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The Lived Experience of Psychological Treatment

On June 28th 2022 Mad in America published my piece ‘The UK’s IAPT Service Is An Abject Failure’. Unsurprisingly the Service was re-branded NHS Talking Therapies in  January 2023.  I’ve just discovered that on March 16th 2023, Ewan Beck reported his lived experience of the Service thus:

‘I went through IAPT, and a lot of what you’ve said here resonates with me. 

I was going through a particularly low period at the time, which tends to happen to me every now and then, but this was the first time in years that I was experiencing suicidal thoughts and urges to self-harm, so I decided to finally try and get help. I saw a mental health advisor at work who referred me to IAPT, and following a short assessment over the phone, I was short-tracked (because of the suicidal thoughts I guess) and given weekly over the phone appointments. 

My therapist was nice enough, but the sessions were highly impersonal, stilted, and even patronising at times. In the first session I explained that I had issues with anxiety, that I’d read up about mindfulness etc. but had never been able to make anything work. My therapist then proceeded to explain what anxiety was, the fight or flight response and it’s supposed origins in our hunter-gatherer past. Things I’d read a gazillion times already, as he might have known if he’d asked, or even guessed from what I’d already said. Worse than that, every week I had to remind him of the details of our previous conversations, and he would often repeat things we’d already gone over.

His advise was never personally catered to me or what I was saying. Once we reached the 6th session (I think) he told me that I was going to be discharged because my scores showed I’d improved. I was a baffled, I didn’t even realise I had given higher scores, and I didn’t feel as though I’d really made any progress. As you allude to in this article, I’ll hit a low and then come somewhere closer to normal after a few weeks. That doesn’t mean I’m cured or have progressed mentally in any fundamental way. When I said to him that I didn’t feel like I was done, he said that because of my test scores, unless there was some specific issue I needed help with, his “boss” would tell him to discharge me. So I said that actually I was still feeling worried about bumping into an ex-friend I’d had to cut-off recently (whom we’d talked about in previous sessions). He was pretty dismissive of that, he made me feel like I was making a big deal out of nothing, saying something along the lines of “you know eventually it might happen and it will be fine when it does”. 

I thought that maybe I’d just been unlucky with it, and could give it another go if I got bad again. But over the next few months I found out a few of my friends had also been through the service, and they’d all had very similar experiences. None of them had found it helpful, all 3 mentioned it feeling awkward and that they felt their therapist was patronising them (which is more likely just a byproduct of the impersonal process than the fault of the therapists themselves).

To give some credit, when I did my initial assessment I had mentioned that I wasn’t happy in my work, and that I found filling out application forms really brought out feelings of self-loathing, so they also put me onto a job coach, who was much, much more helpful than IAPT. She actually listened to me, remembered the things I would say, and catered her approach to me personally. She was great, and I actually managed to change jobs with her help. Thinking about it now, if my scores did improve, it was certainly more thanks to her than the IAPT.

 To give some credit, when I did my initial assessment I had mentioned that I wasn’t happy in my work, and that I found filling out application forms really brought out feelings of self-loathing, so they also put me onto a job coach, who was much, much more helpful than IAPT. She actually listened to me, remembered the things I would say, and catered her approach to me personally. She was great, and I actually managed to change jobs with her help. Thinking about it now, if my scores did improve, it was certainly more thanks to her than the IAPT.

Updating to today, NHS Talking Therapies forthcoming conferences are sponsored by a) Limbic an artificial intelligence company and b) Silver Cloud, an online CBT self-help platform. The claims of neither have been independently verified. Small wonder that the robots are taking over.

Dr Mike Scott

 

 

 

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