Jobless to be offered ‘talking treatment’ to help put Britain back to work

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http://www.guardian.co.uk/society/2009/dec/04/jobless-therapy-talking-cbt-unemployment

 

Guardian  |  Allegra Stratton, Political correspondent  |  04 December 2009

Jobless to be offered ‘talking treatment’ to help put Britain back to work

Jobcentres will bypass doctors to refer claimants for cognitive behaviour therapy at up to 300 centres

The government has announced mental health co-ordinators will be based in Jobcentres.

Jobless Britons are to be offered therapy to help them get back into work, under a “talking treatment” programme to be announced by the government over the next few weeks.

On Monday the Department for Work and Pensions will announce that mental health co-ordinators will be based in Jobcentres. The plans, which will make mental health treatment and particularly cognitive behaviour therapy (CBT) central to the fight to get Britain back to work after the recession, will eventually see centres providing CBT set up around the country.

In the medium term, Jobcentre Plus will be encouraged to send unemployed people for CBT without the need for a doctor’s referral. Within five years the government wants 250-300 therapy centres set up across the UK.

Sessions of CBT – which encourages people to look for potential solutions rather than the causes of difficulties – are today available to patients referred by their doctor, but the government wants to build on 60 pilot schemes to provide therapy centres in most primary care trusts. Successful pilots have shown that a mix of ages and ethnicity is to be encouraged so centres can offer group therapy with a cross-section of people.

The chancellor, Alistair Darling, has signed off the commitment which will cost £550m a year redirected from what the government hopes will be a fall in unemployment. There is no new money involved.

Under the plans, unemployed people would be eligible for eight therapy sessions immediately. Within five years anyone, including people in work, would be allowed to “refer themselves in” for treatment.

One in four people are likely to experience a mental health problem and the effects on the jobs market are acute. Some 6 million adults in the UK have been diagnosed with depression or anxiety, many of whom are on incapacity benefit.

The move follows years of lobbying by Tony Blair’s “happiness tsar”, economist Lord Layard. Provision of cognitive behaviour therapy on the NHS was his earlier triumph but Layard has continued to lobby for it to be central to the jobs strategy.

Layard and others were concerned that people with mild depression attributable to unemployment or working difficulties and referred for CBT by doctors were rarely asked to consider work-related issues. Likewise Jobcentres did not prescribe therapy for those for whom varying degrees of depression were a barrier to work. The former work and pensions secretary, James Purnell, said: “Mild depression doesn’t have to be a barrier to work.”

About 40% of long-term sickness benefit claimants have depression. Work is being done on whether some people should have CBT before they go on to employment support allowance, which an official described as “an eight-week period which prevents people even going into long-term disability”.

The official said: “We want a service where everyone who needs it can get access to basic talking treatments. The pilots are proving so successful that, whilst there are short-term costs, we expect the programme to save money in the long-term by helping people back into work, cutting the benefit bill and lowering costs in the NHS.”

Ministers are worried that past recessions have led to huge rises in the numbers of long-term unemployed.

What is CBT?

Cognitive behaviour therapy doesn’t attempt deep psychoanalysis but instead works to recommend to a patient practical steps to overcome the depression that has proved debilitating for them.

Created in the 1960s by the American psychiatrist Aaron Beck, it operates on the assumption that since emotions are based on patterns of thinking, if the patterns of thinking can be changed so too can the emotions. To the end of changing those patterns, patients are given targets and homework to isolate what makes them blue, and then they can set about managing that trigger.

The government’s adviser on these issues, Lord Layard, believes that a short course of CBT delivered by a therapist with only basic training is all that is required to cure a substantial proportion of those out of work because of depression or mental health problems.

He recommends double the figure the government is suggesting – 16 course sessions – which he costed at £750 a head, something he pointed out was about the cost to the state of someone remaining on incapacity benefit.

Critics accuse CBT of being the ultimate quick-fix solution for a quick-fix age, driving real problems that had possibly surfaced for a reason, deeper into someone’s psyche with unknown later effects.

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See also:

BBC News  |  07 December 2009

Depression targeted in government policy shift

http://news.bbc.co.uk/1/hi/health/8396147.stm

“10-year strategy expected to call for better identification of those most at risk and wider access to psychological therapies for patients.”

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New Statesman

http://www.newstatesman.com/ideas/2009/11/cbt-treatment-health-face

Textual health  | Alyssa McDonald | 26 November 2009

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From October 09

On Sunday, the Observer reported on cutbacks faced by Improving Access to Psychological Therapies (Iapt) programme which is failing to meet government tarkets:

The Observer | 4 October 2009

http://www.guardian.co.uk/society/2009/oct/04/mental-health-therapy-cbt-psychiatry

Flagship mental health scheme faces cutbacks

Only 400 therapists have been trained out of the 3,600 needed for the scheme

by Jamie Doward

“A flagship government strategy to train an army of therapists to get the nation off antidepressants and into work could be dramatically scaled back amid claims it is experiencing problems.”

The government claims the Improving Access to Psychological Therapies (Iapt) programme will treat 900,000 people and help about half of them to make a full recovery. It also aims to get 25,000 people suffering from anxiety and depression off sick pay and benefits by 2010/11.

But the Observer understands there are now concerns about whether these targets can be met.”

Read full article here

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Related material

Tories would force jobless to work  |  Sunday Times  |  4 October 2009
http://www.timesonline.co.uk/tol/news/politics/article6860233.ece

Cameron to slash benefit payouts to 500,000 now deemed ‘unfit to work’  |  Times |  5 October 2009 http://www.timesonline.co.uk/tol/news/politics/article6861137.ece 

Iapt documents: http://www.iapt.nhs.uk/publications/

See also: The Elephant in the Room Series Two: More on MUPS

See also: Lords Debate on CBT

Image and video hosting by TinyPic“They run your life, so you don’t have to” courtesy Gordon’s Good Idea

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