What therapy is available on the nhs?

[Supermagicsmile]

I went through a self referral scheme. I had a phone call assessment and was then offered 6 sessions with a 'psychological wellbeing practitioner.' I waited 4 months for an appointment and recently had a face to face one for an assessment. She feels I have a couple of issues and waits to work on one of them (fear of germs.) I know I have very, very deep seated issues with self esteem/self worth etc that we didn't get much time to look into. I feel these are more of a problem than my fear of germs. These sessions seem to be, find a quick fix to the problem, read a booklet etc.

Does the NhS offer any other talk therapy that is more talk based rather than 'actions?'
The next few sessions will be on the phone to see how I'm doing after the I read the booklet she gave me .

[MissSlighcarp]

It sounds as if what you've had is the very bottom tier of the 'stepped care' system.

This is based on starting everybody on the least intensive (and cheapest) level of intervention, and then working up the scale for people who need more. Which sounds fine in theory, but for some people the lower tiers of self-help/CBT are never going to be effective, so it can lead to a waste of resources as well as possible additional distress and delays for people having to engage with services that were unlikely to be effective anyway.

There are longer-term psychoanalytic therapies available on the NHS, but not in every area, and generally not accessible without a referral from someone higher up the system, ie a senior psychiatrist rather than a GP. Have you talked to your GP? Good GPs will know what services are available in your area, and what the referral pathways are.

But if your problems are not severe, you may well not meet the criteria for NHS referral, even if the service does exist. As an alternative your GP may be able to refer you to voluntary agencies for low-cost therapy, if you can't afford full-cost private therapy. Going private will give you a much wider range of therapy options, so you should be able to find something that will meet your needs.

[shellacnails]

I've had long term psychotherapy on the NHS, I did have to get referred by a psychiatrist and I was on the waiting list for nearly a year. I live in a London borough and there is a specialist clinic near me. My MH issues are very severe and enduring (I'd been in the MH system for 12 years before I was offered therapy, and I've had numerous suicide attempts).

[Supermagicsmile]

If I was to try and find my own therapist, what would I be looking for? Is it just 'talk therapy' or should I be looking for a psychotherapist etc?

[Itisnoteasybeingdifferent]

Smile, why are you wide awake in the small hours... ?
I suspect it is difficult to advise on that one. I can only suggest that you find a practioner who seemls to be able to tell you if you need other help and point you in the right direction. It is a bit like an accountant should refer you to a tax specialist if you have a very complex tax situation.

[fempsych]

It seems that you are in an IAPT service which works on Tiers and the bottom tier is wellbeing practitioners and guided self help.

There are higher tiers where you may have psychology although generally also CBT focused. These are defined as for people with difficulties impacting more on their wellbeing.

Some areas also have psychological services separately on the NHS. Although these may only be open to people expericing emotional distress that is fairly severe.

Re private therapy. It depends what you want really...basic rule make sure they are accredited with a relevant organisation. Fairly easy to qualify as a basic counsellor so they might be hit and miss. Psychotherapists and Psychologists are more experienced and expsensive due to their level of qualifications. Cognitively analytic therapists are fairly well regarded. Avoid CBT if you want a more exploratory therapy - CBT is more action focused although if done well should also have an exploratory edge.

If you can afford private, Best to see two or three people for initial assessment and then chose the person you felt suited what you wanted to get out of therapy.

[AnxiousCarer]

OP if you work somewhere with an occupational health department that may be a good option. You can often self refer in. It would depend what is on offer. I have accessed a councellor several times through mine and this time she has refered on to a psychologist as she feels I need more specialist input. I have never accessed the NHS services as occi health services where I work have much shorter waiting lists, though my GP is aware of what help I am getting through them.

[Thatwaslulu]

I have been going to CBT for the last few months but have found that just as it started to help make a difference, I have come to the end of my permitted therapy (counsellor is going on maternity leave and she has said I'm not making progress fast enough to be transferred to another counsellor). I feel like it has dredged up a lot of issues I had suppressed effectively for 20 years and then at the point where I have started to deal with them the rug has been pulled out from under me.

A lot of the actions I have been asked to do have been unhelpful and the counsellor has said that because they are not working for me that maybe I'm not ready for therapy - rather than considering that it's the wrong type of therapy or the wrong focus for much of my time. The more advanced and useful stuff has been crammed into the last two weeks and will end this week.