A few weeks ago I was listening to an audio clip from the Beck Institute on the topic of determining treatment length in cognitive behaviour therapy (CBT). In the talk, the father of cognitive therapy Dr Aaron T. Beck, speaks about how the length of treatment in CBT is difficult to predict when you first meet a patient, and how many factors besides symptom severity come to bear on the question of how long therapy might take. We discussed his talk as a group on our Facebook page which got us to thinking whether Dr Aaron T. Beck might be willing to write a letter to the Federal Minister for Health, the Hon Peter Dutton MP, explaining why 10 visits of psychological care is often not enough. I am very pleased to report that he agreed to write a letter, which you can read here.
This morning I forwarded the letter to the Minister, in which I explained the significance of this letter of support. For those who may not be aware, Dr Aaron T. Beck invented cognitive therapy, which is one of the main psychological therapies approved for use in the Medicare system. Over many decades Dr Aaron T. Beck has conducted a huge amount of research in CBT and has trained thousands of therapists to apply these techniques. In his letter to the Minister he calls for patients diagnosed with depression to have access to up to 24 visits of cognitive therapy for an optimal level of recovery:
I have been in charge of a moderately large clinic for many years and cost containment has been one of the issues. Our experience has been that optimum treatment for depression probably required up to 24 visits or possibly more.Professor Aaron T Beck
As we explained to the Minister, you can see how our request for Medicare to provide each patient with access to at least 15 to 20 visits of psychological care is not much to ask. If we are truly interested in the psychological well-being of people living with common mental health conditions like depression, then offering just 10 appointments will not do. As Beck has explained so well, the length of treatment which is needed has to do with so many more factors than simply the type of disorder, or the severity of a patient’s symptoms (see below).
We need to consider other factors too such as the learning curve of a person, their personality, the level of support around them, and so on. That’s why we disagree with the APS proposal to gatekeep access to therapy beyond 10 visits based on symptom severity alone. People are far more complicated than that and it doesn’t make sense to impede their recovery right at the point where they are starting to get better.
It would be great to hear some of your comments below...