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Somerset Talking Therapies

Posted By Victoria L

"Somerset Talking Therapies"

About: Somerset NHS Foundation Trust / Adult community mental health

(as the patient),

I was referred for anxiety & depression.  I was contacted by someone via phone to have an assessment.  This consisted of a question and answer format, which I didn't like much, as it didn't give any space for me to say what I wanted or needed to say and was extremely prescriptive.  As I was desperate for help and don't currently have the funds for private treatment I went along with it.

I received an appointment to focus on anxiety.  As it was a phone appointment I felt little or no connection to the person on the other end of the phone.  Again they asked me a series of questions which mainly were not what I would have chosen to talk about.  When I tried to say something about my feelings, the person said yes yes...didn't go into those feelings, but carried on with the questionnaire which I felt was almost irrelevant to me.

I was told that CBT is the most effective form of working with anxiety.  I don't think this is true and if you look at the most recent research, it shows that any therapy gives equal results to CBT.  I felt worse after the appointment, like I hadn't been listened to properly or responded to as an individual.  I was also told that my anxiety had dropped to below the clinical level, or words to that effect.  I felt that I was judged and measured on a scale which I was forced to participate in.  I also don't believe that the person I spoke to had any counselling training at all.  Apparantly that is not important, but getting through a questionnaire is.  CBT might work for some people some of the time but it is not a one size fits all solution.  As I said it made me feel worse and there is nothing else on offer I can access.  There should be different types of therapy available in person.  For me - utter fail.

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Responses

Response from Somerset NHS Foundation Trust 5 years ago
Somerset NHS Foundation Trust

Submitted on 31/01/2019 at 16:48
Published on Care Opinion at 22:28

Dear Victoria L

Thank you for your feedback and I’m sorry to read you had such an experience of the support you received from Talking Therapies.

We are part of the national Improving Access to Psychological Therapies (IAPT) framework. As an IAPT service we attempt to make our initial contact with patients as accessible and prompt as possible: telephone assessments are one of the ways we seek to achieve this, as encouraged by the national guidelines. Although assessments do need to include the mandatory questionnaires on mood and anxiety, there should also always be space for the patient to express themselves and their concerns, and indeed that is essential in thinking about which of our treatments would be most effective. I’m sorry that you did not feel such space was offered you. Assessments do though follow a template to ensure all issues are covered.

It sounds like you were referred for Guided Self Help for anxiety. This is mostly offered over the telephone and there is a strong national evidence base for the success of this. It does of course again allow prompter, more accessible treatment. Guided Self Help is a CBT-informed, lower intensity intervention. As far as I am aware, the National Institute of Clinical Excellence (NICE) guidelines still recommend CBT as the only effective intervention for anxiety, based on the evidence. If you are aware of other conclusive evidence, I would be very interested to hear further about it.

The worker who treated you would have been a Psychological Wellbeing Practitioner. They are Psychology graduates who then train either at Exeter University, or previously in-house, in all such Guided Self Help interventions. You are right that they would not have received any specifically counselling training, as this would not be part of the national curriculum. It appears from what you wrote that by the end of the treatment you were presenting as Recovered. This is a particular IAPT term to indicate that a patient’s scores on the weekly questionnaires (PHQ9 for mood & GAD7 for anxiety) have moved down to a functioning level. It sounds like this did not coincide with your felt experience and I’m sorry to hear this was not explored with you. We do have other forms of treatment available, including face to face, short term counselling. However, this is a much more intensive intervention and as such - and due also to its very brief nature - it is not always helpful to a patient. Indeed the evidence shows that it can in fact be harmful. For example, a patient may feel they have disclosed a lot of information and then the therapy terminates after only 8 sessions, resulting in them feeling abandoned. It would not be offered to a patient who already presents as Recovered from a successful lower intensity treatment.

I would be happy to discuss these issues with you further if you wish to contact the service.


Marc McDonagh
Service Lead, Talking Therapies

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