"Psychological Therapies"

About: Rotherham, Doncaster and South Humber NHS Foundation Trust

(as the patient),

I want to share my battle to receive treatment I believe will help me fully recover from my mental health problems and allow me to return to gainful employment.

After multiple acute episodes and constantly being told I am too unstable for psychotherapy I finally managed to get across the point that giving me some form of psychotherapeutic intervention might help me break the cycle of acute episodes. I still had to fight to get an initial referral and that referral had to go to a panel of team leaders, none of whom knew me. I was one of the lucky ones. My referral got through this third hurdle, thanks in no small part to the person writing my referal.

Hurdle No. 4 - I received a letter asking me to explain why I wanted the therapy and why I thought It would benefit me.

Hurdle No. 5 - and two months later I finally get my assessment appointment. At the end of a gruelling appointment I am asked what type of therapy I think will help me. I tell the psychologist that I feel given the nature of my problem I believe I need to have psychotherapy which looks at the causes not just strategies for dealing with the symptoms.

To my dismay I am told under NICE guidelines the Trust can only offer me short term CBT consisting of 12 sessions.

Hurdle No. 6 - There is also a waiting list of 4 months for this treatment.

A lot has happened to me over the past three years and I'm sure will happen over the next four months.

In my view the Trust needs to simplify the process for gaining access to Psychological Therapies.

It also needs to consider making it clearer to patients that they don't have a choice of treatment, The only treatment on offer initially is CBT. I presume if there is a relapse later on after treatment, other more expensive options would then be considered.

I think thhe Trust also needs to explain to patients that they don't get a say in whether or not they are accepted for treatment.

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Response from Patient Engagement/ Psychosocial Interventions Lead, Rotherham Doncaster and South Humber NHS Foundation Trust

Dear SantaClaus, thank you for taking the time to post your opinon regarding psychological therapies. I shall forward your posting to the approriate manager to offer a response. I also invite you to contact the Patient Advice Liaison Service (PALS) should you require any help or support regarding any Trust services. PALS can be contacted at: 0800 015 4334 pals@rdash.nhs.uk Yours Sincerely, Nick Arkle

Response from Rotherham Doncaster and South Humber NHS Foundation Trust

Dear SantaClaus,

I am sorry to learn that your experience of attempting to access psychological therapies has been difficult. Without more details it is hard for me to respond to your particular concerns. However, I would like to reassure you that evidence based practice is used to ensure that patients receive the most appropriate treatment for their needs. There are a range of treatments available including psychotherapy but a decision has to made, based on the assessment, about which treatment is most likely to be effective. If cognitive behavioural psychotherapy appears not to be effective and the therapist’s view is that psychotherapy is appropriate they can make an internal referral for psychotherapy. All interventions have to be offered on a time limited basis due to the limited availability of psychological therapists. If you would like to provide more details please contact me and I can then look into your concerns and provide a more detailed response.

Diane Williams,

Assistant Director,

Psychological Therapies


Update posted by SantaClaus (the patient)

Thank you for your response. However, I would like to pick you up on two points. Firstly, you do not, in my opinion need further details from me about my specific case to look at the problems associated with the process patients are having to go through in order to get offered treatment. Everyone has to go through the hurdles (stages in the process) I went through to get to the point I am today.

Secondly, the person carrying out the assessment stated that under NICE guidelines, the only treatment on offer to me was CBT consisting of 12 sessions. However, having spoken to my GP, I checked on the Nice guidelines for people with my diagnosis and out of curiosity other mental health diagnoses and was surprised to learn that NICE recommend the following:

Depression should be offered 16 – 20 sessions over 3 – 4 months

Bi-Polar should be offered 16 sessions over 6 – 9 months

Borderline Personality Disorder the guidelines clearly state do not use brief interventions of less than 3 months, they also state that the choice and preference of the 'service user' be taken into account. They should be provided with written information about the treatment on offer so they can make an informed choice, there should also be an opportunity for them to discuss not only this information but also the evidence for the effectiveness of different types of psychological treatment.

I was given no written information and to date still haven't. Not every patient has access to a knowledgable GP or the Internet.

Response from Nick Arkle, Patient Engagement/ Psychosocial Interventions Lead, Rotherham Doncaster and South Humber NHS Foundation Trust

Dear SantaClaus, Thank you for your further posting. I am sorry that you have not been given written information; you indicate that you have seen the NICE Guidance, to be found here. this document also signposts to some other organisations that may be able to offer information and/or advice: Borderline UK Ltd, www.borderlineuk.co.uk • BPDWORLD, 0870 005 3273, www.bpdworld.org.uk • Rethink, 0845 456 0455, www.rethink.org Please feel free to contact PALS if you think we can be of any help, or Diane Williams, Assistant Director, Psychological Therapies, if you wish to raise your concerns directly with her. Best Wishes, Nick
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Update posted by SantaClaus (the patient)

Thank you for your follow up reply. I apologise if my last posting confused you. I do not have a diagnosis of Border Line Personality Disorder, so whilst the links you have given will be of benefit to other patients, they are of no benefit to me.

You have, however still failed to address my basic points:

From my first posting - The process patients have to go through to get access to psychological therapies is long winded and testing for those who are already unwell.

What is the Trust doing to improve this?

Two points from my reply to Diane Williams:

NICE guidelines for people with my mental health problems did not match what I was being offered, yet I was told it met NICE guidelines.

Why are patients not being offered treatment in line with NICE guidelines by this Trust?

My GP gave me a link to the full NICE guidelines, which like many other patients I am capable of reading and fully understanding, even though I have a mental health problem.

I should not have needed to ask my GP or read the guidelines for myself.

Why is the Trust not giving patients information sheets to take away with them following an assessment that would help them to make an informed choice about the treatment on offer, compared to other recommended treatments?

These are general points that could apply to any patient being referred for psychotherapy for this Trust.

Response from Nick Arkle, Patient Engagement/ Psychosocial Interventions Lead, Rotherham Doncaster and South Humber NHS Foundation Trust

Dear Santa Claus,

Thank you for your posting.

The Trust is in the process of implementing a new service model, which should reduce the hurdles currently facing people who need to access services. The new model will offer an assessment by the Access Team, followed by a referral to the service that will best meet the needs identified.

As Diane Williams, Assistant Director for Psychological Therapies stated in her response, therapies are offered on a time limited basis.

Information leaflets are being developed, and some are already available. I am sorry if you were not given written information.

Please contact PALS or Diane Williams if you have any further concerns regarding the posting.

Best Wishes,


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