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Discovery Alternative Support Additional In Schizophrenia

Posted By ssh

"Discovery Alternative Support Additional In Schizophrenia"

About: Collective Voice: North West Standing Conference Lancashire & South Cumbria NHS Foundation Trust / Adult mental health

(as the patient),

The purpose of this post is to illustrate and promote a working example of long term therapies which support the medical model used for myself and could be used to extend the current British National Institute of Health and Clinical Excellence guidelines (NICE) – in order to incorporate a long term therapy concept regarding schizophrenia and other conditions and diseases.

The theory is that alternative support, like long term clinical hypnotherapy and long term CBT plus psychotherapy and counselling, was effective in helping my schizophrenia by reducing my medication in order to improve my quality of life. The analysis criterion is the medical evidence of my lifetime recovery in terms of quality of life with my long standing schizophrenia of over 28 years. I have discovered these alternative therapies personally and I now report a permanent improvement in my condition. My conclusion is that the alternative therapy experience is effective in reducing my medication for schizophrenia to the international minimum recommended dosage level by the Medical Model; for me this was an effective support mechanism to the Medical Model.

Schizophrenic symptoms for most people in Britain today are controlled with the use of psychotropic medication and for the last 28 years I have been under this regime.

My experience is long term therapy in order to reduce long term schizophrenic medication.

In October 2002 – under medical supervision – I started to reduce my 50mg weekly injection of depixol medication for schizophrenia. I had been having this 50mg weekly injection for 15 years. At the same time, my medication reduction experiment started, I began weekly sessions of CBT and clinical hypnotherapy – plus psychotherapy and counselling.

In 2009, I finalised my medication reduction and reached a 60% reduction of depixol. This tremendous reduction of depixol has only been possible through persevering with the weekly therapy sessions which were funded, experimentally, by my local education authority as part of my disabled student package. Later I changed to the newer risperidone 6mg daily medication.

It must be stressed at this point, that my weekly therapy sessions enabled me to cope with substantial withdrawal symptoms; these included chronic irrationality, an increase in hearing voices, paranoia, delusional ideas and severe and terrifying hallucinations. Long term, this alternative therapy more than adequately supported me through these symptoms.

For me it was my unconscious and not just my conscious mind which needed addressing. I felt I needed clinical hypnotherapy to get deep inside my mind, so that the other therapies could penetrate those hidden recesses.

I think the 12 weeks CBT offer from the NHS is not enough for a single (i.e. 5mgs) medication reduction. I have read that even the pharmaceutical industry recommends at least 16 weeks for a single medication reduction. So, in my opinion and experience – the NHS has got it wrong.

Because I am a severe case of schizophrenia I was only able to reduce my weekly depixol injection medication by 60%. Also, I believe the above mentioned therapy and counselling regime could well prove to be effective with cases of depression, bipolar, anxiety, alcoholism and drug abuse.

Incidentally, my schizophrenic mother, whose first language is Gujarati, was refused my therapy and counselling treatment because her English was not good enough. These therapies and the counselling I think therefore need to be made available for non English speakers.

I think my therapy experience costs less in costs than a lot of the smoking and drinking alcohol a lot of people do each week in many countries not just England so I hope one person is inspired to go for counselling from my story one day - all I can do is hope for that. Good Luck!

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Responses

Response from James Maclachlan, Web Officer, Communications, Lancashire Care NHS Foundation Trust 14 years ago
James Maclachlan
Web Officer, Communications,
Lancashire Care NHS Foundation Trust

I manage the content for the Trust intranet and internet sites

Submitted on 05/02/2010 at 15:54
Published on Care Opinion on 08/02/2010 at 00:00

Thank you for posting your comment

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by ssh (the patient)

Thankyou to Lancashire Care NHS Foundation Trust for your reply and thinking my article is of a little bit of value to someone. I hope one person somewhere is inspired to go for counselling one day from my article but some people will not know what counselling actually does for them please tell them to read about it or ask someone who knows about the value of counselling?

Therapies and counselling should be available in all languages and for everybody that needs them. Counselling gives me emotional relief otherwise I would be smoking, drinking alcohol ot taking illicit drugs or getting angry and aggressive. Counselling helps people to work things out? Einstein said "we need to show even more kindness to all people" I hope one day even more people understand what counselling does? Thankyou to the NHS! kindest regards from my soul. "Nothing ventured - nothing gained?" a wise old saying.

Response from Mick McKeown, Principal Lecturer in Mental Health, University of Central Lancashire 14 years ago
Mick McKeown
Principal Lecturer in Mental Health,
University of Central Lancashire

Submitted on 09/02/2010 at 14:40
Published on Care Opinion on 10/02/2010 at 00:00

My name is Mick McKeown and I help to support the Collective Voice network for mental health service users and carers. It really is good to hear about this positive experience of achieving medication reduction with supportive therapies. You also raise some interesting points about the general availablity of therapies such as CBT. Particularly for sufficient duration to adequately address the needs of people with serious ental health problems. Similarly, you point out an important equalities issue concerning the availability of CBT in languages other than English. I think that it is important that both these points are made to the commissioners of services and the commissioners of staff training. Hopefully, Collective Voice will also have an interest in taking forward these ideas. I can pass them on for discussion within the network, or you could make a posting directly onto the Collective Voice network website and encourage others to join in and support. Collective Voice website
  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by ssh (the patient)

Dear UCLAN lecturer,

firstly, alot of people do not understand what therapies and counselling will do for them they need educating about it please ask them to speak to a knowledgable person about it?

Secondly, a "typical" symptom of schizophrenia is lack of motivation and not easily understanding the social world.

Thirdly, I had to travel very long distances for my therapy and counselling nothing especially significant was available for me locally.

Fourthly, therapies and counselling should be available in all languages and be offered to the people that need them.

Fifthly, my therapy experience costs less than alot of the smoking and drinking alcohol some people do every week in this country so my therapy experience is replicable by quite a few people,

Sixthly, I only have average ability with alot of severe specific learning disabilities so alot of people can learn faster than me and my therapy experience is replicable to alot of people.

Seventhly, because of "typical" symptom of lack of motivation in schizophrenia this is probably why alot of them do not move forwards easily not just lack of therapies and counselling but lack of motivation.

Eigthly, alot of people do not know what therapies will do for them so they don't put themselves in the postion to be helped by therapies and counselling thats all to do with motivation and lack of knowledge?

Ninethly, I have my therapy experience published in some of the top journals in Britian. legacy is left but it took 30 years for my therapy experience to be accepted, probably will not be fully accepted in my lifetime.

Tenthly, I hope one person reads my article one day but I am not big headed about that and they get inspired to find out what counselling and therapies will actually do for them first before writing it off?

Eventhly, I only have less than average learning speed but alot of people could go for therapy if they overcame some of the "typical" symptoms of schizophrenia one is usually a lack of motivation.

Twevelthly, you have my writen permission from now to distribute my ideas.

In conclusion therapies and counselling should be available in all languages and should firstly just be available adequately but some people need to wake up to what therapies and counselling will do for them first for this to happen.

I hope one day one patient reads this and finds out if they do not know or only think they know what therapies and counselling will do for them but I am not big headed about websites, glossy reports and glossy publications because we have had them since the invention of print.

things take along time to change.

Change involves mental pain so for some it is easier suffering and not putting heir neck out.

Nothing Ventured - Nothing Gained?

Good luck!

Thankyou.

Response from Mick McKeown, Principal Lecturer in Mental Health, University of Central Lancashire 14 years ago
Mick McKeown
Principal Lecturer in Mental Health,
University of Central Lancashire

Submitted on 15/02/2010 at 10:38
Published on Care Opinion at 00:00

Thanks for your additional posting giving more details about your experiences of supportive therapies.

I can certainly pass on your views to the Collective Voice network which I help to support. Learning from each others' experiences is a useful function of networks such as Collective Voice.

You mention that your experiences have been published in a journal. If you are willing and able to do so, it would be helpful if you could pass on a reference so other people could have a look at this.

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by ssh (the patient)

Dear Mick,

I have joined your Collective Voice website and I have put my full article and references on your website at end of my article in your website in Discussion Section. Please note that the ethics of this Patient Opinion website is complete anonymous nature something I did not want but its just the ethics of this website I cannot control other people.

I only have average ability level with some severe learning disabilities but let me know if I can help you I will be glad to help you?

My therapist is writing proper professional article when it is ready I will put it up on your Collective Voice website asap.

My journal references are on your Collective Voice website already.

I am also a full time carer and psychology student and I have had almost an unbearable amount to cope with in my lifetime but I will try to help you but alot of people do not know what therapies and counselling will do for them, please tell them to ask someone with enough deep knowledge.

You have alot of right good resources at your place and your counsellors are excellent.

Counselling and therapies stop me from getting locked up and never coming out again, might be worth more than money to me. I would like to thank your counsellors they are affectionate, kind and loving people - thankyou !

You can contact me though your Collective Voice website easily I put my full article up there a few days ago on Discussion Section.

Don't get me wrong I only have average ability with some severe learning disabilities but my therapy experience can be replicated by many people because I have subnormal learning speed but I will try to help you.

from,

ssh

I have scraps of articles published, it does not mean I do not understand - and I am not big headed because I know about articles being published.

Its mainly about how we all chose to spend our little amount of money we have in this rich country. my therapy experience can be replicated by alot of people I am nothing special and I never said I was don't get me wrong about that please.

thankyou. Nothing Ventured - Nothing Gained? a wise old saying ?

Response from Mick McKeown, Principal Lecturer in Mental Health, University of Central Lancashire 14 years ago
Mick McKeown
Principal Lecturer in Mental Health,
University of Central Lancashire

Submitted on 23/02/2010 at 10:01
Published on Care Opinion at 00:00

Thanks for joining Collective Voice and thanks also for your enthusiasm and commitment. Collective vOice is full of people like yourself who want to use their experiences to help others.

You are a passionate supporter of counselling and psychotherpies and wish to publicise their value as widely as possible. I am sure that many people belonging to Collective Voice will share your views on these therapies. Issues of access and availability are clearly important.

Posting your articles for others to read is a good way of using the Collective Voice website. Hopefully this will prompt further discussion and engagement with your ideas.

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by ssh (the patient)

In reply to Mick McKeown,

thankyou for your reply Mick.

I know there is a big problem with access to therapies and counselling but alot of people do not know what therapies and counselling will do for them in the first place they might be better off speaking to someone who knows about it deeply enough? I am one of the poorest people in this country and I only get counselling and therapies with my committment and by scraping my last pennies together every single day of my life - I am one of the pooreset in the country and deprived myself in alot of ways myself so alot of people could go for counselling and therapies if they shopped at discount and economical places because the cheaper stuff an old man like me would tell you is not specially greatly different than the designer expensive stuff just paying for the Company Labell usually - we have to keep it practical and economise every single day - change involves upset for alot of people and for some they suffer but they know where they are in that state sometimes easier sometimes not.

I know some people have a belief in black magic and voodoo and this stops some families from moving forwards but ask them to please not write off therapies and counselling even before they know what the stuff does for them because with me my reasoning and comprehension is severely afected by my severe schizophrenia and medication giving me specific learning disabilities and therapies and counselling help me to reason and comprehend stuff otherwise my other choice would be back in an institution again and his time never coming out again.

Its not just access to therapies and counselling that is the issue but some people have alot of money and spend it on other stuff I am one of the poorest people in this country so alot of people could have counselling and therapies not just me.

It about economising our money each day and realising that the cheaper stuff is not much different to the brand name stuff this stops some people getting angry and annoyed with the cheaper stuff.

Please ask people not to write off therapies and counselling if they don't know what it does for them because for me it helps with my daily reasoning and functioning and comprehension making me slightly pleasant enough to be in the community otherwise I would be back in an institution again and this time never come out again?

There is a wise old saying "don't burn your bridges before crossing them?"

Nothing Ventured - Nothing Gained?

from,

ssh

thankyou for reading this.

my alternative is an institution and never coming out again? I know which choice I would make?

Response from Lancashire Care NHS Foundation Trust 14 years ago
Lancashire Care NHS Foundation Trust

Submitted on 25/02/2010 at 19:30
Published on Care Opinion at 00:00

Dear ssh

I was pleased to read that you have had such a beneficial result from the combination ofpsychological therapy in conjunction with medication. There is a steadily growing evidence base that psychological therapies can be beneficial in the treatment of complex and severe mental health problems such as schizophrenia. Certainly psychological therapy is not just for the"worried well" as used to be thought rather dismissively.

You make the case for long term therapy - in your own case this seems to have been weekly input from 2003 to the present date - some 7 years, and state that the NHS has got it wrong in suggesting 12 sessions. Personally I think the 12 session "rule" is a bit of a misunderstanding - the Improving Access to Psychological Therapies (IAPT) programme funded by the NHS recommends 12-20 sessions of CBT for people experiencing common mental health problems of the mild to moderate degree of complexity. This fits with the research evidence base suggesting that 16-20 sessions are most likely to be beneficial for that clientele.

I am of the opinion that the amount of therapeutic input should be related to assessed client need, rather than a specified number of sessional appointments, though guidance from the research evidence is useful in plotting what the average course of therapy input is likely to be - and of course it is also useful to have guidance around when to stop therapy if the client is getting progressively worse. In general if no improvement is seen/or the client deteriorates over the first 5-6 meetings the prognosis for therapy is poor and should probably be stopped.

There are issues that the provision of long term therapy raises which are not touched upon in your discussion however.

Firstly, although the recipient may feel supported, there are longer term risks of dependancy upon the therapy relationship/therapist.

Secondly there are issues about cost effectiveness around longer term work, especially as the NHS does not have an infinite budget.

Thirdly studies have demonstrated that a law of diminishing returns operates so that the longer the therapy the less effect each continuing session supplies.

Lastly and by no means least - the therapy resource needed to supply long-term psychological interventions to all would be enormous - well beyond the resources of the NHS not to mention the supply of trained staff.

I wonder if it might be helpful to distinguish here between active therapy which can be highly beneficial, though not always - and in some cases is positively to be discouraged, and psychologically informed support, which could come from a variety of sources.

In Lancashire Care Foundation Trust Adult Network we put forward some of our ideas in a consultation document entitled "Making Psychological Care Everybody's Business", which ultimately has the intention of equipping all staff to deliver psychologically informed care, based on a psychological formulation of the persons current difficulties, their history as well as their strengths and current needs. This will not replace formal psychological therapy but in conjuction will, we believe, deliver therapeutically informed care to all those who come into contact with our services

regards

David Hodgetts

Lancashire Care Foundation Trust

Adult Network Professional Lead for Psychological Services

01282 657941

Update posted by ssh (the patient)

Reply to David Hodgetts,

My counselling and therapies just relieve my severe schizophrenic symptoms I will probably need them for the rest of my life.

Access to Psychological Therapies (IAPT) Programme came out after my article "NHS has got it wrong" my article is half a decade old was ok for its time then now history long gone and past its sell by date long and gone.

Therapy response like medication response has INDIVIDUAL RESPONSE CURVE - in laws of nature sometimes a wound gets worse before it gets better.

Law of Diminishing Returns you say about might not tally with INDIVIDUALITY and INDIVIDUAL RESPONSE CURVES to therapies and medications.

Patients sometimes get DLA which a bit could be used for therapy and counselling.

Patients sometimes could be taught self help therapy techniques so dependency could be just on his/her self sometimes.

Volunteers could provide some of the therapies and some other people have family and money to pay for therapies themselves but typical medical symptom of schizophrenia is a LACK OF MOTIVATION.

Also therapies and counselling should be available in all languages.

Part of it is that some people spend their money on other stuff I had to half starve to afford therapies and counselling but I am nothing special and I never said anywhere I was special.

That old out of date article of mine in The Psychologist "NHS has got it wrong" its an old out of date article psychology has moved on since half a decade ago everything has moved on its out of date and old article I am not big headed I know what some of these articles amount to nothing it was just an opinion - my counsellor once said that opinions are like body organs we all have them its no big deal its old out of date stuff needed at the time of the old days.

Glossy reports, glossy books, and glossy articles come out all the time but there is sometimes PSYCHOLOGY POLITICS AGENDAS?

I never said I was anything special I half starve to afford counselling which relieves my severe schizophrenic symptoms the alternative is back in residentail care home again and never coming out again.

from,

ssh

thankyou for your reply.

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