To be beyond frustrated my MH trust told me I’m too complex?

[Sillyquestion123]

I had my assessment call today, and the lady albeit very nice and understanding told me that they spontaneously be able to help as the talking therapies within my trust don’t deal with complex trauma.

As I’m also not currently depressed nor anxious, and only get symptoms when triggered I’m no way a priority.

Ive already contacted Mind which were nice, and NAPAC who were super helpful.

apparently the next step is my GP to ask to be referred to a psychiatrist.

I've only heard about his via the charities.

So AIBU for feeling so let down by my local trust?

my issues are "too complex" for CBT

This kind of statement is very frustrating to me (not a reflection on the poster, more on the system). The issue is not that CBT cannot deal with complex issues or severe problems. It is one of the most important ways we have of understanding psychological difficulties.

The problem in the UK is that most CBT is offered by people who have very little training, and there is a big emphasis on 'core professions' as if your nursing qualification makes more difference to what kind of therapy you can do than your actual training in psychotherapy. That training is treated like a top up, and lots of people get into it because they want higher banded jobs than available through their professions.

There desperately needs to be an overhaul of the way people who go on to offer psychotherapy are trained and accredited.

there are different teams that deal with different levels.
example is that someone with borderline personality disorder and having a flare up of this would not be well managed dealing within rhe local bereaved or low level anxiety team. Wouldn’t you agree? It’s already mismanaged and underfunded.

Urghh. I relate. Diagnosis of EUPD/BPD with Complex Trauma here. Spent a long time being pushed from pillar to post between mental health services who didn't know what to do with me and IAPT who weren't equipped for my needs at all. I did eventually manage to get 2 years of DBT on the NHS, which has been a game changer (had to wait a long time, but was worth it ) but found there were some aspects of the trauma that DBT by itself wasn't touching, so had to look around for a private Trauma therapist who didn't shy away from my diagnoses. I first stumbled upon a charity in the South West who helped a lot but they went bust, and then went on the BACP website sending an email stating what I was dealing with and giving a little outline of my history. I wasn't expecting to find anyone I could afford with the right kind of experience in my area, turns out I was lucky. I'm glad I persisted with seeking help, the frustration is horrendous and it can feel so invalidating when it seems no one wants to help or the help just isn't there which is a huge trigger for many survivors.

💐💐💐💐

They actually need to assess people before deciding which services are / are not appropriate, don't you think?

And if you are assessed they should be automatically directing you to the correct services rather than you scrambling around having to go back to the GP as it shouldn't actually involve the GP once you are in the mental health system, don't you think?

As in they take responsibility and direct you to the correct department rather than dumping you because of no not my problem, we don't care and he'll if we can't assess you who gives a shit if you end up dead in a ditch from our incompetence.

And it's short term. Complex Trauma can affect your ability to trust, 12 weeks is way too short to build up that trust . CPTSD takes years to treat in many cases.

If you’re within an hours drive or so of this organisation, I’d strongly recommend them.

Beacon House Therapeutic Services and Trauma Team.

They can’t diagnose ASD, but they work with clients with ASD and trauma. (The hour driving window is their own recommendation, in case you were wondering).

I’ve spent years in the NHS and private MH system, including a six month stay at a residential trauma clinic - Beacon House is by far the best treatment and care I’ve experienced.

Just marking my place to catch up with another time. Wanted to say thanks for this thread though OP, I was thinking I was the only one going through this, but sadly not! I am paying for private long term trauma informed therapy, also paying for other private treatment for physical issues I can't get help with either. On massive long waiting lists. The cost is breaking me and taking up so much time I've had to reduce hours at work. Sick pay is running out soon and I'm terrified I won't be able to carry on treatment. It really sucks. Turned down for pip too.

Unfortunately it’s 6 hours away :(

Not always
A service will be set up and will know what trained staff they employ and will have a service Spec to say what they can offer and they cannot offer and what cohort of conditions meet their needs.

Services are usually able to triage at the point of referral on the basis that information they receive is accurate and meets their service criteria. For example, someone which a complex eating disorder may be different to someone with complex personality disorder resulting in hospital admissions.
Neither would be suitable for a service that specialises in low level mental health services.

There may be cases that the information on the referral is inaccurate and in which case the person may be seen but then referred elsewhere.

Yes I have read Pete Walker thanks, I’m not uninformed 🙄 I’ve worked in this area for almost 20 years.

l also know how they assess PTSD in talking therapies services and they are looking for presentations that fit with the ehlers and clark model which is based around a more narrow idea of what it looks like. It also expects 12-16 sessions to be enough which for CPTSD it likely won’t be.

But this is the problem. The lack of joined up services in an area where this is essential otherwise it literally harms.

Stop making excuses for the failure to be able to direct people in a way that's easy and doesn't put them at risk.

I agree there should be better signposting. The service I worked in was actually ok at this. We wouldn’t make referrals for people but we would share info on where they could self refer.

GP can refer into secondary care MH teams but they’re not always the best at knowing what third sector options there are.

CBT is not short term therapy!!!! It is a major theoretical underpinning of the way we understand human behaviour. You are mixing up CBT with the approach of the Talking Therapies programmes!

Talking Therapies - or IAPT as was - trained a lot of people in CBT techniques for a narrow range of problems when it started. There are also counselling treatments on offer, but the emphasis was on CBT because it lent itself to time limited models of treatment, which were 20 sessions. The people who have only done this training are NOT fully trained psychotherapists but because there are few protected titles in the UK, anyone can call themselves anything.

Over the last 15 years pay for this treatment has been cut repeatedly, so the stay afloat, services have to limit sessions to somewhere between 6 and 12.

Some CBT programmes work with people for a year or two. Some properly trained psychotherapists use CBT as their main approach and may work with people for longer.

So once again CBT AND TALKING THERAPIES ARE NOT THE SAME THING.

Quick update, I got in touch with my trust and the waiting list from this point is now 3 YEARS! For an Autism diagnosis. However, I can transfer it to another provider if I wish to

Hi OP. I was in a similar position to you - fine 95% of the time and then occasional triggers would really cause problems.

After many years of specialist talking therapy, which did immense good but didn't resolve it all, I got EMDR from my local NHS community mental health team. It was incredible. No problems in two years. I would very much recomend it for 'stuck' trauma.

My route in was through crisis - I was suicidal and ended up online googling urgent mental healthcare. Somehow I ended up in the right place, I think maybe through NHS 111, and I got a call same day, then an assessment within a week or so and then onto EMDR within 3 months. I was able to explain in the assessment that I didn't need more CBT or more talking therapy - I needed EMDR as the trauma was 'stuck', I had hardly any memories of it.

I don't know what's available near you but my experience says that the NHS can give this, and without huge delay. Good luck x