Cbt and Diversity
Cognitive Behavioural Therapy (CBT) is recommended by the NICE guidelines as an effective treatment for many mental health problems, specifically depression and all of the anxiety disorders.
But is it a therapy open to all?
When Professor Lord Layard wrote his paper: “Mental Health: Britain’s Biggest Social Problem?” in 2005, he noted that:
“16% of adults of working age have a mental illness” Of these 16%, he stated that, only a quarter were utilising any type of treatment. It was this sort of finding that lead to his recommendation to increase accessibility to proven therapies such as CBT. This was achieved with the roll out of the Improved Access to Psychological Therapy (IAPT) programme. The diagram below shows how the IAPT programme has been divided up into 3 steps:
It is this stepped approach that will contribute to overcoming some of the barriers that societies diversity may have with accessing CBT.
What might these barriers be?
One of the first barriers an individual faces may be around the concern of being stigmatised. It may be too hard for them to think about accessing CBT therapy for fear of what others may think. They may not want to take time off work to attend sessions for fear of it impacting negatively on their career prospects. The stepped care model means they are able to receive the lowest appropriate service tier support. This may mean that an individual is able to access therapy using guided self-help, allowing them to work through the programme in their own time and at their own pace.
Online programmes such as “Fearfighter” and “Beating the Blues” allow the individual to access therapy where and when they like. Not only do these sort of programmes overcome the fear of stigma but they also overcome the issue of long waiting lists meaning that the individual can access treatment on their terms almost instantaneously.
Only if this level of support proves unsuccessful will the individual then be “stepped up” to the
But is it a therapy open to all?
When Professor Lord Layard wrote his paper: “Mental Health: Britain’s Biggest Social Problem?” in 2005, he noted that:
“16% of adults of working age have a mental illness” Of these 16%, he stated that, only a quarter were utilising any type of treatment. It was this sort of finding that lead to his recommendation to increase accessibility to proven therapies such as CBT. This was achieved with the roll out of the Improved Access to Psychological Therapy (IAPT) programme. The diagram below shows how the IAPT programme has been divided up into 3 steps:
It is this stepped approach that will contribute to overcoming some of the barriers that societies diversity may have with accessing CBT.
What might these barriers be?
One of the first barriers an individual faces may be around the concern of being stigmatised. It may be too hard for them to think about accessing CBT therapy for fear of what others may think. They may not want to take time off work to attend sessions for fear of it impacting negatively on their career prospects. The stepped care model means they are able to receive the lowest appropriate service tier support. This may mean that an individual is able to access therapy using guided self-help, allowing them to work through the programme in their own time and at their own pace.
Online programmes such as “Fearfighter” and “Beating the Blues” allow the individual to access therapy where and when they like. Not only do these sort of programmes overcome the fear of stigma but they also overcome the issue of long waiting lists meaning that the individual can access treatment on their terms almost instantaneously.
Only if this level of support proves unsuccessful will the individual then be “stepped up” to the
References: • Ceranoglu, T.A. (2010) Video games in Psychotherapy. Review of General Psychology, 14, 141 – 146 • Gaynor S.T. et al (2006) Measuring Homework Compliance in Cognitive-Behavioral Therapy for Adolescent Depression. Behav Modif , September 2006 vol. 30 no. 5 647-672 • Hudson, J.L. (2005) Efficacy of Cognitive-Behavioural Therapy for Children and Adolescents with Anxiety Disorder. Behaviour Change, 22, 55-70 • Layard R. “Mental Health: Britain’s Biggest Social Problem?” 24th January 2005. PDF file • Morland, L.A., Greene, C.J., Grubbs, K., Kloezeman, K., Mackintosh, M., Rosen, C., et al. (2011). Therapist Adherence to Manualized Cognitive-Behavioral Therapy for Anger Management Delivered to Veterans with PTSD via Videoconferencing. Journal of Clinical Psychology, 67, 629-638. • Stallard P. ( 2002) Think Good - Feel Good: A Cognitive Behaviour Therapy Workbook for Children and Young People. Chichester: Wiley and Sons.