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Despondent after online therapy...


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I am just coming to the end of my online CBT sessions and feel really despondent as I am not the changed woman I hoped I would be! Although I feel I have made great progress in regards to my unwanted/intrusive thoughts, sadly my contamination OCD and emetophobia are still very much present. I had honestly hoped that when I had finished my online sessions I would feel confident and ready to start living my life, but unfortunately I don't see much change in myself. 

I actually feel very let down by the sessions I have been receiving and wonder if doing it online via typing (not video) is not a successful way to make progress. There is no personal connection between you and the therapist and however much I open up and speak about difficult times, I never feel I get much back from them. Sometimes I feel I am writing it out as plain as day that I really need help and all I get back is "I understand". Where is the sympathy and compassion, where is the help I am desperately asking for?! My sessions have nearly come to an end and they are happy to just get rid of me knowing I am still struggling and have not offered me any further guidance where I can receive some more help. They just keep telling me "you are doing great" which I think is what they just tell everyone, even though you know you're not. I have had 20 sessions but the process is incredibly slow and I feel like I have had half that time. There isn't really much structure or continuity and before making progress with one thing they are moving you onto the next. It hasn't helped that I've had 3 separate issues to work with but to be honest I haven't received much help at all to do with my emetophobia, even though on many occasions I have asked for it. 

I honestly don't know if it is just me (maybe there is no hope for some) or the type of therapy that I have received, but I want to get better than this, I want to be making more progress!! I just don't know where to go from here....... 

 

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9 minutes ago, Lorna02 said:

They just keep telling me "you are doing great" which I think is what they just tell everyone,

I think you're possibly not far off the mark, it is very much a typical therapy response :rolleyes:

I personally do think face to face therapy is the best, for many of the reasons you cite.  Video link a better 2nd option.  It also depends on the type of therapust you've been engaged with.  The range of therapists and experience is vast and whilst many will say they treat OCD, their speciali st knowledge is minimal.  How did you source this therapy?

17 minutes ago, Lorna02 said:

I honestly don't know if it is just me (maybe there is no hope for some) or the type of therapy that I have received

Almost certainly the type of therapy you've received, most of which you could have achieved working on a good OCD self-help book and help from a forum like this one.

The Emetophobia  may be very distressing but it isn't much different in it's cause or treatment than other anxiety/obsessions.  Don't be too dismayed, you can get better from this.  I haven't checked any of your other posts, and you nay have already done this......but it might be helpful to start a thread about the particular problems you're having and see what help others can offer :)

 

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1 hour ago, Lorna02 said:

I actually feel very let down by the sessions I have been receiving and wonder if doing it online via typing (not video) is not a successful way to make progress. There is no personal connection between you and the therapist and however much I open up and speak about difficult times, I never feel I get much back from them.

I get frustrated typing in a chat box for 10 minutes trying to sort stuff at the bank. I can only begin to imagine how difficult it must be to have therapy this way. :eek:

I agree with Caramoole. Try a good self-help book and using the forums and see how you feel in a few weeks. Then maybe ask for some face-to-face or video CBT rather than typing.

There are lots of possible reasons why the CBT sessions you've had didn't get you to where you hoped to be.  But the main message to take away from this is that CBT does work - when given in the right way, by a therapist who knows what they're talking about, and with a client who's ready to change. If any one of those elements isn't quite on target the first time a second round of CBT often works better. So don't be despondent. Regroup, refocus and try again.  :)

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I was offered online instant chat therapy and I gave up after one session. It was such as waste of time, quite literally as much of the session was spent staring into space waiting for a reply. The only instance when I think it would be useful is if someone had extreme social phobia and couldn't communicate in any other way. 

 

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Thank you Caramoole and snowbear for your replies.

Typing therapy is difficult, you have to wait a while for responses and you really don't get through very much in the hour. Also you are conscious of typing too much and taking up too much time, but then feel extremely despondent when you have poured your heart out only to get a short response back. I personally would not recommend this type of therapy but feel very hopeful that you both think face to face works much better, and also talking to people on here. I have recently purchased a book so fingers crossed this may help too. 

Your words of encouragement and help and advice is very much appreciated. Thank you both! 

 

Edited by Lorna02
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1 hour ago, Lorna02 said:

Although I feel I have made great progress in regards to my unwanted/intrusive thoughts, sadly my contamination OCD and emetophobia are still very much present. I had honestly hoped that when I had finished my online sessions I would feel confident and ready to start living my life, but unfortunately I don't see much change in myself. 

It is good to hear that you have made some progress after your online CBT.  Having finished a long series of CBT sessions in November '21, I felt in a similar way to youself.  That is to say that I was expecting to be further down the road to recovery.  After a few days of reviewing my position I thought to myself  that the end of therapy sessions was only the start of the recovery road.

I joined up with these forums through OCD-UK and also went back through my therapy notes and highlighted the key points.  By doing this I have moved further along the road.

My therapy was through the local NHS Mental Health Team with a CBT therapist.  Due to COVID meausures it was done by phone, but I believe face to face sessions are on their way back in in some areas.

Is this something you have tried before or could try now?

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5 minutes ago, Wren said:

I was offered online instant chat therapy and I gave up after one session. It was such as waste of time, quite literally as much of the session was spent staring into space waiting for a reply. The only instance when I think it would be useful is if someone had extreme social phobia and couldn't communicate in any other way. 

 

Sorry, I have only just read your response after replying to the first two. 

I have since read quite a few negative reviews online saying this type of therapy didn't work for them. It is nice to know I am not alone. 

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3 minutes ago, Lorna02 said:

Sorry, I have only just read your response after replying to the first two. 

I think we must have been typing at the same time! I can feel my anger rising just remembering that therapy session, I had to restrain myself when writing my first reply to you so I didn't go off on a rant. I hope you find something better, this forum is great and if you want to work through a self help book, people here will be happy to try and help you.

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2 hours ago, Lorna02 said:

I have since read quite a few negative reviews online saying this type of therapy didn't work for them. It is nice to know I am not alone. 

 

2 hours ago, Wren said:

I can feel my anger rising just remembering that therapy session, I had to restrain myself when writing my first reply to you so I didn't go off on a rant.

The typing method of online therapy is clearly not working and the people providing it need to know that. Would either of you @Lorna02 @Wren feel able to give them that sort of feedback? It could save more people having to go through the same thing again.

If you don't feel confident about speaking to the provider yourself, would you both please consider emailing Ashley@ocduk.org so the charity can start to gather information on user experiences for feedback to the government. Pointless the policiticans claiming they are spending millions extra on mental health if it's being wasted in typing sessions instead of video sessions or phone or something which works.

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Thanks for your concern Snowbear, I wouldn't feel comfortable making a complaint as I had the session at least five years ago and I can't remember the details. I've a vague memory that I might have been offered a choice between phone and chat sessions and I choose the chat because it meant I wouldn't have to worry about my flatmate overhearing what I was saying (as a side note I think this aspect of remote medical care is overlooked, must be even worse if you are in a vulnerable position and living with non supportive family members). So it was probably partly my fault. It was also an assessment session to see if that form of therapy would be suitable, and I can't remember what the outcome was when I said I didn't want to continue. I was later referred to cmht. 

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Fair enough, Wren. I agree the worry of being overheard at home is a concern for many people. But I don't think typing sessions are the solution for that. Just to be clear though, I'm not suggesting anyone make a complaint - just give feedback on the difficulties of the method. They can't fix it if they don't know it's broken. :(

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Good point, if they don't know they can't fix it. Part of my anger was that I knew it wouldn't work but I felt I had to go through with it to 'show compliance'. I would guess that the amount of info that could be exchanged in a 30min chat session could be condensed into a 5min phone call. An email exchange would have been more productive. 

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18 hours ago, northpaul said:

It is good to hear that you have made some progress after your online CBT.  Having finished a long series of CBT sessions in November '21, I felt in a similar way to youself.  That is to say that I was expecting to be further down the road to recovery.  After a few days of reviewing my position I thought to myself  that the end of therapy sessions was only the start of the recovery road.

I joined up with these forums through OCD-UK and also went back through my therapy notes and highlighted the key points.  By doing this I have moved further along the road.

My therapy was through the local NHS Mental Health Team with a CBT therapist.  Due to COVID meausures it was done by phone, but I believe face to face sessions are on their way back in in some areas.

Is this something you have tried before or could try now?

Thank you for your reply.

I totally understand what you are saying and maybe I should be taking some positives from my sessions as I definitely have a better understanding of OCD and have made progress in some areas. I was just hoping for so much more and I believe now I will hopefully receive this if I go down the face to face route which is something I have never done before. I will also not expect some miracle cure, I will look at it like you said, as the start of the road to recovery. 

Were you referred by your doctor and was there a long waiting list? 

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15 hours ago, snowbear said:

 

The typing method of online therapy is clearly not working and the people providing it need to know that. Would either of you @Lorna02 @Wren feel able to give them that sort of feedback? It could save more people having to go through the same thing again.

If you don't feel confident about speaking to the provider yourself, would you both please consider emailing Ashley@ocduk.org so the charity can start to gather information on user experiences for feedback to the government. Pointless the policiticans claiming they are spending millions extra on mental health if it's being wasted in typing sessions instead of video sessions or phone or something which works.

I have two more 30 minute sessions left with my online therapist which I will complete first. I will then send them my feedback via email and express the issues I have raised on here as like you said, it would be very helpful for them to know so maybe they could change things in the future. 

 

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18 hours ago, Fredagain said:

Was it erp or? Sounds like talk therapy

We have been working on exposure and response therapy. I just felt every session we were moving onto sometime new before I had chance to make much progress on what I was working on. For me, there was not much continuity and I just feel online therapy is not for me. That is not to say it won't work for others though. 

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3 hours ago, Wren said:

I would guess that the amount of info that could be exchanged in a 30min chat session could be condensed into a 5min phone call. An email exchange would have been more productive. 

This is exactly how I feel. My sessions have been 1 hour although my last two are going to be just 30 minutes. You just don't get through very much at all in that time and although I've had 20 sessions, it really doesn't feel like I've had anywhere near thatl! So much time is wasted with typing, or waiting for them to begin writing back to you. I will definitely raise the issues I have experienced with this service after I have finished my sessions. 

 

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Lorna.....why don't you try some of your exposures over onto the Challenge Thread.  It's quite good to do a targeted challenge on and you'll get support, tips and encouragement from the others tackling their own challenges.

 

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2 hours ago, Lorna02 said:

Were you referred by your doctor and was there a long waiting list? 

I was referred by my GP to the local Mindsmatter Team.  This referral started a 3 stage process:

  1. The initial assessment was with the mental health triage team.  Even though you say you would like CBT, they want to check if there are any underlying mental health conditions.
  2. The next assessment was with a mental health practitioner in the Mindsmatter Team.
  3. The third appointment was with a CBT therapist.  I went on to have 20x 1hr sessions over 6 months.

From GP to stage 2 was about 10 weeks. Then the waiting list for CBT took about 10 weeks.

I have just checked and you can self refer to Mindsmatter.  This is in Lancashire, your area might differ.

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5 hours ago, Caramoole said:

Lorna.....why don't you try some of your exposures over onto the Challenge Thread.  It's quite good to do a targeted challenge on and you'll get support, tips and encouragement from the others tackling their own challenges.

 

Oh I didn't know about this, I will take a look, thanks. 

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5 hours ago, northpaul said:

I was referred by my GP to the local Mindsmatter Team.  This referral started a 3 stage process:

  1. The initial assessment was with the mental health triage team.  Even though you say you would like CBT, they want to check if there are any underlying mental health conditions.
  2. The next assessment was with a mental health practitioner in the Mindsmatter Team.
  3. The third appointment was with a CBT therapist.  I went on to have 20x 1hr sessions over 6 months.

From GP to stage 2 was about 10 weeks. Then the waiting list for CBT took about 10 weeks.

I have just checked and you can self refer to Mindsmatter.  This is in Lancashire, your area might differ.

Thank you for sharing all this helpful info. I have to admit it feels pretty scary thinking about the possibility of starting from the very beginning again. It took me a long time before I plucked up the courage to ask for help in the first place and I kinda feel a bit like I'm back at square one again! But like snowbear said, I just need to take some time to regroup, re focus and start again! 

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9 hours ago, Lorna02 said:

I have two more 30 minute sessions left with my online therapist which I will complete first. I will then send them my feedback via email and express the issues I have raised on here as like you said, it would be very helpful for them to know so maybe they could change things in the future.

Great! It's important they get this kind of feedback. :) 

I hope the next round of CBT you are offered is better.

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