Survival Manuals for Depression, Anxiety Disorders and PTSD – Free

Simply Effective Group CBT All Appendices

Separate Manuals for each disorder/s together with screening instruments from, ‘Simply Effective Group Cognitive Behaviour Therapy: A Guide for Practitioners’ (2011) Scott, M.J London: Routledge

They can be used as the basis for individual or group CBT and in a self-help context.

The included pocketbook contains diagnostic questions for each disorder and ‘Sat Navs’ detailing treatment targets and matching treatment strategies.

 

Here is a copy of ‘Simply Effective Group CBT Therapy, free to download:

 Simply Effective Group CBT All Appendices

Warning Bell for Psychological Therapy?

If we continue as we are then psychology will diminish as a reputable science and could very well disappear’ so wrote Chris Chambers in his just published book The Seven Deadly Sins of Psychology: A Manifesto for Reforming the Culture of Scientific Practice (p. ix). Princeton University Press.

The problem is the widespread failure to replicate original positive findings, and the aversion of psychologists to independent direct replication, preferring instead the enthusiastic marketing of any novel positive finding. This is unfortunately also true of the clinical field where there are few independent direct replications.

Medicine and science are largely self- correcting. Until  the paper by Topiwala et al in this week’s (June 10th 2017)  British Medical Journal , 430-431 it was considered that studies suggested that a little drinking of alcohol was good for you  but it has been discovered that even moderate drinkers (up to 21 units for men) were three times as likely as abstainers to have hippocampal atrophy. Chambers (2017) cites a similar example of self-correction from the field of physics, were in 2012 a study was published that suggested a sub-atomic particle a neutrino was  found to have travelled faster than the speed of light, thereby upstaging Einstein’s theory. Within a few years there were 3 independent replications of the same study all with opposing findings. The original experimenter went back to the drawing board and found he had a faulty fibre-optic cable in the initial experiment. Unfortunately to ask for independent direct replication of bench-marking studies in psychological treatment is regarded as being negative and a fudge of conceptual replication is offered in which another study is conducted  with a key feature absent e.g a blind assessor using a standardised diagnostic interview.

Mrs May, today threatens those like ‘Angela’ below who would take action against the unfounded Draconian actions of Social Services

 Family, Mother, Children, Boy

A client ‘Angela’ that I successfully treated with CBT for depression had her 3 children removed after a psychiatrist diagnosed her as having an emotionally unstable personality disorder (EUPD). I protested that this diagnosis was without foundation (she turned up for every therapy session and did all homeworks) but Social Services refused to consider my report, viewing her behavior through the lens of the EUPD, and she was mandated to attend a 10 session mentalisation treatment. In the event the Court appointed an independent psychiatrist who agreed with me that she did not have an emotionally unstable personality disorder. Despite this she was moved simply from supervised to unsupervised access, an ongoing denial of her right to a family life and the mandated attendance at treatment rescinded. Misdiagnosis destroyed family life. The case is ongoing, more about this anon.

Dr Mike Scott

What Chance Effective Psychological Treatment?

“If You Have Heart Problems and Depression You Are Four Times More Likely To Die In The Next Year or Two Than Those With Cardiac Problems Minus Depression”

– All In The Mind, Radio 4 May 3rd 2017.

 But scarcely more than the ‘tip of the iceberg’ of those with mental health problems receive psychological help

Iceberg, Water, Blue, Ocean, Ice

Here are two examples of people that I have seen recently who have been drowning in the ‘frozen waters’

‘Sarah’ was made redundant and had a fall 3.5 years ago. She has suffered from depression since and the only help she has been offered is antidepressants by her GP. Psychological therapy which is the NICE approved first line treatment for depression has not been discussed.

‘Ivan’ recently had a serious road traffic accident two years ago, and was referred by his GP to his local IAPT Service. He said that had a few face to face conversations with the staff but they did not offer him a diagnosis and said that they did not have the funding to treat him. Ivan was referred back to his GP with a recommendation he be referred to secondary care. On examination I found that he was suffering from PTSD complicated by the back pain he had suffered in the incident. The Secondary Care Unit provided no diagnosis but suggested a group programme could cater for his needs but he was not keen on this.

Dr Mike Scott

 

Moving Forward

Perhaps this diagram may help us in how we can move forward from this:-

 

Ultimately we want to make a socially significant to client’s lives, a real world difference, [See Scott (2017) Towards a Mental Health System that Works: a guide for practitioners. London: Routledge], not just a questionable change on some psychometric test.

Wounded Healers

“Two thirds (68.6%) of workers in low intensity CBT (PWP’s) are suffering from burnout and so are half of workers in high intensity.”

(Journal of Mental Health, published online January 13th 2017 “Predictors of emotional exhaustion, disengagement and burnout among improving access to psychological therapies (IAPT) practitioners” Westwood et al).

 

The position is no better than a year ago.  On February 3, 2016, The British Psychological Society reported on a 2015 survey of over 1,300 psychological therapists working in the NHS. The survey found that 46% reported depression, with half (49.5%) feeling they are a failure. One quarter considered that they now have a long-term chronic condition, and 70% said that they find their jobs stressful. Reported stress at work was up 12% in 2014: ‘The overall picture is one of burnout, low morale and worrying levels of stress and depression . . . the majority of respondents made negative comments about their work environment, 10% of comments were more positive’,

Should working in IAPT carry a government health warning? One educator said to me recently ‘I wouldn’t work in low intensity for a ‘gold clock’!

Hospitality

This new website is intended to be a safe-harbour for cbt clinicians – many will be the ‘wounded healers’ described below. Hopefully, it will help clinicians chart new directions and empower them to advocate change, not least via the Discussion Forum and the careful monitoring of service provision.

Hospitality’ has to begin with welcoming clients, as we would a friend/relative in difficulty. MP’s and GP’s insist on face to face contact with those whom they serve in the first instance, but curiously those with mental health difficulties are expected to book a telephone assessment with the least qualified mental health clinician, is this a perpetuation of stigma?  Head over to the forum and have your say.

Welcome to the website, invite others

Dr Mike Scott