They use to call it Cognitive Behaviour Therapy - you can now rename
it: Compulsory Behaviour Therapy.  Compulsory, because the government,
in rather a similar way to cafe option portrayed in the Monty Python
'spam' sketch, are serving the public CBT, CBT, CBT and not much else!

As CBT isn't actually a therapy at all, being rather more akin to life-
coaching, one wonders whether it's use for all the purposes listed on
the government's new IAPT website, could actually leave potentially
dangerous conditions untreated.

http://www.iapt.nhs.uk/services/

There is something awfully un-psychological happening in our society
at the moment.  The scientists, who found that certain classifications
of drugs were not particularly dangerous, were told to go away and
find proof that they were.  When the scientists went away and looked
at the issues again, the results confirmed their original view -
however, the government did not want that view in the public domain,
preferring instead to release information containing a political bias.

On a military level, we see today wide criticism of the government,
who here have so frequently rejected military advice about the poor
outcomes associated with low investment options.

Now here, in the area of psychology, we discover that the wisdom of
dozens of years of research and clinical evaluation, are being pushed
to one side, while a cheaper, one-size fits all experiment, is
conducted on a vulnerable public and an unquestioning media.

One is tempted to say that IAPT should stand for 'It's a Phoney
Therapy'.  CBT does have it's uses, and their will be gains from early
intervention on very low scale socially inhibitive behaviour - though
there is a substantial view that even here, CBT is a short-term
solution, which will deliver itself right back at the door, once the
'do this' routine has worn off.

CBT is NOT therapy.  Treating with it, is a little like grabbing a
plant by the branches and snapping them off, yet leaving the roots
hidden beneath the ground to grow further.  The roots of acute
psychological problems are nearly always deep-rooted and prone to re-
forming if the 'circuits', which connect negative thoughts, are not
properly and therapeutically 're-wired'.

So much of the IAPT work seems to rely on call centres helpers
‘treating’ with CBT - even it seems, for severe depression!  Weekly
attendance to real therapy is essential for the suicidal, an
experienced therapist can pick up the decline in someone just by the
appearance of smell on their clothing, the sight of their grime, the
condition of their hair, the smell of alcohol, or the dark rings
beneath their eyes.  NONE of this is revealed in a telephone call -
yet there is so very much more to a face to face session - which
perhaps could be the one day all week that the patient actually goes
out!  Many suicidal people will not tell you they are – particularly
if you are being annoyingly positive.  CBT IAPT style, certainly will
not want to hang about.  The whole process is more akin to a conveyer
belt.

IAPT say they don't want to burden the person; but the person IS
burdened – that’s why they sought help!  Usually, people who say 'they
don't want to upset someone, are saying they don't want to upset
themselves!  I suspect that the burden is really on the health
services and that the easy answer, as with so much of our lives today,
to them, is the setting up of a call centre.

The first evidence is coming through that IAPT are cherry picking,
perhaps for statistical reasons.  They are apparently supporting the
'easy-to-treat' people, but there is no money left in the pot to
support the harder cases; these are patients going back to their GP's
who report – “there is nothing else we can do for you - our funding
has been removed”.

All in all, there is a possibility, that what we are seeing, is a
cutting back of real psychological services, only to be replaced by a
high-profile, 'Question Time friendly', fake, tick-box therapy that
will be manipulated to produce statistics for the purpose of
frustrating debate.

I wish IAPT and the new, in some cases, psychologically damaged and
untreated people who will be administering Compulsory Behaviour
Therapy, the very best.

However, I suspect the lack of proper access to psychological
therapies caused by the CBT experiment, will result in a substantial
setback to the nation's psychological advancement, great individual
disillusionment, and many deaths of people who deserved so much
better.

The NHS have started cutting back on jobs and most vacancies that do
occur, seem to be for CBT counsellors.  It’s a bit like asking a
skilled forklift truck driver to join Formula 1 – on pretence that the
two can be transposed.  Both are values – but their skills and
required suitability are entirely different.

Turk182

On Sat, 07 Nov 2009 11:37:43 -0800, Turk182 wrote:

> They use to call it Cognitive Behaviour Therapy

{huge post snipped}

IAPT helps people with moderate / severe problems indirectly.  It funnels 
people with less severe need out of secondary care into more suitable 
treatment, allowing psychological therapy services to concentrate on 
providing services to people with more severe need.

There's gentle worry that people getting access through IAPT are getting 
new services, sometimes with people without much training.

Otherwise, IAPT is excellent.

cobble wrote:
> On Sat, 07 Nov 2009 11:37:43 -0800, Turk182 wrote:
> 
>> They use to call it Cognitive Behaviour Therapy
> 

Or 'Cock and Ball Torture' depending on what sites you visit.

On 7 Nov, 19:58, Geoff  wrote:
> cobble wrote:
> > On Sat, 07 Nov 2009 11:37:43 -0800, Turk182 wrote:
>
> >> They use to call it Cognitive Behaviour Therapy
>
> Or 'Cock and Ball Torture' depending on what sites you visit.

Sorry.  This thread was deleted and a new one posted.

Turk182 wrote:

> There is something awfully un-psychological happening in our society
> at the moment.  The scientists, who found that certain classifications
> of drugs were not particularly dangerous, were told to go away and
> find proof that they were.  When the scientists went away and looked
> at the issues again, the results confirmed their original view -
> however, the government did not want that view in the public domain,
> preferring instead to release information containing a political bias.
>
> On a military level, we see today wide criticism of the government,
> who here have so frequently rejected military advice about the poor
> outcomes associated with low investment options.
>
> Now here, in the area of psychology, we discover that the wisdom of
> dozens of years of research and clinical evaluation, are being pushed
> to one side, while a cheaper, one-size fits all experiment, is
> conducted on a vulnerable public and an unquestioning media.

CBT is not a universal panacea, but it has a successful track-record, 
supported by extensive research.

What other model of therapy do you advocate should be provided at public 
expense, and what evidence is there for it's efficacy?

On Nov 7, 8:46 pm, "Steve Walker"  wrote:
> Turk182 wrote:
> > There is something awfully un-psychological happening in our society
> > at the moment.  The scientists, who found that certain classifications
> > of drugs were not particularly dangerous, were told to go away and
> > find proof that they were.  When the scientists went away and looked
> > at the issues again, the results confirmed their original view -
> > however, the government did not want that view in the public domain,
> > preferring instead to release information containing a political bias.
>
> > On a military level, we see today wide criticism of the government,
> > who here have so frequently rejected military advice about the poor
> > outcomes associated with low investment options.
>
> > Now here, in the area of psychology, we discover that the wisdom of
> > dozens of years of research and clinical evaluation, are being pushed
> > to one side, while a cheaper, one-size fits all experiment, is
> > conducted on a vulnerable public and an unquestioning media.
>
> CBT is not a universal panacea, but it has a successful track-record,
> supported by extensive research.
>
> What other model of therapy do you advocate should be provided at public
> expense, and what evidence is there for it's efficacy?

"has a successful track-record, supported by extensive research."

Really?, perhaps you can link us to any mid- to long-term, outcome
studies?

WM

On Nov 8, 1:38 am, Nigel Oldfield 
wrote:
> On Nov 7, 8:46 pm, "Steve Walker"  wrote:
>
>
>
> > Turk182 wrote:
> > > There is something awfully un-psychological happening in our society
> > > at the moment.  The scientists, who found that certain classifications
> > > of drugs were not particularly dangerous, were told to go away and
> > > find proof that they were.  When the scientists went away and looked
> > > at the issues again, the results confirmed their original view -
> > > however, the government did not want that view in the public domain,
> > > preferring instead to release information containing a political bias> > > On a military level, we see today wide criticism of the government,
> > > who here have so frequently rejected military advice about the poor
> > > outcomes associated with low investment options.
>
> > > Now here, in the area of psychology, we discover that the wisdom of
> > > dozens of years of research and clinical evaluation, are being pushed
> > > to one side, while a cheaper, one-size fits all experiment, is
> > > conducted on a vulnerable public and an unquestioning media.
>
> > CBT is not a universal panacea, but it has a successful track-record,
> > supported by extensive research.
>
> > What other model of therapy do you advocate should be provided at public
> > expense, and what evidence is there for it's efficacy?
>
> "has a successful track-record, supported by extensive research."
>
> Really?, perhaps you can link us to any mid- to long-term, outcome
> studies?
>
> WM

I will start:

Cognitive behavioural therapy for major psychiatric disorder: does it
really work? A meta-analytical review of well-controlled trials.
http://www.ncbi.nlm.nih.gov/pubmed/19476688

WM

Paul C. Dickie wrote:
> In message , Steve Walker
>  writes

>> What other model of therapy do you advocate should be provided at public
>> expense, and what evidence is there for it's efficacy?
>
> "it's efficacy"?  It is efficacy?
>
> In your case, Steve, one might suggest a course of remedial English.

http://www.thefreedictionary.com/efficacy

On Tue, 10 Nov 2009 18:17:41 +0000, Steve Walker wrote:

> Paul C. Dickie wrote:
>> In message , Steve Walker
>>  writes
> 
>>> What other model of therapy do you advocate should be provided at
>>> public expense, and what evidence is there for it's efficacy?
>>
>> "it's efficacy"?  It is efficacy?
>>
>> In your case, Steve, one might suggest a course of remedial English.
> 
> http://www.thefreedictionary.com/efficacy

They were refering to POSSESSIVE ITS HAS NO APOSTROPHE.

In message <4af5d176$0$9751$6e1ede2f@read.cnntp.org>, Geoff 
 writes
>cobble wrote:
>> On Sat, 07 Nov 2009 11:37:43 -0800, Turk182 wrote:
>>
>>> They use to call it Cognitive Behaviour Therapy
>
>Or 'Cock and Ball Torture' depending on what sites you visit.

Do you suppose that might help chronic anxiety by giving the sufferer 
something _real_ about which to worry?

-- 
< Paul >

In message 
, 
Nigel Oldfield  writes
>Cognitive behavioural therapy for major psychiatric disorder: does it
>really work? A meta-analytical review of well-controlled trials.
>http://www.ncbi.nlm.nih.gov/pubmed/19476688

And, of course, it doesn't really work for schizophrenia or bipolar 
disorder, whilst having limited effects on major depression - which is 
pretty much what anyone with any sense might expect.

I'd not say that a reliance on CBT alone, without pharmaceutical 
intervention, "could lead to deaths" - I'd say that it _will_ lead to 
deaths.

-- 
< Paul >

In message , Steve Walker 
 writes
>CBT is not a universal panacea, but it has a successful track-record,
>supported by extensive research.

Have you ever studied experimental design, Steve?

If you had, you would surely know that it would be difficult - if not 
downright impossible - to conduct a double-blind study of CBT against a 
placebo, or of CBT against a given type of drug.  The two therapies are 
so totally different that not only would it become immediately obvious 
to a researcher who was in the trial group and who was in the control 
group, it would also be obvious to the trial subjects.

All that can be tried is CBT+placebo against CBT+drug, then subsequently 
to try to resolve the confounded variables by comparing the results to 
another trial of drug against placebo in the hope that the effect of the 
CBT alone can thus be resolved.  This, however, should not be used to 
support the idea of offering CBT alone, but may be used to give some 
guidance to likely outcomes were CBT to be offered with a different 
drug.

>What other model of therapy do you advocate should be provided at public
>expense, and what evidence is there for it's efficacy?

"it's efficacy"?  It is efficacy?

In your case, Steve, one might suggest a course of remedial English.

-- 
< Paul >