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"I asked to be referred to a trained counsellor"

About: Talking Therapies

(as a service user),

I was referred to Worcester Healthy Minds after a significant life event and ill health. This was an extremely shocking and distressing time in my life and I was struggling with anxiety and depression. As I had become unwell, it also became apparent to me that I needed to speak about some unresolved childhood trauma; I therefore asked to be referred to a trained counsellor. 

The first noteworthy occurrence was that I met with a psychiatric nurse at my GP practice to discuss my referral; and after discussing my needs at length (and agreeing a course of action) they wrote to me stating that I could not be referred for counselling (due to me having significant physical health needs) and instead, I should attend a support group. 

When I challenged this (due to my mental health diagnoses), they asked me to write an email to them detailing my needs; effectively I felt like I was completing my own comprehensive referral when I was already feeling very overwhelmed and in desperate need of some help. This person demonstrated no empathy or concern for my welfare. 

The second instance of poor service, was when I eventually was allocated to a practitioner. This individual was trained in CBT (which I felt was not appropriate to my needs at this time) and was unable to do any meaningful work outside the worksheets they issued to me on a weekly basis to complete. These sessions added greatly to my stress and only made me feel more upset, hopeless and not listened to. The worker frequently spoke over me when I attempted to answer their questions and (I felt) spoke with sarcasm and disdain. 

Very fortunately, I had enough remaining strength to ask again to be referred to a qualified counsellor; and I’m so very grateful I did. I was then allocated to a fantastic, experienced and fully trained psychotherapist who really helped me keep my head above water whilst I continued to experience a period of trauma in my life. They provided knowledge, empathy, guidance and support that gave me hope for the future and skills I continue to use every day. Sadly, this person has now moved on; I can see that they were outside the norm of the services I mostly received and I just feel very grateful that, when I needed help, there was this one skilled person who was willing to really help me. I cannot state strongly enough that this professional prevented me from giving up. They made me feel that my life still had value. 

I have taken the time to write this review for two reasons: 

1. To encourage others to persevere in asking to be seen by a qualified, experienced and empathetic health professional when you need this. You would not ask your neighbour with a 6 week online course in mechanics to fix your car! 

2. I hope that professionals might read this; people who are maybe burned out, disillusioned, less qualified or less suited to working in mental health, and consider their actions.

Do you have a similar story to tell? Tell your story & make a difference ››

Responses

Response from Kate Wood, Community Engagement Manager – Digital, Herefordshire and Worcestershire Health and Care NHS Trust 3 weeks ago
Kate Wood
Community Engagement Manager – Digital,
Herefordshire and Worcestershire Health and Care NHS Trust
Submitted on 10/04/2024 at 11:57
Published on Care Opinion at 11:58


Thank you for you feedback Ombersley65.

I am sorry to hear of your experiences within the Service. I have sent your comments to the service manager and will come back to you with a response.

Kate Wood,
Community Engagement Manager,
Herefordshire and Worcestershire Health and Care NHS Trust

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Response from Kate Wood, Community Engagement Manager – Digital, Herefordshire and Worcestershire Health and Care NHS Trust last week
Kate Wood
Community Engagement Manager – Digital,
Herefordshire and Worcestershire Health and Care NHS Trust
Submitted on 18/04/2024 at 20:37
Published on Care Opinion on 19/04/2024 at 08:24


Thankyou for taking time to feedback on your experience with Herefordshire and Worcestershire talking therapies for anxiety and depression (formally known as healthy minds). I am sorry that your journey was initially not a positive one for you. I am concerned to read that your experience with a CBT therapist left you feeling upset, hopeless and not listened to and added to your stress. I am saddened to read that you felt the clinician spoke with sarcasm and distain. This is not how we expect those using our service to be left feeling, I would really value the opportunity to discuss your experience with you further and identify areas of learning for us as a service.

I would like to reassure you that all of the clinicians within the service are either fully trained in the treatment that they are providing or are training within that treatment with close supervision from a qualified clinician.

Talking therapies for anxiety and depression follows a ‘Stepped care’ model to treatment in line with the NICE guidance for depression and anxiety disorders. This means that following an initial assessment with the service and on identification of the main difficulty the least intensive treatment for that difficulty is offered first.

In line with the guidance the first step for most experiencing symptoms of depression or anxiety will be accessing and working through Cognitive Behavioural therapy self-help information and strategies with the support of a Psychological Wellbeing Practitioner (PWP), or Trainee Psychological Wellbeing Practitioner (TPWP). This support is delivered in a variety of mediums including groups, one to one via weekly 30mins telephone sessions, or through computerised programmes, and includes setting and completing weekly tasks aimed at understanding patterns contributing to the problems, and making changes to work towards agreed goals. We appreciate that this form of treatment is not for everyone, and we would expect that any concerns of difficulties engaging with treatment would be appropriately and sensitively raised by the clinician during the course of treatment to reach a collaborative understanding and decision on moving forward with treatment. I am sorry that this did not appear to happen for you.

PWP’s are fully trained in supporting others to work through self-help strategies, having completed a Post Graduate Certificate in Low Intensity Interventions. This involves a full year of training with two days at university and three days in practice. We require all qualified PWPs with the service to be registered with the British association for behavioural & cognitive psychotherapy (BABCP).

TPWP’s are closely monitored, receive weekly supervision with a qualified PWP, and have their practice regularly reviewed to make sure that they are utilising and growing in essential skills, supporting others in line with the evidence base, and keeping this support collaborative and patient centred. All those accepted onto the PWP training will have already had a variety of experiences working in mental health care and developed essential skills and knowledge.

Should the guided self-help not be effective in the treatment of the problem then following the stepped care model a higher intensity of treatment is offered. This is offered by a therapist who has undergone appropriate training within a specific modality, and are accredited with the appropriate professional body, or by a clinician training within that modality and who already has significant experience working within mental health care, and is receiving regular clinical supervision.

We would expect all clinicians within our service to be aware of and be able to develop a supportive and collaborative therapeutic relationship, using interpersonal skills such as empathy. I am sorry that you felt there was a lack of empathy demonstrated with the clinician with whom you were working. Once again we would really value being able to discuss this further with you in order to explore and address any areas of learning.

If you feel able to discuss this more fully then please could you contact the service on 0300 013 57 27 and ask to speak with Service Lead – Dominic Dutton Edwards, or deputy service lead – Rachael Wall, alternatively you can speak with the Patient Advice and Liaison service on 01905 68151.

Thankyou again for bringing this to our attention we really welcome feedback to help us continually improve the quality of the services we offer.

Rachael Wall
Deputy Service Clinical Lead for Herefordshire and Worcestershire
NHS Herefordshire & Worcestershire Talking Therapies

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