To think therapy culture is turning self-reflection into self-obsession?

[MirrorFatigueJay]

It feels like we’ve gone from under-feeling to over-analysing everything. Not every discomfort is a trauma. AIBU to think constant introspection can actually make people unhappier?

@Dr940p Would you agree that most of children suffer with their MH problems are diagnosed with ADHD.
Personality disorders, bipolar, anxiety disorder, developmental delays, hyperactivity, no concentrate or hyper focus, no awareness or hypo sensitive, even psychopaths.
There is 1000's of mh conditions that are treated with medication as ADHD in children.

You quoted from it and didn’t link. It was written by Lucy Foulkes , the same academic in the newspaper article and no data was used in said opinion piece.

Assuming you’re not Lucy F I suggest you have a day in the real world of life with children and young people battling mental illness and difficulties in a broken and non existant system.

The NHS commissioned Mental Health Support Team in Schools (MHST) is evolving and many schools still don’t have it. They do also offer consultations , work shops and training to children families and education staff too alongside 121.

As leaving struggling children , schools and families navigating a broken system unsupported is not an option do let us know what you suggest as an alternative. Just sitting in an ivory tower pontificating whilst mild and moderate difficulties turn into severe does not help anybody.

Absolutely not.

How many people come to see you because they just “had a bad day”?

I am a clinical psychologist and I have worked in CAMHs, so I have spent many a “day in the real world of life with children and young people battling mental illness and difficulties in a broken and non existant system”.

I have said over and over again, the only way to address the issue is to increase funding and address systemic issues. A chat about CBT in schools will make no difference, what will make a difference is getting children access to qualified mental health professionals.

I did post the link - otherwise how would you know who the author is?

And yes, given it’s a systematic review, it’s not one paper. It’s a collection of peer reviewed studies conducted by a variety of researcher, so claiming it’s a biased study doesn’t really work.

Perhaps accidentally running to Windsor? Worth a punt 😆

I searched the title, the link was not given.
It’s an opinion piece as it states. No data was used in said piece.

The NHS MHST initiative is still being rolled out and offers much more than a chat about CBT, it’s concerning that you seem so uninformed.

And given increased funding isn’t going to be happening any time soon what do you expect schools, families and children to do in the meantime?

That's because you are on social media. I abandoned all social media years ago and I don't see it.

Before you ask, I do not regards discussion forums like these as social media, because everyone see the same posts in the same other. I might make an exception for the personal feed though.

It’s normal (and helpful) to feel anxious or sad at times but there does seem to be an explosion of ‘MH’ issues now, where people can’t cope with general life.

I have a friend who makes the same mistakes time a time again and wonders why the outcome is the same. Spends hours on the phone to me complaining about her life and how hard it is and how she’s never got money, she’s always working and about her DP (who is a waste of space, alcoholic, never has a penny etc)

She can’t understand how the decisions she makes impact her life. Sh feels unlucky and hard done by and has had ‘therapy’ via charities but I wonder what the point is because nothing will change. Her life is a product of her own choices so no amount of therapy can help someone who doesn’t learn or take personal accountability.

I often think the therapists time will likely be better spent on someone with true trauma, whereby things happened to them that were beyond their control and nothing to do with poor decisions.

You have 1 friend that does this! Of course therapy could help- highlighting the patterns, where it’s come from and giving her the tools to stop making the same mistakes.

“Potential harm from universal school-based mental health interventions: Candidate mechanisms and future directions” is it this title you searched? This is not an opinion piece, a review. There is also reference to several other reviews in the paper.

I think we’re on the same page that more need to be done to help children and young people. However, we can’t just give things a go and hope they help, especially when the evidence indicates it’s not only not helpful, but potentially harmful. It’s the same reason we can’t just randomly offer children new types of therapy that haven’t been studied, offer medication with no evidence base etc. You could easily say “well, increasing funding isn’t happening anytime soon, so let’s roll out hypnotherapy”.

As I quoted from the review (which you ignored) “The specifics of negative effects vary widely across trials. Negative effects have been reported across a range of self-report measures including a worsening of symptoms of anxiety, depression, hyperactivity/inattention difficulties, obsessive compulsive disorder and panic, and a decrease in parental relationship quality, prosocial behaviour and wellbeing”. They then reference the studies which found this, highlighting that the paper is a review, not an opinion piece.

The MHST has been in place since 2018, as can be seen on the NHS website. These are not new programs (“Since 2018/19, the NHS has been implementing new mental health support teams (MHSTs) in schools and colleges across England). I don’t believe I am uninformed, given I’ve worked in CAMHs and have a good knowledge of the conflicting evidence base. I think calling someone uniformed because they disagree with you is silly, personally.

So why are these illnesses not being diagnosing until later in life as a co-condition rather than the primary condition.
My DS was diagnosed with ASD, but he had a genetics mutation discovered later that can present with ASD traits.
I asked tne doctors was he mis-diagnosed with ASD as the issue presents as ASD but not ASD, he said they won't dispute an earlier diagnosis.
There is very little follow-up on an adhd diagnosis, as I mentioned above. I know a few DC who settled down after a few years without medication.
There should be a follow-up ever 4 years.
At one point 22 out of 38 young offenders in Dublin were diagnosed with ADHD.
If other mental health illnesses were explored and treated correctly. It might reduce the violence in society.

Funnily enough, she’s had therapy twice as I stated in my post she’d had it. Guess what? Makes not a jot of difference…. Which is why I said I sometimes I think it would be more beneficial to someone else as I know my friend, know what she’s like and know that no amount often therapy will stop her making the same decisions.

You missed out -“Given that negative effect sizes in this literature are typically small, we are cautious about describing negative effects as evidence of definitive harm, and instead refer to them as potential harm”

And the fact that no data was used and the MHST are evolving.

Again what do you suggest schools and families do instead whilst navigating a broken and non existant system?

Your son does not speak for everybody.

You love to think that your opinion is the only valuable opinion because you're defensive about your families diagnosis and won't consider anything else.

He's unique to me, his circumstances aren't. 🤔 he won't be featuring in any medical journals.

Why would I be defensive, why would I need to consider anything else and how about linking to some evidence for your claims.

What do you mean no data was used? Data was clearly used in the papers they are reviewing, that’s how reviews work? They use secondary data, not primary data. This is the same as meta-analyses.

Yes, but potential harm is still very significant. I wouldn’t want my child exposed to any potential harm. I also wouldn’t be happy if my child was given hypnotherapy, which also carries potential harm, just because the waiting list for CAMHS is too long.

All mental health services are evolving, it’s called service development.

As far as I can see, none of the MHSTs focus on providing psycho education classes to children. On the official document, the three objects are

1. to deliver evidence-based interventions for early support for mental health issues (which is individual therapy).
2. to support the senior mental health lead in schools and colleges
3. to give timely advice to school staff and liaise with external agencies (CAMHs, social work etc)

In other words, to provide individual therapy and work systemically with the student. There is no mention in the guidance about implementing CBT (or any other therapeutic) psychoed classes in school, which is likely because the evidence shows there is potential harm.

@GagMeWithASpoon You'd be surprised what those with enough disposable income come to therapy for. The same as parents sending children to therapy for very trivial reasons. A good therapist will signpost onto a more suitable service.

https://camhsdorset.org/about-camhs/mental-health-support-teams-mhsts

It’s clearly evolving.

Would love to know what potential harms are involved with any of that. What might the harms be?

And again what do you suggest schools and families do- nothing?

https://www.swlondon-healthiertogether.nhs.uk/resources/information-on-local-healthcare-services/mental-health-support-team-mhst-schools

hiowhealthcare.nhs.uk/our-services/a-z-list-of-services/mental-health-support-team-schools-portsmouth

I think there is a wider shift going on - from what sociologists would call collective cultures to a more individual oriented one, probably through the expansion of american culture through SM. In the past, people who were concerned about what others though, and fitting it, and getting along, to people who have been encouraged to think their own needs should be centred.

Now, I do believe that your wellbeing should be central to your own life. Because you cant help anyone if you dont look after yourself. But at the moment it seems to have gone to the extremes and people seem to have the attitude that nothing in their life should be challenging, difficult or distressing. Some self reflection is a good thing. But too much is incredibly damaging. The YouTube about the woman who was talking to AI about her psychiatrist illustrates this perfectly.

There is no mention in the guidance about implementing CBT (or any other therapeutic) psychoed classes in school, which is likely because the evidence shows there is potential harm.

I think its more likely that prevention has never really been a focus, money and research tends to focus on treatment. But it would be money well spent to head off problems before they develop. Apparently that is in the NHS plan going forward so fingers crossed.

And to the poster who mentioned DBT - I agree, but you know that this developed out of CBT, right?

None of the links you posted mentioned anything at all about psychoeducation classes teaching the basics of thoughts, feelings, physical feelings and behaviours though? This is what the evidence is saying is potentially harmful and was the original comment of yours I replied to.

I’m a huge supporter of MHST. What they do (1-1 therapy, supporting school staff and liaising with external agencies) is great and very, very helpful. What they don’t do is teach kids CBT in a group with no 1-1 support, which evidence suggests is potentially harmful. This is what you originally said would be helpful, and what I originally said has been shown to be potentially harmful. Not the concept of MHSTs themselves.

In my experience of both providing and receiving therapy, I think it would be very upsetting to realise what is going “wrong” (cognitive distortions, avoidance, physical responses like fight and flight etc) but be given no support to address this. Having an awareness of the issue and having the tools to manage it is not the same thing.