free psychotherapy for people on low incomes and benefits
Dear Free Psychotherapy Network (FPN) members,
I would like to thank you for organising an inspirational free conference yesterday for members of your Network and others with interest in this field. I have spoken with Stewart and Amir, the co-chairs (lived experience/ professional) of the Greater Manchester NHS Values Group (GMVG) and they would like to invite some of your network members to attend and participate in a future GMVG network meeting with a joint focus on positive work taking place in our communities around wellbeing, examples from the disability movement, peer led mental health survivor movement and the peer led drug and alcohol recovery movement. (the terminology may not sit right with everyone here and it is just a first go!) I’ve copied in other colleagues and members of the Equality and Diversity Council Lived Experience /Inclusion Health sub group who will be interested in what you do.
Alix from the FPN has kindly agreed to come along to our GMVG meeting at Urban Village this Tuesday evening to meet some of our group members! Stewart will be able to tell you more about the Greater Manchester NHS values group and some of its activities so far around influencing health policy from a lived experience and equality perspective, ‘inclusion health’- improving access for those most marginalised by the system and asylum health, recovery and asylum health, sex worker health, supporting survivors of domestic violence.
I just wanted to recap and feed back to the GMVG and other colleagues on what I learned yesterday morning at the Mind the Gap: Free Psychotherapy in an Unjust World conference at the Friends Meeting House. (Apologies in advance if I have not fully captured the aims and work of FPN accurately)
The Mind the Gap conference aimed to explore and develop sustainable networks of psychological support which are community led and to create a collaborative space for therapists and service users. Themes explored included sick individual or sick society, bringing people together across the professional/community divide to create a new way of collectively looking after ourselves rather than relying entirely on professional ‘experts’. Influencing health policy.
Central to this is the role of peer led initiatives and organisations, the importance of tackling stigma, access to high quality emotional, physical and spiritual support when you need it, peer led groups –what works, what doesn’t. Minding the gap between professional and clients,building the relationship between FPN and community groups, developing FPN local groups, the experience of FPN so far –free work and working free from funding and institutional restraints.
FPN want to promote more genuinely open and mutual exchanges where the client is empowered yet the psychotherapist still has ‘agency’ and can be effective.
FPN want a departure from a mass production assembly line approach to psychotherapy which can be weighted toward CBT and its derivatives.
FPN want to make a symbolic provision of free psychotherapy and group treatments as testimony to the scale of mental illness in modern life and the proliferation of anti-depressant treatment
FPN is linked to the network of counsellors for social responsibility and wants to play a role in transforming society.
FPN want to work with people who would benefit from the experience of practitioners, who haven’t been able to get the kind of support they need from the health service or from voluntary services and who do not have the money to pay for psychotherapy. FPN want to work as far as possible from local bases in communities they are connected to, to encourage people to collaborate, support each other and share experience and understanding of psychological difficulties.
FPN have a vision of transforming society and social relationships and of opposing the individualisation and medicalization of the social, political and material causes of hardship and distress.
The FPN network grew organically, attracting people who wanted to participate.
FPN practitioners strive toward a mutual exchange of emotional resource and nurturing. Clients self refer. Practitioners want freedom to work without increased regulation and to transform the expert professional provider and passive client recipient consumer relationship.
FPN practitioners want psychotherapy to have a role in transforming society and promoting social responsibility and social justice.
Thus far FPN has not been able to look at the demographics of who has received the free therapy. Would be useful to have some breakdown according to groups protected by the equality act and other inequality markers (social class, areas of deprivation etc) There are some regional groups of FPN members who have self organised eg in Cambridge, Manchester, Bristol and the Midlands.
Paul Atkinson. Organiser of the conference, psychotherapist and founder member of FPN
Ian Parker. Manchester Psychotherapist and clinical supervisor.
Yasmin Dewan. Manchester Psychotherapist and life coach.
Yasmin Dewan. Manchester Psychotherapist. Talked about her lived experience of serious mental illness in the family ; ‘if it doesn’t kill you it makes you stronger’. She talked about how her family had grown stronger and about putting the ‘fun’ into dysfunctional. Coping with MH issues alone is excrutiating –and at a point where you are at your most vulnerable emotionally and at your lowest level of practical functioning. Linkage to the proposal around the 5 tenets of personality: Extroversion, openness, conscientiousness, agreeableness and neuroticism. Prevalence as individuals and cultures of self-limiting and fatalistic beliefs. Need for therapy /promotion of resilience and emotional fitness to link to our awareness of our core values and what is important to us. TLC? Tough love and coaching? We want high levels of self esteem, good mental wellbeing, human emotions are a product of our experience.
Ian Parker. Manchester Psychotherapist and clinical supervisor.
talked about the values that FPN psychotherapists had in common and the different frames through which they also see things.
Paul Atkinson, psychotherapist and a founder member of FPN and the organiser (alongside the Manchester group) of the Mind the Gap conference, talked about the impact on mental health of austerity, benefit sanctions, the social housing crisis, the absence of community social work and concerns about the increase of ‘limited view’ mainstream therapeutic provision where there can be limited access to therapeutic support if this is needed and a disproportionate focus upon pre-determined numbers of CBT sessions which may not meet the needs of many.
He referred to a long history of free provision eg some of Freud and Ernest Jones clinics, and that the Tavistock Clinic grew partly from that tradition. Mainstream therapy can be organised around normalising and promoting positive attitudes to and acceptance of the status quo, locating anxiety and depression exclusively within the individual psyche and placing responsibility for succeeding within the existing system on the individual patient. Experience of generalised anxiety can be seen as a product of today’s society and it’s inequities. Equality is the best therapy.
2006 onward-increasing focus on regulation and IAPT- danger that psychotherapists are becoming isolated and dsconnected with what their clients are experiencing in the outside world. Society increasingly individualistic-understanding MH issues through people’s individual histories and their responsibility to do something about it. Need to connect psychotherapy with outside world.
Grow and support local networks to share experiences. Peer led work needs to be modelled from the top down and the bottom up. Mentoring / advocates who are also policy makers- personal empowerment as opposed to lip service and prescribed tokenistic involvement. JSNAs- possible for individuals to push and see if needs met- informs via JSNAs and STPs through to H&WB boards.
Peer support workers/independent advocate models/ E by E roles VITAL and often are usurped by professionals not E by Es.
Links to Asylum Magazine for democratic psychiatry and the experience of the Italian Triest movement where hospitals closed and community MH services were set up, bringing together self harm, paranoia, survivors speak out networks, increasing demand by activist survivors who wanted psychotherapeutic provision that was democratically accountable and would share power in a different way.
Mainstream therapy can exclude those don’t show ‘psychological-mindedness’ or talk in the way professionals expect them to.
How can we get beyond binary oppositional thinking. White coat thinking. Shift from master/slave, prof/service user relationship- need transformation Need space and determine how can think more creatively about getting voice heard.Link decision makers in. Patient participation not enough. Many asked to tell their story can feel pressed to say what think the profs want to hear. Can sometimes feel disempowering and voyeuristic. Need people who can influence change/ are decision makers to be part of grass roots social movements. Binary opposition enforced in the clinical training –proud that they haven’t had MH issues themselves- experience of the therapist as ‘the one who is well’. Psychotherapy does at least require trainees to undergo therapy and at least gain experience of working through issues. What it is to be a human being-not to claim the voice of the survivor. Working at the fragile boundary.Speak out of your experience rather than of it. Service users want someone who has had their own dark night, knows what you are talking about and willing to walk with them when they feel they are teetering on a mental and emotional clifftop.
Equality & Diversity Council chaired by Simon Stevens. Some people of Lived Experience are full members selected from the Greater Manchester NHS Values Group.
Disability activists spoke about wanting justice and rights at a time of austerity and about successful examples of where healthcare professionals and service users have worked together to raise awareness of negative outcomes from welfare reforms.
Head of Equality and Health Inequalities