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The NHS’s CBT mailshot is a scandal

It’s costing us a fortune and we don’t even get to see a therapist face to face

4 May 2019

9:00 AM

4 May 2019

9:00 AM

A leaflet came through my door from the NHS inviting me to take part (if that is the right term) in Cognitive Behavioural Therapy.

What a kind offer, I thought. They must know I’m stressed. Fine, so I didn’t think that. I thought: what a blasted cheek!

This leaflet is a mailshot, clearly, and has been distributed to every home in my area at a cost of goodness knows how much. I looked at the glossy thing in all its impudence and presumption and decided to chase after the postman.

He was three doors down when I caught up with him and he wore a cheery smile as usual. ‘Can I ask you something?’ I called and as I approached him he could see I was waving the leaflet.

He grimaced. ‘I know,’ he said, ‘it’s a cheek, isn’t it?’

‘Well, I’m glad you say that because that’s exactly what I was thinking. Please tell me everyone has got one of these? Because if not, the state is even more overbearing than I thought. I’m worried the thought police have been reading my columns and have decided I must be sent for re-education or some form of mind control.’

He shook his head. ‘No, everyone’s getting one, don’t worry. It’s not just you. And the worst of it is, they post them all first class recorded. So we have to tick off on a list when each one is put through each door. It takes us ages. It’s costing them so much money you would not believe.’


‘It’s costing us so much money,’ I corrected him. He laughed: ‘You got that right!’

I read and reread the leaflet and it directed me to a website, whereupon the biggest cheek of it all was revealed: they weren’t offering me free CBT at a local NHS hospital or GP surgery, which in spite of everything I would have had a bit of, just to get my money’s worth and make a nuisance of myself.

No. They were directing us to a website where, get this, we could have an online consultation. What an absolute dead loss. I know nothing much about CBT other than it is not to be confused with CGT, which I keep typing by mistake and which is, of course, capital gains tax. But I know you ought to sit in a room with the therapist.

I also know that Cognitive Behavioural Tax, sorry Therapy, is the big, new cure-all that everyone is blathering on about.

Every friend who has had a go at it has told me how wonderful it is. ‘Oh, it’s marvellous,’ said a horsey mate. ‘It really sorts out your crowded head.’

I like my crowded head. It’s one of the few things I do admire about myself. My ability to cram anxiety upon anxiety into my cranial space is a source of great pride to me.

However, every now and then it does all get a bit much. And then there is this business of how I’ve apparently now paid, with my tax, for this leaflet to be delivered to me and for the online CBT counsellors who are waiting for me to log on and have my head uncrowded, or whatever it is they are going to do.

So I went on to the web page and read about how it is done:

‘The therapist and client work together to understand problems in terms of the way people think, feel and behave. For example, David received a letter asking him to meet with his boss. He immediately thought “They reckon I’m rubbish and are going to sack me.” This led him to feel really anxious, his heart started to beat faster and he felt dizzy. He thought he would faint if it got any worse and would humiliate himself. He felt unable to go into work and avoided contact with colleagues. Now, it could be that David is actually going to get the sack, faint and humiliate himself. However, it might also be true that this reflects a tendency to expect the worst and to be critical of himself. Often we think, feel and behave in a particular way for a reason. This can be related to our childhood, life experiences and the circumstances we live in (life events, families, housing, society, etc.)’

Yeah, I’d go with the first option. I’d say David is basically going to get the sack, faint and humiliate himself because that is what life does to you. I wouldn’t go into work if I were David. I’d pull that duvet over my head quite tightly and not come out for days.

After which, you know, I’d tell myself to get over it. These thing happen. What doesn’t kill you makes you stronger.

I don’t think I’m a good subject for CBT.


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