Uk Nhs Therapy

[Meadowsweet]

Im reading a lot about therapy, both good and bad experiences, and one theme that seems to recur is that its important to choose the right therapist or the right therapy. But I'm from the UK and we have a national health system, which is wonderful because its free, but I dont know if I have any choices with regards to my therapy, or what I would do if it was awful.

I'll give a brief account of where Im at: I went to my GP first, she reffered me for an initial asessment with the mental health asessment person, who asked me lots of questions and got me ticking boxes etc. During the session he asked if I wanted to tell him about the trauma and I gave a brief overview of the most recent incident, but I was nervous and didnt want to open up to him at that moment. At the end of that session, he initially suggested cbt therapy to work on my trust and social issues. But in response, I mentioned that I'd like to be able to say things that have happened out loud (at the moment I feel like Im physically choking or will be sick if I try to speak about trauma). So hearing this, he suggested that I might be better with emdr therapy.

But he made it sound like its one or the other outcome. What I really want is to be able to form trusting, close friendships, and because Ive driven most of my friends away by not being able to explain whats going on in my reactions, I feel that being able to be speak openly about things is important to future friendships.

So Im confused and worried about therapy, but I really want to do it too. Its taken such a long time to get around to asking for help, and such a long time on waiting lists, that Im worried if it doesnt work, that I'll be back to square one. So, what happens in the UK if the therapy youre offered isnt effective? and...do you get offered a limited number of sessions and then get told to get on with it? or are you assessed again at the end of the initial treatment?

 

[Oberons Wife]

Hi Meadowsweet,
I shall try to answer but I can only do so from the perspective of a NHS user rather than knowing the system from a professionals point of view.
I am presently seeing an NHS therapist for one hour a week. Initially she has booked me in for 16 weeks, but she says this can be extended. I waited for over a year to achieve this, and only got onto the waiting list after farting around from pillar to post for 8 months.
She is a CBT councellor.
I said there was no point me seeing a man, or participating in a group, as I would sit there in silence, but this meant I waited longer. I was not offered any other forms of councilling. I was told this is a funding issue and that the CBT have persuaded the government to fund in that direction?
Twenty years ago I went to Rape Crisis for about 18months and was seen by a psychoanalytical therapist. It helped enormously.
I lived in remote Scotland more recently and saw an NHS therapist there, but she couldn't cope with what I was telling her (she kept covering her mouth with shock, and getting flustered and upset) so I stopped going.
I am struggling at the moment as I'm feeling more suicidal with the regular therapy sessions and don't seem able to say this to the therapist. So I have no idea if it's helping.
I don't have any friends as something happens to scare me and I avoid seeing them again.
I don't know if that will ever change.
I am single for the same reason.

I don't expect this to change, but it would be good to avoid suicide whilst my child is still a child. That will be a success. I don't know if the therapy will enable this. It doesn't feel that way at the moment.

But maybe you will experience therapy the way I did in my twenties, and whilst it was difficult it was like being given permission to be a completely new version of me.
Good luck
x

 

[Meadowsweet]

Thankyou for your reply and being so open. I can understand having no friends and being a single mum and I worry too that this will make therapy really hard. But you do have this site, and I hope you will find that extra support here.

Thankyou for the information you have given me. I think perhaps, like other aspects of nhs treatment, what is available may depend on where we live.

I hope your therapy goes well and you start seeing some positive results soon.

 

[anthony]

This is the problem with mental health, period... uneducated professionals giving out half arsed advice to the clients.

[DLMURL]https://www.ptsdforum.org/c/threads/removing-therapy-type-confusion.15534/[/DLMURL]

EMDR is not primarily a talk therapy, its actually majority done in silence, in your head.

CBT, the common name flung around for cognitive therapy, is a talk therapy.

There is also no such thing as a CBT entity that influences Governments to use its therapy, as CBT is an umbrella term that combines several unique and individual therapy models, as well as umbrellas others due to sheer similarities in the collective initial model.

What you want is a trauma therapist... that therapist will then have a diverse range of therapy types they will use / not use upon you, depending on their individual assessment with you, based on what makes you most comfortable.

 

[amethist]

Hi Meadowsweet, nice name.

Depending which area of the UK you live in can depend how good the therapy is. Some is really good, some is non existent to nil.

I am a supporter and sometimes it a battle to get recognized that help is needed. Maybe you could ask to be be referred to your local Community mental health team by your GP, you could get lucky and find some really good support that way, my husband did after the first few.

I hope you find some good face to face help and support, there is always here what ever happens.

Take care.

Amethist

 

[PTSD sufferer]

I think the problem here is that the initial visit you have at NHS Mental Health, is conducted by a social worker and not a therapist. That is why you tick a lot of boxes and briefly talk about what was happened. So the in the initial visit you were not talking to a therapist, and therefore, they can mention treatments, but don't know much about which one suits you. That assessment will be for the therapist.

Anthony is correct as always with his explanation of therapies. Do read the information he has provided. It clear and concise and helpful as always.

I think the problem I ran into with the NHS is that you need to be classified as a candidate for early intervention to get seen more quickly under the service. The NHS standard MD/ GP system is excellent, but in targeted areas such as PTSD, and even fertility, they have limited resources, so you often end up on a waiting list behind those that have more obvious mental health issues.

Waiting until you speak to your psychologist about the right treatment for you is best. Don't base your decisions on the social workers who take your initial information, because they are not equip to suggest or explain the therapies.

 

[anthony]

That explains a lot if your mental health interview is with a social worker. That is no different from having a mental health assessment by a GP. Useless.

You need a psychologist or psychiatrist to be assessed correctly in mental health.

Social workers, counsellors, nurses, GP's, etc... they can all help you with the guts of your trauma with therapy and such, but assessment is really important from those two qualifications for mental health. They are the qualifications needed to correctly assess and diagnose mental health. Even then... a psychiatrist is the better of the two for assessment. You don't need to see them again after that.

 

[Meadowsweet]

Thankyou Anthony, the info is helpful and when I meet the therapist I've been reffered to, hopefully I'll be able to ask the right questions about what they do. I don't know how familiar you are with the NHS, but the therapist is chosen for me and I won't know anything about them until I get a letter about making an appointment. When that happens, I'll be sure to find out more about them.

Thankyou Amethyst. I went to my GP initially, she referred me to the mental health team for assessment, and they have now referred me for therapy. I was warned that the waiting list was long and so currently, I'm still waiting to hear.

The problem for me with the asessment is he didn't explain the jargon he used or take the time to explain his assessment or the way the system works. And I'm somebody who likes to know everything.

 

[Oberons Wife]

I think the structure changes from area to area, I haven't seen a social worker at all. I was referred by a Mental Health Nurse to the APTS team at the Hospital, and inteviewed again by a therapist there. No Social Workers, but very little explanation or choice. When I insisted I was not seeing a man, the therapist was displeased. So no, they're not keen on choice. In Scotland the therapist was into Art Therapy.

 

[amethist]

We got the same problem at first, it was only when hubby was sent an appointment for his first visit with his therapist that it made sense. It was then around 8 months before he started his therapy sessions.

But by then I had found this forum so I had a better idea of what was going on.

You will learn a lot form here, and then when you finally do see a therapist, you will have a bit of a head start.

It is hard waiting and not knowing which way to turn, but it will work out OK in time.

Amethist

 

[Meadowsweet]

Thankyou all. I saw the mental health asessment counsellor and I was informed that his job was only to asess and then refer me in the appropriate direction for treatment. But I guess it would explain why he couldn't explain the treatment.

Regarding time scales. I saw my GP at the beginning of September. When the letter came to make an appointment I was told I couldn't see anyone until the end of january. At the time I felt like I was going mad, so I phoned and asked if I could see anyone at a different hospital or something. The medical secretary was doubtful about that, but a week later I was given an appointment, I think perhaps there had been a cancellation.

It is horrible waiting for therapy, but at least there is hope. Waiting to be asessed when you feel like youre losing it, I think has a detrimental effect and can make stmtoms worse.

 

[PTSD sufferer]

That explains a lot if your mental health interview is with a social worker. That is no different from having a mental health assessment by a GP. Useless.

You need a psychologist or psychiatrist to be assessed correctly in mental health.

Social workers, counsellors, nurses, GP's, etc... they can all help you with the guts of your trauma with therapy and such, but assessment is really important from those two qualifications for mental health. They are the qualifications needed to correctly assess and diagnose mental health. Even then... a psychiatrist is the better of the two for assessment. You don't need to see them again after that.

Absolutely right Anthony. The thing is that NHS is free in the UK. Unlike medicare, where you pay for part of your medical treatment, NHS is entirely free for residents. It is heavily administrated, and highly inefficient. You need to go through the administration process, which can have three layers sometimes, before you reach the psychologist, let alone a psychiatrist. But as it is a free service paid for by the government, for some this process is the only option.

My initial treatment with NHS Mental Health wasn't great. I was offered a social worker to visit with me every month and a psychologist who prescribed me the wrong medication, and who I was only going to see me every three months. At the point I saw them I was in super flashback mode and had been dealing with daily flashbacks for about 4 weeks....so yes I agree....with your statement that, in my case, it was useless.

Needless to say, my hubby and I discussed and decided I needed to get out of the NHS Mental Health system and into private care. I'm glad we made that choice.

I think very highly of my NHS GP, who is really good. And, as Amethyst says, NHS Mental Health care can vary across the country....others might have more luck than what I had. And the 'free service' is sometimes the only option - NHS Mental Health care may be better than no care at all.