Friday 25 January 2013

In Partnership

A GP (not my usual GP, because getting appointments with him is next to impossible) recommended I see a local service provider called Positive Step when I tald them about anxiety. Positive Step deal in Cognitive Behaviour Therapy, that's their stock in trade. I have actually seen them before and frankly didn't really find it particularly helpful. I'm not knocking it, but CBT seemed to require a particular level of awareness that isn't commensurate with stress. In fact developing that clarity of thinking is half the problem, so it didn't work for me. The service is delivered in a specific way with no real on going support: I used their online provision. The alternative is a classroom environment that was not practical because of location (nothing local). 

I decided to go with the GP's recommendation more to avoid being seen as refusing help, but I don't mind trying it again maybe it will be a bit different. When an appointment will become available is another matter entirely. In the meantime I'm looking at their website and dicsover they are in partnership with, amongst others, ATOS! 

I'm not sure what this means. What does in partnership mean? I'd mentioned that dealing with the DWP and the incoming WCA I will have to attend is a major part of the cause of my anxiety (as anyone that's dealt with ATOS knows). Positive Step told me they can't get involved with this and that they can't help; all they do is deliver a programme of CBT. So what's the involvement with ATOS and can their partnership help people like me who have been successfully assessed by Positive Step as having problems (problems enough to green light access to their service - no doubt that's how they get funded) deal with the WCA? ATOS of course will say that it isn't down to them as regards the final decision, but everything that can be provided to help make a case surely has to be considered. I'm not sure how to pursue this.

6 comments:

  1. A few years ago I was referred by the GP to Positive Step. On the leaflet it stated, in a small font that "Positive Step is an ATOS company" I took it to mean that it was owned by ATOS. It's quite likely that PS have no operational connection to the arm of ATOS that carries out the WCA.

    I have met some people who have been through the PS group CBT sessions and found them less than useless, often for the reasons you have mentioned. Some people with complex problems have said they've found them harmful.

    I'm still relieved that CBT was found (on assessment) not to be suitable for me.

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    1. I don't know about people harmed byt CBT! That's pretty serious! I'm willing to give it a go and see if it works better when not done via their online programme. But that it revolved around being able to constantly step outside your negative thinking caused me problems because that seemed to be the problem itself!
      I don't know what the connection between ATOS and PS really is. It's probably fair to say that the staff on the ground, the advisers on the ground that I'd speak to, probably are nothing to do with such a connection and aren't priovvy to it. But my point is to speculate on whether PS, with it's connection whatever it may be, can help with my WCA.

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  2. The only help it will be as far as WCA or Work Focussed Interviews or getting effective support from any work programme provider goes is to show that you are taking steps to manage your condition.

    CBT, because it can be delivered cheaply and in a generic form is the go to referral for pretty much every mental health problem these days. This is idealogically driven by a previous government. I have known of people with mild depression (for which it can been very helpful) through to people with schizoaffective disorder referred for group CBT.

    Although CBT is recommended by NICE for PTSD it is not recommended for survivors of complex trauma, yet I have spoken with people who have CPTSD who were convinced to take part in group CBT with PS and found the approach very harmful, because telling someone who has a history of abuse and trauma that they must just ignore their past, that the present is all that matters and past experience has little relevance to their life today can cause terrible problems for an individual. The trouble with complex trauma (especially early life abuse of all types) is that it disables natural development of certain aspects of the self in a healthy and enduring way.

    For someone who has a notion of self that has developed in reponse to surviving trauma, to be told that their past experience is not valid in the present, this is where the harm is caused. It can be very reductive.

    I'm sure you can see there is never one tool that will do all jobs. Although it was good that the last government agreed to fund "talking" therapies, it is a shame that they only fund one type - the cheapest.

    Good luck with PS.

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    1. I've just got off the phone with them. They can't offer 1 to 1 sessions unless you go through their group stuff first, which I can't afford to do. The adviser tells me that everything is self help anyway (oddly) and they can send me some materials to work on and then speak to me in a fortnight. Unfortunately where I live there is, as ever, no support at all. This never chagnes. Quite honestly, I'm willing to consider anything, who isn't, but this just seems a waste of time really. The root of the problem is the complete lack of support for mental issues and that isn't going to change anytime soon.

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  3. What you write doesn't surprise me. There's even a huge waiting list for direct 1:1 for people in severe crisis. Even after sectioning, people just get bounced back into primary care and there are a raft of people who go into PS and just get sent back with the legend "sorry your problems are beyond our scope" This is what happens when a gov't just funds one type of therapy and bars access to all others (blame Simon Wessely)

    The groups run for a bout six sessions and are fairly innocuous and to my mind, box ticking. Often the people running the groups are recently out of a few weeks training themselves, work to a script and there's no room for individual help. It's mass processing. For some it helps, for many it does little.

    Dealing with mental health conditions is arduous for the person who has them, trying to get appropriate and effective help is a dreadful and unnecessary trial. Being palmed off with the "think happy and you will be cured" self help mantra is just offensive.

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    1. The adviser I dealt with was certainly inexperienced. I assumed it was someone (and it might well still be) fresh out of med school or something. Fair enough, everyone in these professions has to start somewhere. But if I'm brutally honest, I don't think she really is going to be able to do much except follow a script which is really all this process involves.
      I don't know what the group sessions are like as I haven't attended, but from what I gather it's just a few techniques to help deal with stuff: so I imagine it will be the usual deep breathing, take your mind off it, approach to anxiety. Nothing per se therapeutic. Again if that's what helps others, good luck to them.

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