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Thursday 29 September 2016
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Telephone and online cognitive behaviour therapy trial

The effects of telephone and online-based cognitive behaviour therapy (CBT) is to be the subject of a £3m Scottish government-funded pilot study.

GPs in the Western Isles, Shetland, Borders, Greater Glasgow and Clyde and Lothian regions will be able to refer patients to the telephone-based CBT system.

A dedicated NHS 24 number will be available for patients to be talked through any mild anxiety and depression issues they may be experiencing.

Therapists and self-help coaches will be employed in the regions to provide further professional help and support, and special CD-roms will be made available.

Self-help clinics, group sessions, workbooks and college courses are also being run to aid patients with their CBT, while a website with self-help tips and other advice is being developed.

The Scottish government has set a target to stop rising rates of antidepressant prescriptions in the coming years, and hope the use of CBT can help to reduce this.

Minister for public health, Shona Robison, said: "Along with our partners in NHS boards across Scotland and at NHS 24, we have sought out new ways of helping people who experience anxiety and depression.

"This funding will deliver accessible, user friendly cognitive behavioural therapy, and put people more in control of their mental health."

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"I am totally in favour of using AI and IT to the greatest extent possible and hope that this experiment will prove revealing – BUT I am very wary that this could have serious unintended consequences such that any individual, whether presenting a psychological problem or not, may be 'discovered' to have aberrant behavior or opinions that need to be 'cured'. Although from the start that the targets for treatment will be patients already on drugs for depressive ailments referred by GPs, we have been told of the benefits of having seamless delivery of health and social services, and, of course, CBT lies somewhere at the interface. So could CBT open the door to a Kafkasque or Orwellian nightmare? Will the very practice itself engender paranoid fears? Is this really a cheap, automated, cure for many social ills, from drug addiction to political deviance? How does CBT really articulate with welfare to work and such-like initiatives – could CBT be a useful tool in detaching those fraudulently claiming invalidity benefit from dependency on state support and pushing them into the labour market? Could it be applied to reduce tobacco/alcohol addiction in nubile women – or even to 'cure' potential terrorists of suicidal-bomber tendencies? CBT seems to me to have the potential to be a powerful weapon in the hands of those who would do good for society by manipulating the thoughts and behaviour of the eccentric and the dissident. Whether it is effective or not may not matter so much as its availability to identify, constrain and 'treat' those who might cause society cost or nuisance. How long will it be before I am 'discovered' to have a 'problem' because I dare to doubt the good intentions of the practitioners of CBT or the possible role that CBT might be playing in the development of the mechanisms of social control? This mass application of CBT raises in my mind some very complex ethical issues. I would like to know a great deal more about it" – Professor Fenton Robb