Generalised anxiety disorder (GAD) is a serious, debilitating condition which affects around 5% of the UK’s population, therefore it is vital that the advice given by health care professionals to help cope with this disorder is accessible to all those who require it. Currently, once an individual is diagnosed with GAD, the main recommended treatment is cognitive behavioural therapy (CBT) to help control their anxiety levels as it is regarded as one of the most effective treatments. However, the lengthy waiting times to access this therapy are extremely concerning and they are having a detrimental effect on patients. Therefore, changes need to be made so that those who need CBT can access it within 28 days of requesting it as this will ensure that individuals are receiving the support that they need to cope with their disorder.
The psychological therapy of CBT is one of the first line of treatments recommended by the NHS (2018) to those diagnosed with GAD. Medication such as the antidepressant SSRIs are also often offered. Generally, CBT is preferred over pharmacological treatments by patients to manage their anxiety, as it is considered one of the most effective treatments by psychologists and does not have distressing side effects like medication. Also, because after completion, patients can still apply the skills learnt to their daily lives which significantly decreases the chance of symptoms returning. Therefore, CBT has longer lasting benefits compared to medication. This personal view article will focus on how even though those with GAD are often advised to go through CBT to help them cope, this treatment is not suitable for everyone and not as accessible as it should be due to long waiting times ,which in my opinion lowers the effectiveness of this advice.
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CBT for individuals with GAD entails around 12 to 15 weekly sessions(NHS, 2018). Therefore, in comparison to medication this is a time-consuming treatment and requires extra work outside of sessions to be effective. I think CBT is then not always the most suitable way to cope with GAD for those with hectic lifestyles. For example, a working parent could be put off by the commitment required as they would struggle to make time for it. Such individuals are likely to opt for SSRIs instead, especially because improvement is often seen quicker and less time and effort is needed.
I first came across the problem of lengthy waiting times when a close friend was diagnosed with GAD. I was shocked and saddened to see her have to wait 8 months until her first CBT session. She believed this was due to being a low priority case and even though I understand that cases should be seen to in order of priority, I believe an 8 month wait is unacceptable. Especially, because this debilitating disorder was affecting so many aspects of her life, there were days where she struggled to leave the house. Whilst waiting, her symptoms became increasingly worse and it was extremely difficult to see her struggle and still not receive the help she needed to cope with her anxiety. When her CBT eventually started, her therapist cancelled on multiple occasions for higher priority cases, sometimes 4 weeks would pass in between sessions which inevitably made progression difficult.
Given my friends experience, I was intrigued to see how common this problem was because if it is a prominent issue it lowers the accessibility of CBT and decreases the effectiveness of this coping method. I found that long waiting times were sadly a common occurrence. One survey showed that 10% of those who required therapies such as CBT had been waiting for more than a year and more than 50% had been waiting for over 3 months (Mind, 2013).The British Medical Association (2018) also reported concerning waiting times: they found that 3,700 individuals waited for over 6 months to receive psychological therapies in 2017. I understand these lengthy waiting times are due to the increasing awareness of mental health leading to more people seeking help, which is undoubtedly a positive thing. However, health care professionals are struggling to cope with this demand due to a lack of funding.
Timely access to CBT for those with GAD is vital to ensure that they can receive the help they require. Lengthy waiting times can cause substantial damage because whilst individuals are waiting their symptoms often intensify and there is the risk of this resulting in a mental health crisis. I witnessed how this affected my friend, it led to her giving up her job as she felt she could no longer cope, this was devastating to see. The long waiting time and multiple cancellations resulted in her switching to private CBT as she felt let down by the service the NHS had provided. This had a significant financial impact on her, but she saw no other option as her condition was deteriorating daily. Private CBT is around £40- £100 per session(NHS, 2019), many individuals are unable to afford this, no matter how desperate they are. Therefore, it is imperative that more is done to improve how accessible CBT is on the NHS, so everyone in society has the same opportunities to access the help they need to cope with their anxiety.
The Health and Social Care Act 2012 states that mental health should be equal to physical health. For this to be achieved it is vital that psychological treatments should be as accessible as physical treatments, especially with regards to waiting times. Therefore, I strongly and passionately believe that the NHS should provide CBT to all those with GAD that require it within 28 days of the initial request, which is equivalent to the standard waiting time for physical health problems. This should be every individuals’ right. Unfortunately, currently this is not the case. I do recognise that waiting times have improved recently, but they are still nowhere near the level they should be and I believe more needs to be done. This is because research shows how even today, despite increased funding, a large proportion of individuals are still waiting far too long to access CBT. This is having a detrimental effect to patients’ quality of life, which is unacceptable.
To conclude, the effectiveness of CBT as a method to help those with GAD cope and the benefits it has over other treatments is undeniable. However, we should not forget that even though CBT is often the recommended first line of treatment, it is not always the most suitable option for everyone due to it being time consuming and requiring the patient to put work in too. Furthermore, those who cannot afford private CBT are currently stuck in long queues whilst their symptoms worsen. Therefore, I believe crucial changes need to be made through reducing waiting times, so this treatment is more accessible to all those who require it. This will ensure that CBT is an effective coping mechanism for anxiety for everyone and not just those who can afford private therapy.
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