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Who is responsible for the delivery of CBT?

This question was prompted by by Prof Kendall’s response to my previous post ‘flexibility within fidelity’, he writes: 

‘THANKS…I agree—sometimes I say change the system when, in reality, it takes time and may not be possible in some places‘.

This is the time of year when many of us look at workshops we might attend to boost our CPD .   There are many good ones at CBTReach and bespokemental health  that focus on the delivery of an empirically supported treatment. But by and large they are by clinicians who do not have the constraints to which clinicians in routine practice are subjected e.g number of sessions, meaningless outcome measures, sanctions for not achieving targets.    BABCP run workshops by clinicians working in low intensity interventions but they lack the evidence base of randomised controlled trials with independent assessment.  

It may be that clinicians in routine practise are rather like the 1000 + sub-postmasters prosecuted  by the Post Office. Their voice has also  not been heard over the past 15 years and they have struggled to implement a flawed system, one which has not been subjected to independent evaluation. Is NHS Talking Therapies any better than the Post Office/Fuijitsu.?

Dr Mike Scott

 

264 replies on “Who is responsible for the delivery of CBT?”

I agree completely with this Mike. The vast majority of people in NHS talking therapies are trying their best to make a dysfunctional system work and many are paying a high price in terms of their own wellbeing, it’s really sad.

TT is like Alison in Wonderland – in some services that i’m aware of, there are various names given to sections of the service eg low intensity, high intensity etc – There was also for many years one called ‘brief integrated therapy’ and this i’d say was a fair approximation of what was on offer – 6 sessions on the production line and out, however in order to keep up appearances and tick more boxes this was simply changed to ‘intermediate CBT’ most of the folk working from this waiting list have core professions, have done basic CBT training and are perhaps trained counsellors but none are actually CBT therapists – so clients are being misled, as are commissioners and staff burnt out. No one cares though just keep the funding coming.

I agree folks, people are not getting what they have been led to believe they are getting and Integrated Care Boards are being conned. It seems that the power holders have therir hands over their ears and are saying ‘don’t tell me what is actually going on’, it is reminiscent of the Police in Rochdale not listening to victims of abuse. How long does this have to go on?
Mike

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