After The Guardian spatt on a Welfare Reform article
By Jonathon Ruthford
with Brett the Best
This dogology above was called for .
By the Way - CBT :
Cheek Behavioural Therapy is available
At USERWATCH ROOMS
(Look what we do for that Silvis Rivers ...)
Wicked exchanges below noted from the Guardian .
LORD BRETT :
Good article, good thread and I fully agree with 99% of posters, however,
"neck bolting cogbottery of CBT"
As a CBT therapist myself, I`d be interested in a more informed discussion as to your seeming distaste of this approach, rather than the concern I assume you have (which I share with many) that it (like anything else) be abused for dubious political ends. Put simply, Is it the therapy you dislike or how it can be abused
SILVIS RIVERS :
Silvis Rivers ! Your 1% per cent disagreement figure here !
There's a sketch of a mental health User colleague - Yep - a neck bolted cogbottery success story
SEE HERE : So seee I have an evidence base Lord Brett
However , Welfare and Reform, and CBT supply eh ? .. Oh yes, many do know they are all woven policies
The supply sides of therapy up and down the country available through PCT's , Trusts and GP surgeries are coming on stream with the £173 million of Govt funding over several years.
The Govt took it upon themselves to push CBT – it was endorsed of course as part of the welfare to work reforms by Dick Layard (LSE) to get people back to work and some very simplistic things were claimed of it like 10 – 12 sessions would see many thousands go back to work as CBT successes.
I believe this approach was flawed at many levels both therapeutic and at the recognition of individualised need for therapy help and personal pace. Personalised services were the kinds of things we were promised which have been overtaken by large planning and system delivery gurus ..
There was plenty of supply sides (unharnessed) for therapies already in the private sector and if MH patients had had a patient choice culture through say local purchasing (GP level) then slowly a culture of decent therapies would have taken root and the useless practitioners would have been weeded out by patient satisfaction being measured at a local level ..
There's no competition with the State so the State cannot claim a Patient Choice culture and in mental health as I say we were promised Patient Choice and better personalised budgets for recovery and we've seen bagger all that cuts the mustard, and now we are getting welfare deformed-reform oppression
The Mild to Moderate depressive category of those out of work who were going to be the first candidates of CBT is another example the strange language of system driven welfare reform bureacracy . People with depression present differently with different reasons for being depressed and many (excluding Bipolar) have years of compressed misery and likely or not special events they need to emotionally alleiviate and resolve ..
CBT as its promoted is simplistic and its going to be played with by graduate-workers employed by the NHS… That is wrong …
After 36 years of seeing mental health suffering of all varieties I can honestly say I think that's a mistake and there are plenty of skilled practitioners out their in the market place where Patient's could get a real choice to find ways to resolve their pain , depression and misery .. The money was there in 2004 but the Govt saw fit to create NIMHE (now defunct) which went on to spend in excess of £100 million. I see that as a major loss of treatment opportunity for people who needed therapy choices years ago .. The market was left untapped and even alienated by the insistence it come under Govt control through the Health Professions Council despite bodies like UKCP and BACP and others having adequate ethical comittees and complaint processes.
CBT is not Patient Choice - its being used for State dominion - Neither in my opinion is it a depth approach to resolve difficult emotional pains and states by actually feeling them towards resolution and integration, which is an emotionally realistic way to deal with most of the human condition.
Its a lightweight application with limited scope and I think many MH patients and people in the community will be shortchanged by it - if its allied to deeper emotional approaches and acceptances of peoples feelings, and feeling states towards resolution, then maybe it will become useful because then it creates a place for recognition of feelings - proportionality of reaction, and past and present and how one can serve to whip up reactions in the other .
I do hope you like my evidence base ..
yes I like your `evidence-base`. It made me smile and that is always welcome in my book.
I share your scepticism at the new use of CBT and the almost factory-style production of `fast-track` IAPT practitioners who will be as limited in their ability in all likelihood as their rushed training implies.
However, those of us who trained a while ago and took many years to do it, including starting with a nursing qualification and many years of experience in that field too might feel slightly irritated that because CBT has been co-opted by NuLab, many people including sad to say, your good self view it as lightweight and trivial as the politicians who seem to push its use.
This view of CBT as not addressing `real issues` and a `quick fix` simply reveals a lack of knowledge of the subject and is in a sense, as lightweight, uninformed and thin a dismissal as the behaviour of those you claim to despise.
SILVIS RIVERS :
Hey if you feel you are adequate fine ... I have not personalised this issue - and your sadness is noted but so is the pain of others in my community of mental health Users that are shortchanged by system top down thinking and would be welfare reform applications
Welfare Reform and the top down way its being planned included CBT jackboots too or maybe they should be called "Dick-boots" after a certain person who is economical with therapy .
Personalisation of services has gone out of the NHS window and welfare reform has become the new psycho-work-alot religion . Even Job Centre staff hover in and and around NHS mental health Trusts.. Its intimidating and upsetting people . Some of us are so affected by the assault of the planning gurus that we do wonder if death is better . Now that's being hurt .
But on therapy there should have crucially been choices not just one favoured application (CBT) and all the training money to my mind gone to it is wasted when its obvious we could have enjoyed monitored patient choices years ago using available local supply sides . God knows some of us could have grown into more functionality .
The whole point for me and others in the User-community was to believe in a patient recovery led by choices and incremental growth . Its what we were all promised . I've seen CBT used by "practitioners" in the NHS where they expect the patient to do"homework" to identify negatively co-reinforcing thought and feeling patterns and the poor boggers have been lost .
I've talked to these people and discovered so many are seriously wounded people from life and they need deeper more empathically providing applications
After your post I have taken a decision to ask USERWATCH to make an exception against CBT slagging off and therefore you have been offered a Dogology .. Now this is rare
I'd swipe a copy of it quick ..
Seeeeee now I do have the power of magical smiling and wickedish therapy which makes Lords laugh ..