Counselling For Sexual Abuse And Childhood Abuse Survivors

[Queen Boudica]

85% of the mixed bag of people with mental health issues. He could not tell me how many were complex trauma, just that in that sample size there would be a few.

comparisons across various other samples: Link Removed

Now I look at those reports am I mad or are those results not saying that 20 sessions will lead to 85% recovery. In fact they are full of flaws?

 

[Deleted member 1860]

I think if anything its an overly simplified article. It would have been nice if the author had gone into a bit more depth.

I'm from the USA and curious about the Aussie Medicare system.....is yours like ours in that it caters primarily to the retired crowd (65+) so other health services get thrown to the side and are either lacking or not covered? Our GYN care is like that.....Old people? They don't need that care! Let's screw the younger crowd who are on disability and restrict their access to reproductive services. Nah, let's not think ahead and even consider the fact that helping to prevent pregnancies will lighten the load on the system because.....dun, dun, dun.....chances are that kids born to those on disability with be on benefits themselves! (But hey that's my ongoing vent.)

I did get a good laugh at the link at the bottom of the page that went to an article about quinoa being hipster fairy dust! That cracks me up! Good to know that its not just USA "news" pages that have idiotic comments at the bottom.

 

[Queen Boudica]

that's Australian news for you. We can't cope with complex that would imply the population has to read and apply cognitive processing. No save that for sport

 

[moonbeam]

I think 20 is way too short. And setting a number will mean its difficult for people to get more.

With IAPT in the UK (Improvong Access to Psychological Therapies its an NHS program) the sessions go from 8-12 sessions with 12 being the maximum they can offer. This was for counseling and not CBT though I guess they have the same timeline for both. I was very lucky that I could go straight from there to my current T (who works for a nonprofit so has a Max of 2 years) but I know many people who were just left to cope on their own when sessions ended. And 12 was nowhere near enough.

I would worry if they set a number at 20, how much longer would they be able to extend it for more complex patients?

 

[Queen Boudica]

They are not arguing for complex cases. Although I've just pushed for it and now they are trying to come up with ideas to incorporate the 15-20% of patients that they claim will not get meaningful results in 20 sessions.

I should add that at this current time, we are eligible to 10 sessions every year. They are arguing for 20. but what I think they are in danger of is limiting it to 20 for everyone and none the next year. Because that is what their evidence is suggesting. So you can't have it both ways.

 

[Queen Boudica]

I should also add that we are eligible to 50 sessions a year with a psychiatrist most of which do not do talk therapy and are there to dole out drugs and are far more expensive than psychologists.

 

[joeylittle]

So, as of right now, if you are a person needing ongoing therapy, you can see a therapist once a month for 10 months out of the year, and a psychiatrist once a week for pretty much the whole year (except for 2 weeks off, which one could assume are holiday weeks)?

That is really interesting. And by interesting, I mean f*cked up.

It is a sad thing that the advocates aren't advocating, but instead going right to a 'reasonable compromise' sort of stance. 20 isn't the solution, and they know it. It's hard to shift these things incrementally - better to just go to bat for a big reform (in my opinion).

Has anyone proposed just lumping it all together, and calling it 60 (or 70) sessions per annum of mental health counseling, and letting it be divided between psychiatry or therapy as needed?

Or, it just needs to be renewable at the discretion of the provider. 20 sessions, and if you need more, you re-up for another 20, up to 3x per annum. No lifetime cap.

 

[Queen Boudica]

Yes @Joeylittle.Thankyou exactly what I have been arguing with them and somehow they still come back with NO we must just argue the 20 sessions. Exactly what I have been strongly trying to put across and been accused of attacking them and going against research evidence.

I have proposed exactly that. Divide it up. Or just let people choose. But no there is some politics going on psychiatrists vs psychologists and what that means is that we get the shit end of the deal.

Thank you. I don't think they are advocating. They are putting up a façade and saying they are not saying that complex mental health care will not need more, but they argue a minimum case. And when I argued back against a PHD psychologist he just gaslighted and twisted his argument to make it look like I was attacking him, when I was criticising both his approach and using this research that he is claiming is evidence based and strong based. I think it is a façade

It isn't a reasonable compromise that is what I have said, it is condemning people to suffering and not healing and it is not economically viable but he is using his position and that research to go for this argument and I think it is wrong

 

[sun seeker]

The longer course of treatment being suggested by the alliance for better access, that will provide meaningful help for 85% of mental health sufferers is 20 sessions.

What does "meaningful help" mean for that 85% though? How was the study done? Did they decide there was meaningful improvement at the end of the 20 sessions, or did they do a followup a year or five after the sessions ended? Or if it's 20 per year, how were the clients when they came in for another round the following year? There is a certain amount of improvement that can be expected just from being engaged in a process, but does it carry over into real changes that a person is able to carry forward on their own? That's very significant imho.

Identify Developmental Trauma. It is like a cancer and requires, imho, a complete rebuild.

Absolutely agree.

 

[shimmerz]

50 sessions a year with a psychiatrist most of which do not do talk therapy and are there to dole out drugs and are far more expensive than psychologists.

Follow the money. The doling out drugs part I feel would offset the cost of the psychiatrist. Plus, any psychiatrist I have had the pleasure of seeing has shuffled me into and out of the office in 8.5 minutes or less.

 

[moonbeam]

What does "meaningful help" mean for that 85% though? How was the study done?

If its anything like the NHS they give you a questionaire every week including one you bring the first day that asks you to rank like 20 different things from 0 to 4 for frequency of issue. Like suicidal thoughts, feeling hopeless, etc. I had to do one before the first session and then bring one with me every week that ranked how I had felt from the last session until that morning. And they entered it into a system to track.

It isn't the best tracking because it doesn't allow for outside circumstances. Like time of year. Or change of employment status or anything like that.

 

[Queen Boudica]

What does "meaningful help" mean for that 85% though? How was the study done? Did they decide there was meaningful improvement at the end of the 20 sessions, or did they do a followup a year or five after the sessions ended? Or if it's 20 per year, how were the clients when they came in for another round the following year? There is a certain amount of improvement that can be expected just from being engaged in a process, but does it carry over into real changes that a person is able to carry forward on their own? That's very significant imho.

Exactly. I gave the link to the summary of the research. samples: Link Removed

I cannot see these questions answered. It is a façade I think. But I do not feel qualified enough to argue this. I am arguing this against a PHD psychologist. I am not good at debating and my language is poor and my anxiety gets the better of me and I doubt myself. But your points here are all what I have been trying say and explain and I feel have been knocked back. I look at that research that he claims is strong evidence and I just see statistics and exactly these questions are not answered. It is a thesis, that they set out to justify and it is not reality.

Maybe I am wrong. I don't feel I can argue this strongly. I feel I am going up against another system. But I think this is wrong.