Psychotherapy including CBT and other counselling - benefits and harms

Is the ban really going ahead in the UK, or has it been stalled? Also note that the planned ban on conversion therapy does not include all sexual minorites, for example asexual people.

Forum thread here: https://www.s4me.info/threads/plans-to-ban-gay-conversion-therapy-uk.4857/

 

Yes but how do you know they’re any good and can we know? Do the regulatory bodies require therapies to be tested in trials which provide interpretable data? Or would they consider data from unblinded trials which rely on subjective outcome measure to be acceptable?

My friend Pete (not his real name) isn’t a therapist and doesn’t give me therapy. He’s just a friend but he comes to see me regularly, listens to my problems if I need to talk about them, and sometimes gives me advice. If he was a stranger, set himself up as a therapist and I paid to speak to him professionally I’d probably say he was pretty good as we see things in a similar way, he understands my illness and he tends to make sensible suggestions which I find helpful. I wouldn’t be opposed to someone like Pete, or anyone else, setting himself up as a professional unqualified person to speak to about problems. I’m just not convinced that someone who is qualified as a psychotherapist would necessarily be any better by virtue of being qualified. And they could be a lot worse because of their qualifications – ie if they had been trained in false theories like the BPS model of ME/CFS, and goodness knows what other nonsense is taught.

 

Absolutely. I think that official registration as a psychotherapist should be an immediate debarment from clinical practice.

 

Further to my post above, I was referred for an emergency psychiatric assessment more than 20 years ago. 2 community psychiatric nurses came to see me in my bedroom on my 30th birthday. I had been in a lot of uncontrolled pain for a long time and my GP was being obstructive. The community nurse suggested the referral to me and I was happy to accept because I was desperate for any help I could get.

I was exceedingly lucky. The community nurse was wonderful and so were the psychiatric nurses who assessed me. One of them came back to see me every week for several weeks and then every month until she had to retire due to an aggressive cancer.

On the first day she came to see me on her own she told me that she was going to have to hide my notes from the psychiatrists because she knew that the psychiatrists (who never saw me) would not approve of what she thought I needed. Instead of following the “evidenced-based” protocols for ME/CFS she treated me as someone with a physiological illness who was struggling with chronic pain and a lack of medical support. She was kind and supportive and helped me with some relaxation techniques. My ME/CFS didn’t get any better – that wasn’t why I was referred – but she may have saved my life by using her experience and intuition and ignoring what she had been taught about people with my diagnosis. I’m sure that the some of the skills she was taught or acquired as a psychiatric nurse helped but possibly not as much as her common sense and compassion, and the fact that we got on.

[Edit: when the psychiatric nurse retired the centre where she was based contacted me to see if I needed a replacement. I decided that lighting was unlikely to strike twice and declined.]

 

I know she’s very good because I’m still alive. She doesn’t deal with anything much ME/CFS related, although it imposes limits and causes frustrations so it’s part of the discussions.

 

That may well be true but don’t forget that Miranda Hart says she thinks Alex Howard is good because she’s a lot better. And we thought we knew Esther Ranzen’s daughter thought Phil Parker was good because she’d been told to tell people she was better (even though she wasn’t).

 

The difference is I’m not recommending her to others, and she treated me when I was suicidal and due to other trauma, not ME/CFS.

 

Private psychotherapists in US charge like $250 or more an hour now. (And an hour is really a 45-minute hour, or 50-minutes.)

 

Mine is £40-50 for 50 mins which isn’t uncommon as a price point.

 

I understand that but the point I’m making is that we can’t judge the efficacy of any therapy on the basis of anecdotal accounts. It’s the same with my experience with the psychiatric nurse. I believe that she helped me but it’s possible that I’m wrong and that a different approach would have been better. That’s why we need properly designed trials.

As far as I understand the standards in trials of therapist delivered interventions are insufficient in most cases to determine the efficacy of the therapy being tested. (Paradoxically, PACE was an exception because it actually provided us with good evidence that the interventions don’t work!) I don’t even know if regulatory authorities require different types of psychotherapy to be tested at all.

 

There are benefits to it being regulated, beyond protecting people with ME. Personally I’ve had more harm done by Psychiatrists, employed in the NHS. But at least I wasn’t paying them.
Any psychologist registered with BACP or the UKAP and offering therapy to cure ME should be reported.

 

On one of the popular counsellor-finding websites there is a category for MECFS and a lot of counsellors tick it, I will find it.

 

I don't think there is any harm entailed in counsellors supporting people with ME/CFS.
To my mind what should be banned is theory driven psychotherapy of any sort in any context, since there are no validated theories and a lot of them do harm.

 

Indeed the wording is in fact “what I can help with” and not “what I treat”.