Tag: CBT

Poor working and social conditions are being propped up by the mass provision of CBT

freedom

According to the Counsellor’s Guide to Working with EAP, by 2013, almost 50% of the UK workforce was supported by an Employee Assistance Programme (EAP), representing 13.79 million people. The EAP industry began in the UK during the mid-1980s and has since become firmly established, with a rapid expansion in schemes following the recommendations made by Carol Black and David Frost in their report on sickness absence (Black & Frost, 2011). A high percentage of the larger public and private sector organisations and an increasing number of small to medium sized enterprises provide their employees with access to some form of short-term EAP service.  

The EAP association say, in their 2013 Market Watch report: “The difficult economic climate of the past five years may also be a driver, as employers look to support staff with non-work related issues to prevent these from intruding on the workplace.”

The Conservative’s austerity programme in the UK has presented the wellbeing industry with many lucrative business opportunities, and there are many profits being made on the growing poverty, inequality, social injustices and inevitable subsequent psychological distress of the population.

The relentless political drive towards the privatisation of government functions has turned traditional public services, social security and other safety net provision into profit-making enterprises as well. 

A major cause of economic inequality within market economies such as the UK is the determination of wages by the market. The systematic (and partisan) undermining of trade unions over recent years via Conservative legislation has seen the collapse of collectivism as the main way of regulating employment, and a substantial loss of space for bargaining for working rights, conditions and pay. The substantial cuts to social security support over the past few years have also served to drive wages down further

Neoliberalism, which was adopted as an overarching socioeconomic policy during the Thatcher and Reagan era onward, is premised on an idea that tight monetary control will contain inflation, and that labour market deregulation combined with regressive tax and benefit reform will somehow secure full employment. The expectation is that the more unequal redistribution of income and the freeing up of markets will dramatically improve competitive economic performance, and that the benefits of this higher rate of growth will trickle down the income distribution, benefiting everyone. Of course, that hasn’t happened.

The CBT technocratic sticking plaster

EAPs commonly use Cognitive Behavioural Therapy – usually in digital form – online or by phone – and it’s a “workplace-focused programme” to assist in the identifying and resolving of employee concerns, which affect, or may affect, performance. Such employee concerns typically include, but are not limited to:

Personal matters – health, relationship, family, financial, emotional, legal, anxiety, alcohol, drugs and other related issues.

Work matters – work demands, fairness at work, working relationships, harassment and bullying, personal and interpersonal skills and work/life balance.

According to NHS Choices, Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.

CBT is a talking therapy that can help you manage YOUR problems by changing the way YOU think and behave. It doesn’t address your circumstances as such, nor does it address the socioeconomic and political context that imposes constraints and increasingly untenable living conditions on people.

In fact, the briefing document for counsellors working with EAP says:

“When working with an EAP referral it is important to remember that the organisation is your client as well as the individual concerned, therefore there will be two people who will be ‘in the room’ with you. It is, after all, the employer that is indirectly funding the sessions. Developing your understanding of the organisation will help you work with both ‘clients’ since an insight into the type of business and the pressures of this work can help you build up a rapport with the client.

[…] The employer is often keen to know whether the support offered by the EAP is having a business benefit. This will be part of the implicit or explicit requirements of the employer and they may need to have evidence of any return on investment. For instance, is there evidence that the employee/client has returned to work more quickly as a result of the counselling? Has the counselling prevented the client from taking time off work for sickness?”

This presents a constraining framework of conflicted interests for counsellors with favourable “outcomes” invariably weighted towards employers and not employees. How, for example, does a counsellor support someone in a decision to leave their job and find another with better conditions, more security and pay? In this context, the mass provision of CBT may be regarded as a technocratic “fix” for poor employment and social conditions, and is rather more about policing critical thinking and dissenting behaviours in the workplace than providing support for employees. Treating each individual as if the problems lie “within” their thoughts and behaviours also serves to discourage collective bargaining to improve workplace (and social) conditions.  

Although the briefing paper doesn’t tell us if 50% of the UK workforce have actually accessed the EAP services, the perceived need for this service provision and the growth of the industry tells us a lot about employment and social conditions in the UK.

And what does the mass provision of CBT tell us about how this is being addressed?

CBT has become a means of re-socialising those who have become casualities of neoliberalism to accept and internalise the normative “logic” of neoliberalism. It’s a repressive state “therapy” for micromanaging dissent and critical thinking. It inhibits progressive social change, by locating all of our socioeconomic and political problems within the thoughts and behaviours of individuals.

Meanwhile private providers are making lots of profit on something that can never work in the long term. By coercing individuals to accept the terrible burdens and ravages of neoliberalism, the state and co-opted agencies are propping up a socioeconomic system that is collapsing, and in the process, it is profoundly harming people.

 
 

My work is unfunded and I don’t make any money from it. But you can support Politics and Insights by making a donation which will help me continue to research and write informative, insightful and independent articles, and to continue to provide support to others.

DonatenowButton

Psychologists Against Austerity: mental health experts issue a rallying call against coalition policies.

PAA-550x369

I wrote an article in March about the government plans to make the receipt of social security benefits for those with mental illnesses conditional on undergoing “state therapy.” I raised concern about ethical issues – such as consent, the inappropriateness of using behaviour modification as a form of “therapy,” and I criticised the proposed Cognitive Behaviour Therapy (CBT) programme on methodological and theoretical grounds, as well as considering wider social implications.

The 2015 budget included plans to provide online CBT to 40,000 claimants and people on the Fit for Work programme, as well as putting therapists in more than 350 job centres.

Since I wrote, over 400 psychotherapists, counsellors and mental health practitioners have written an open letter, published by the Guardian, about the broader, profoundly disturbing psychological and quality-of-life implications of the coalition government’s austerity cuts and policies. However, the letter was particularly critical of the government’s benefits sanctions scheme, which has been condemned by many of us – human rights advocates across the state – as brutal, unjust, ill-conceived, ineffective and inhumane.

In particular, the letter stated that the government’s proposed policy of linking social security benefits to the receipt of “state therapy” is utterly unacceptable. The measure, casually coined “get to work therapy,” was discussed by Chancellor for the Exchequer George Osborne during his last budget.

The letter’s supporters included psychotherapist and writer Susie Orbach. She called the Conservative proposals “beyond shocking.” Echoing the concerns I raised earlier this year, she said:

“It undermines the fundamental principles of one’s right to physical and mental care – that you have to be able to consent and that the people you go to have to be highly trained and have your best interests and aren’t meeting targets.”

The letter’s signatories, all of whom are experts in the field of mental health, have said such a measure is counter-productive, “anti-therapeutic,” damaging and professionally unethical. The “intimidatory disciplinary regime” facing benefits claimants would be made even worse by further unacceptable proposals outlined in the budget.

Among the groups represented by the signatories were Psychologists Against Austerity, Britain’s Alliance for Counselling and Psychotherapy, Psychotherapists and Counsellors for Social Responsibility, the Journal of Public Mental Health, and a range of academic institutions including Goldsmiths, Birkbeck, the University of London, the University of Amsterdam, Manchester Metropolitan University, the University of Brighton, Disabled People Against the Cuts and others.

More generally, the wider reality of a society thrown completely off-balance by the emotional toxicity of social conservatism combined with economic neoliberalism (which I have argued is manifestly authoritarian) is affecting Britain in profound and complex ways, the distressing effects of which are often most visible in therapist’s consulting rooms.

This letter sounds the starting-bell for a broadly based campaign of organisations and professionals against the damage that neoliberalism is doing to the nation’s mental health.

The letter said that for now, we call on all the parties in this election to make it clear that they will urgently review such regressive, anti-therapeutic practices, and appropriately refashion their commitment to mental health if and when they enter government.

Andrew Samuels, an Essex University professor, and immediate past chair of the UK Council for Psychotherapy, said he believed there was “a bit of a public school ethos” behind the work-capability regime introduced under the conservative-liberal democrat coalition and new conservative plans.

Characterising the government attitude as “Pull yourself together man, for heaven’s sake,” Samuels added: “It is wholly inappropriate. It symbolises a society that has lost all moral compass.”

Absolutely. Public schools are notorious for a culture of bullying. However, it’s one thing to be treated as a privileged and insulated public school boy by a peer from an elite background to “character building” rhetoric, but quite another to adopt that same bullying approach towards the ill and most vulnerable citizens. All to justify an ideological drive to “shrink the state” and remove support from the poorest.

All of this said, public schools are regarded by many as institutions that inflict a particularly British form of child abuse and social control. I also think it has to be said that soul trauma and pain don’t respect social status.

Samuels insisted the open letter was not “pro-Labour” but was aimed at getting a review of measures taken and proposed over the past five years.

He said: “If Labour decides afterwards all this is in order, it will go on. But I don’t think it will.”

The Labour Party does value professional opinion and rational discourse. The Conservatives, on the other hand, are not widely recognised as a party that welcomes democratic, open debate, transparency and accountability. The Tories simply exclude critical professionals and representative organisations that may challenge and disagree from the discourse.

A spokesperson for Labour said mental health “is the biggest unaddressed health challenge of our age.”

“It’s essential that we give mental health the priority it deserves if we are to thrive as a nation and ensure the NHS remains sustainable for the future,” he said.

The Labour Party have pressured the government to “write parity of esteem between physical and mental health into law,” and in the response, Labour have stated that the party is committed to implementing this policy if elected in May.

The spokesman pledged the Labour will bring an end to the “scandal of the neglect of child mental health,” indicating a welcomed return to a comprehensive preventative approach. He said: “It is simply not right that when three-quarters of adult mental illnesses begin in childhood, children’s mental health services get just six per cent of the mental health budget.”

Richard House of the Alliance for Counselling and Psychotherapy, the letter’s main organiser, said there had been a mounting groundswell of concern: “When one hears story after story of dramatic negative health impacts, psychological and physical, after people are subjected to these back-to-work practices, the time has surely come for an ‘emotional audit’ of the impact of what, to many, appear to be heartless, un-thought-through policies that are merely penalising and punishing the already disadvantaged still further.”

Yes, the time has come for a change of government. On May 7, we must ensure that the regressive, oppressive regime of the past five years is replaced by a progressive, inclusive and democratic alternative.

Related

The power of positive thinking is really political gaslighting

The just world fallacy

Cameron’s Nudge that knocked democracy down – a summary of the implications of Nudge theory

Rising ESA sanctions: punishing the vulnerable for being vulnerable

Suicides reach a ten year high and are linked with welfare “reforms”

Mental Health Services in crisis because of Coalition cuts to funding

The Psychology of Austerity

A group of mental health professionals have come together under the banner of Psychologists Against Austerity (PAA) to highlight the psychological impact of austerity.

Now, with only a few weeks to go before the general election, PAA have started a campaign calling for a Parliamentary Inquiry into the psychological damage austerity has wreaked across the UK.

You can read more and sign our petition here: 38degrees/psychological costs of austerity inquiry.


 

I don’t make any money from my work. But you can support Politics and Insights and contribute by making a donation which will help me continue to research and write informative, insightful and independent articles, and to provide support to others. The smallest amount is much appreciated, and helps to keep my articles free and accessible to all – thank you. 

DonatenowButton