"Well, there is only one piece of advice I can give you," said the wisest of wise men. "The secret of happiness is to see all the marvels of the world and never to forget the drops of oil on the spoon."

('The Alchemist' Paulo Coelho)

Wednesday, February 27, 2008


There is an interesting post on Ellee Seymour's blog which I read this morning and replied to. Coming on top of a comment by a GP on Radio 4 earlier that he had lots of patients with mild depression whom he would like to refer for counselling but knows there is an eight or nine month waiting time 'for CBT counselling', I decided to add my own penn'orth to the debate.
I have had many clients suffering from mild to moderate depression who have been considerably helped by counselling. My counselling approach is integrative humanistic and I use Person Centred and Gestalt as appropriate to the individual client. The humanistic bit means that it is important to build up a good working relationship with the client and it annoys me that the NHS generally focuses only on CBT, in which the client/counsellor relationship is not seen as a priority as other counselling approaches can be equally and often more helpful.
CBT works well short-term as it gives the client a range of strategies to help them in specific areas of their life but does not usually address underlying issues. This means that, in the short term, the client is indeed helped but this does not necessarily last. However, the client finishes the allotted six sessions of therapy and is counted as a success - a tick in the box for the NHS and when the client comes back 18 months later, needing help again, he/she is counted as a new patient.
Humanistic counselling relies on a positive therapeutic relationship with the client, in which client and counsellor work together to help the client regain control of his life, which tends to have a long-term effect.
Although I don't know what the situation is nationwide, another cause for concern in my area is that GPs are now referring clients for counselling at Mind rather than providing a counselling service at their surgeries, which seems to me very much like counselling on the cheap. Strangely, it then no longer seems important that most of the counselling there is non-CBT, but of course, the GP is saving money.


Ellee Seymour said...

Thanks for the link Jenny. It is a very complicated area, I don't know the answers, but I think we all need good friends and someone to talk to.

Jennyta said...

Very true, Ellee and what suits one person will not necessarily be helpful to another.

Iatros said...

Would I be wrong in saying that there is more evidence for CBT working than for the other therapies? (I speak from a position of general ignorance, but was given to understand that this might be the case??)

Yorkshire Pudding said...

You seem to know what you are talking about Jennyta but I don't. My solution to depression is a vigorous walk in the countryside followed by four pints of Tetleys at the local boozer - a doner kebab on the way home and any sense of depression dissolves like magic. Give this advice to your clients and they'll love you for it.

Rosie said...

A few years ago I was going through a personal crisis and depressed. I received the obligatory 6 weeks counselling and because i wasn't suicidal was told that was it. Yes I felt a little better but 12 months later I was back and having more. I didn't complete the 6 weeks this time. It was a diffferent counsellor who I felt didn't care about me. Luckily I was able to sort myself out with the help of friends and family but not everyone is that lucky.

Jennyta said...

You've hit the nail on the head, Rosie. CBT does not regard the client/counsellor therapeutic alliance as particularly important, whereas in humanistic counselling, it is central.
YP, if it works for you, keep on doing it.
Iatros, there is more evidence for CBT working because it is used by the NHS and when someone finishes their 6 sessions and goes off apparently cured, that counts as a success, but when they come back again, like Rosie, a year or so later, they are considered to be a new patient and the process is repeated.


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