Training | 2009.12.04
Jobless to be offered 'talking treatment'
Jobcentres will bypass doctors to refer claimants for cognitive behaviour therapy at up to 300 centres
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 andreferred 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.
For more information, please visit
http://www.guardian.co.uk/society/2009/d[...]erapy-talking-cbt-unemployment
