where I would hit the therapist with every trauma, horror, emotional meltdown and early life happenings I could think of, and let them try to pick the bones out of that. I suspect they'd "refer on" (ie., get rid of you) extremely quickly. Not very therapeutic, but it would get the job done.
Libertad
Sparking up a rollie in the Reichstag
In that one post existentialist you have neatly scuppered the entire "conditionality" of this proposed shitfest. 
Libertad
Sparking up a rollie in the Reichstag
Johnny Void sticks the knife into confirmed waste of space David Rahman whose business venture "Start Smiling Again" is contracted to "practise" in Job Centres in South Wales.
https://johnnyvoid.wordpress.com/20...cess-rate-in-curing-mental-health-conditions/
Rahman can cure M.E. and Fibromyalgia as well, proper miracle worker:
http://startsmilingagain.com/portfolio-item/ive-recovered-from-m-e-and-fibromyalgia/
https://johnnyvoid.wordpress.com/20...cess-rate-in-curing-mental-health-conditions/
Rahman can cure M.E. and Fibromyalgia as well, proper miracle worker:
http://startsmilingagain.com/portfolio-item/ive-recovered-from-m-e-and-fibromyalgia/
existentialist
Tired and unemotional
Every time I read that company name, I think "what a fucking prescriptive, judgemental name to give a company doing that kind of work".
People who are in need of the kind of course that is presumably aimed at depression do not generalyl take kindly to being told to "start smiling" any more than being told to "cheer up" or "pull yourself together" goes down well.
It's facile, ignorant, and I suspect it describes their mindset and modality to a T. It'd be good to be wrong...
*grinds teeth more* I have had long and uphill battles with various people (not clients) about the psychological connection with things like ME and fibromyalgia, which I think do frequently have a psychosomatic connection.
The problem with psychosomatic illness is that it's almost a diagnostic criterion that people who are told their problem has (or may have) a psychological component tend to get pissed off by that. So strutting around boasting about "curing" ME and similar with your own particular brand of therapy is a hell of a way to start things off on the wrong foot.
Looby
Well-Known Member
Thanks existentialist. It hopefully won't affect me because I'll be signed off ESA soon as I'm going to college in September. Good ideas though, it's certainly possible to scupper their dodgy intentions.
I've got an assessment appointment lined up with a charity next month and if that doesn't work out, I should be able to access something through college.
I think I'd prefer psychotherapy because I've had positive experience of that in the past and a very negative experience of counselling. I'm open-minded though, it might be fine. [emoji4]
I've got an assessment appointment lined up with a charity next month and if that doesn't work out, I should be able to access something through college.
I think I'd prefer psychotherapy because I've had positive experience of that in the past and a very negative experience of counselling. I'm open-minded though, it might be fine. [emoji4]
existentialist
Tired and unemotional
I did find myself wondering if there was any danger of the S Wales-based David Rahman's orbits overlapping with this S Wales-based therapist's.
Then I looked at the links to his qualifications in that Johnny Void blog, and realised there was more chance of me bumping into crystal therapists, water-fondlers, aromatherapists and other purveyors of woo than finding myself on the same professional stage as Rahman.
This pleases me.
Then I looked at the links to his qualifications in that Johnny Void blog, and realised there was more chance of me bumping into crystal therapists, water-fondlers, aromatherapists and other purveyors of woo than finding myself on the same professional stage as Rahman.
This pleases me.
existentialist
Tired and unemotional
That sounds more like the difference between a decent practitioner and a not-so-good one than the difference between psychotherapy and counselling, TBH!
superfly101
Well-Known Member
I think you're wrong existentialist
IAPT has become a very political tool and it's role has changed massively since 2010. CBT via IAPT is being heavily promoted as a wonder tool that with an early light touch will cure everybody.
Now under the DWPs Health Work Wellbeing plan by 2012 the 3rd sector and the Work Program would have commissioned all the services being decommissioned under the NHS. IAPT here would have been a low level early intervention tool. Now these non NHS services are never going to happen which has meant the only point of fall back is IAPT. Now since IAPT can't fill that role the only other option is to eliminate the perceived need for those services by over hyping IAPTs ability and finding new ways of combining what little is left and re branding it beyond what it's capable of.
The new Steatham Hub is looking like a model of this in practice. Everything in one place a one stop shop of collaboration between the NHS and 3rd sector. IAPT are even promoting it because it will remove the need for Secondary services with 6 week interventions.
There was also the removal of GP Practice Counsellors in 2012 and placing the referral of patients in the hands of GPs. This coincided with the swapping of talking therapy and drug intervention steps on the NICE pathways.
Practice Counsellors could refer to other services, extend therapy into step 4 and also acted as a vital bridge to translate what the patient was saying into GP speak. Most GP haven't got the time nor a fucking clue about mental health or how to deal with those patients. They also can very very very politicised. A hell of a lot of GPs now really believe in IAPT without truly or fully understanding what it does or it's limitations.
Now if GPs have formed this opinion you can bet that this is also true of the rest of the NHS, the DWP, Councils and also 3rd party providers (charities) etc. It's sort of developed the position drugs did when they were the big thing!
With the 2012 NICE pathways change it's now IAPT then drugs all slapped squarely in the lap of GPs to decide what to do in an environment where services constantly change in availability from day to day. The change from the old pathways; drugs to fully managed referral by the therapist, into IAPT 6 weeks discharge to GP, followed by GP managed drugs means basically a perpetual cycle whereby a GP will find it hard if not impossible to get a patient out of this cycle even if they wanted too.
This is an actual audio recording transcript with a GP in 2012
Background patient in 2010 did an assisted Step 2 to Step 4 via practice Counsellor 13 sessions of 50 minutes. Referred to Low cost Psychotherapy June 2010 but GP changed at time of referral to one who still has this on the practice web about
This GP refused to help with referral Dec 2011 as it was "private" then made patient self refer to IAPT.
After 4 15 min sessions of self guided CBT (where therapist didn't turn up to 2nd appointment then claimed it didn't exist) and the the Awarenesses Centre was 6 50 mins Counselling. Both referral letters from both non IAPT counsellors end with "the patient is determined and commuted too want to get better"
IAPT has become a very political tool and it's role has changed massively since 2010. CBT via IAPT is being heavily promoted as a wonder tool that with an early light touch will cure everybody.
Now under the DWPs Health Work Wellbeing plan by 2012 the 3rd sector and the Work Program would have commissioned all the services being decommissioned under the NHS. IAPT here would have been a low level early intervention tool. Now these non NHS services are never going to happen which has meant the only point of fall back is IAPT. Now since IAPT can't fill that role the only other option is to eliminate the perceived need for those services by over hyping IAPTs ability and finding new ways of combining what little is left and re branding it beyond what it's capable of.
The new Steatham Hub is looking like a model of this in practice. Everything in one place a one stop shop of collaboration between the NHS and 3rd sector. IAPT are even promoting it because it will remove the need for Secondary services with 6 week interventions.
There was also the removal of GP Practice Counsellors in 2012 and placing the referral of patients in the hands of GPs. This coincided with the swapping of talking therapy and drug intervention steps on the NICE pathways.
Practice Counsellors could refer to other services, extend therapy into step 4 and also acted as a vital bridge to translate what the patient was saying into GP speak. Most GP haven't got the time nor a fucking clue about mental health or how to deal with those patients. They also can very very very politicised. A hell of a lot of GPs now really believe in IAPT without truly or fully understanding what it does or it's limitations.
Now if GPs have formed this opinion you can bet that this is also true of the rest of the NHS, the DWP, Councils and also 3rd party providers (charities) etc. It's sort of developed the position drugs did when they were the big thing!
With the 2012 NICE pathways change it's now IAPT then drugs all slapped squarely in the lap of GPs to decide what to do in an environment where services constantly change in availability from day to day. The change from the old pathways; drugs to fully managed referral by the therapist, into IAPT 6 weeks discharge to GP, followed by GP managed drugs means basically a perpetual cycle whereby a GP will find it hard if not impossible to get a patient out of this cycle even if they wanted too.
This is an actual audio recording transcript with a GP in 2012
Background patient in 2010 did an assisted Step 2 to Step 4 via practice Counsellor 13 sessions of 50 minutes. Referred to Low cost Psychotherapy June 2010 but GP changed at time of referral to one who still has this on the practice web about
This GP refused to help with referral Dec 2011 as it was "private" then made patient self refer to IAPT.
After 4 15 min sessions of self guided CBT (where therapist didn't turn up to 2nd appointment then claimed it didn't exist) and the the Awarenesses Centre was 6 50 mins Counselling. Both referral letters from both non IAPT counsellors end with "the patient is determined and commuted too want to get better"
existentialist
Tired and unemotional
I read your post, but I couldn't quite figure out what it is you think I am wrong on, specifically?
superfly101
Well-Known Member
You come across as somebody articulate intelligent and dedicated which is all good tbf!
Unfortunately you are now the exception! I also doubt that somebody like you c/would work for IAPT?
Perception >>>> Reality it's how political change works!
existentialist
Tired and unemotional
I would not work for IAPT, for a number of reasons. The most important of which is that, as I understand it, I would be almost guaranteed to be breaching my professional ethics. Perhaps a more important reason from an outside point of view would be that I lack the necessary training and experience that I would require to do it.
I'm still not sure what it is that I have said that you disagree with, though!
Plumdaff
joy in people
Also IAPT doesn't exist in Wales where existentialist and I work. It's England only. Also as I understand it no IAPT service as yet is co located with Dwp, these are proposals not that non IAPT psychological coercion hasn't been being trialled. It was very obvious from the start of IAPT that this was the end point, it was part of the early proposals. I really feel for the clinicians caught up in this, I bloody hope they're unionised and getting organised. We have Psychologists Against Austerity in this bit of South Wales it needs to spread.
The Welsh situation is in many ways a good thing as these particular pressures aren't put on NHS therapists - not that the ideas aren't present in the Dwp here as we can see from the Start Smiling bollocks. The down side is that all that money that IAPT received never happened here and training for and availability of therapies in the Welsh NHS is patchy to put it mildly. Woeful might be a better description.
The Welsh situation is in many ways a good thing as these particular pressures aren't put on NHS therapists - not that the ideas aren't present in the Dwp here as we can see from the Start Smiling bollocks. The down side is that all that money that IAPT received never happened here and training for and availability of therapies in the Welsh NHS is patchy to put it mildly. Woeful might be a better description.
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existentialist
Tired and unemotional
I hadn't realised Psychotherapists Against Austerity was a South Wales-based thing!
What a militant bunch we are...
I can feel a South Wales Urbanite therapist meetup coming on. Maybe we could gatecrash a Keep On Smiling shindig somewhere
existentialist
Tired and unemotional
My co-tutor is a nurse, and my GP counselling service managers are both ex-nurses.Keep on Kicking has a certain ring to it
And full disclosure I'm first and foremost a nurse, albeit one who tends to use other qualifications more these days.
And quite a few of my students have been nurses.
There's a lot of it about
Libertad
Sparking up a rollie in the Reichstag
So do I but what about the
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