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Re:Therapy Experience Associated with Negative Changes in Pe... by temp246810 on Tuesday February 21, 2017 @03:55PM (#13699851)
It's a shame that stuff like this makes it to the top of HN.

Not because the content itself is good or bad, but because it is precisely someone struggling with this stuff who has a high likelihood of walking away from the article with the wrong message.

I understand that we're all responsible for our decisions etc., but this is really out of our wheel house and hopefully the people in need of therapy consult with professionals before acting on anything that bubbles up here.

Re:Therapy Experience Associated with Negative Changes in Pe... by civilian on Tuesday February 21, 2017 @06:22PM (#13701185)
rolls eyes people have got to have a little agency, and we can't censor things like this just because we're worried about them taking it the wrong way.

You know what would help get more people who need help into therapy? If therapy clinics allowed you to schedule a first session without having to call them! If you're suffering from anxiety and depression, then the thought of some receptionist asking you why you want to schedule an appointment is pretty terrifying.

Re:Therapy Experience Associated with Negative Changes in Pe... by wpietri on Tuesday February 21, 2017 @09:59PM (#13702607)
People who are in need of help may not have much agency to spare. E.g., The notion of Spoon Theory comes from someone with lupus, but you'll often see people with mental illness discussing it online: https://butyoudontlooksick.com/articles/written-by-christine...

And I think there are things between censorship and featuring anything that sounds sensational. One of the primary criticisms of mainstream science journalism is that it will take one recent study and focus on it excessively, giving readers a false impression. The same concern on Wikipedia is known as "undue weight": https://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_vie...

I don't think HN is above criticism on this.

Re:Therapy Experience Associated with Negative Changes in Pe... by DrScump on Tuesday February 21, 2017 @07:36PM (#13701733)
One doesn't have to go into detail when merely scheduling an appointment with a non-therapist. In fact, that would be the makings of a HIPPA nightmare.
Re:Therapy Experience Associated with Negative Changes in Pe... by benevol on Tuesday February 21, 2017 @04:04PM (#13699953)
> hopefully the people in need of therapy consult with professionals

If your health care system gives you the option, that is.

Re:Therapy Experience Associated with Negative Changes in Pe... by epmaybe on Tuesday February 21, 2017 @05:03PM (#13700478)
What do you mean?
Re:Therapy Experience Associated with Negative Changes in Pe... by _null on Tuesday February 21, 2017 @10:47PM (#13702835)
A lot of people simply don't have access to psychotherapy. Many national healthcare systems and health insurers have very limited provision. Many people in the US are uninsured or have very limited access to insurance-funded psychotherapy, despite the MHPAEA and the ACA.

Here in the UK, someone diagnosed with depression or anxiety by their primary care physician is likely to receive no more than six sessions of CBT, often after a wait of many months. Private psychotherapy costs £60-£100 per session, which is totally unaffordable for many people.

We have a chronic shortage of psychiatric inpatient beds and very poor follow-up care. People who are hospitalised after a suicide attempt are often discharged the same day with little more than a prescription for antidepressants and the promise of a home visit by a community nurse.

Sadly, the UK isn't an outlier.

Re:Therapy Experience Associated with Negative Changes in Pe... by DanBC on Wednesday February 22, 2017 @07:16AM (#13704914)
> We have a chronic shortage of psychiatric inpatient beds and very poor follow-up care

I agree with this bit. Although it's important to recognise that hospitalisation for suicidal thinking or suicide attempts probably isn't helpful, and that people need much better crisis team stuff, and that is being mostly addressed via Crisis Concordat work. (And what people need long term is much better prevention).

> Here in the UK, someone diagnosed with depression or anxiety by their primary care physician is likely to receive no more than six sessions of CBT, often after a wait of many months

IAPT wait times are published. Here are some recent figures: http://content.digital.nhs.uk/searchcatalogue?productid=2447...

> In November 2016 there were:

> 126,126 new referrals

> 87,961 referrals entered treatment

> 49,189 referrals finished a course of treatment, of which:

> 88.8 per cent waited less than 6 weeks and 98.5 per cent waited less than 18 weeks to enter treatment

> 45,607 started treatment at caseness, with 48.9 per cent moving to recovery

Your comment "often after a wait of many months" is inaccurate when 88% start treatment within 6 weeks and nearly everyone else starts in less than 5 months. (That over 6 week time wait is worrying, and I hope people have been rigorously triaged)

The executive summary says that about 64% of people going through IAPT achieve recovery: http://content.digital.nhs.uk/catalogue/PUB23389/IAPT-month-...

The other problems with current IAPT provision include

* lack of one to one provision - it's sometimes provided in groups;

* the lack of face to face provision - it's sometimes provided by computer or telephone

* reduced time per session and reduced number of sessions

Re:Therapy Experience Associated with Negative Changes in Pe... by _null on Wednesday February 22, 2017 @12:09PM (#13707061)
The headline stats are blatantly manipulated. Figure 4 of the IAPT stats summary shows that less than 42% of referred patients finish a course of treatment. 27% of referrals ended without the patient being seen by the service and 25% ended after one session of treatment.

In practice, less than 37% of patients are getting prompt and appropriate treatment. The rest are fobbed off with utterly inappropriate therapy, dissuaded from starting or otherwise nudged off the waiting list.

I've heard countless stories from both professionals and service users about blatant manipulation of the IAPT stats. Stories of referrals being "lost in the system" are commonplace. Many services are providing an initial appointment within the 6 week target, but then placing patients on an internal waiting list for further treatment. Many patients with complex needs are simply dropping out, rather than being progressed through the stepped care model.

All this is against a backdrop of massive cuts to "specialist services", i.e. anything that isn't IAPT. The story I'm consistently hearing from practitioners and patient advocacy groups is that the service is failing the most vulnerable patients with the greatest need. Patients with mild depression and anxiety are getting the low-intensity treatment that they need in a prompt manner, but patients with more complex needs are simply being swept under the carpet.

Re:Therapy Experience Associated with Negative Changes in Pe... by Nomentatus on Tuesday February 21, 2017 @05:05PM (#13700501)
Refusal. I've heard of that happening with the original "Catch-22"!