Ethics Doctors and Depression

When a prospective client gets in touch with a therapist, there is a good chance that they will have already been looking for ways to deal with whatever their issue appears to be.

Often that first port of call is the Family Doctor, the GP.

I have a lot of respect for GPs, they spend their time seeing a huge variety of patients with an almost infinite number of ailments. It's not an easy job, I'm sure.

That said, it is often reported that up to 60% of the problems that patients bring to the GP surgery are psychosomatic, that is to say as much guided by the thought processes and thinking patterns as anything else. Depression arising from redundancy, marriage breakdown or some other cause might get some low intensity CBT, some limited counselling or more likely a dose of anti-depressants.

The way that these issues are dealt with will vary from Doctor to Doctor and from one health authority to another. That Low Intensity CBT might even be delivered by means of PC connected to the internet.

So where is the issue?

If this patient has been through this particular mill and found it lacking, he or she may well call their local Hypnotherapist.

They may talk through the issues at some length before even attempting to construct a therapeutic response. It may be clear from this discussion that the depression is a symptom of other life issues (low self esteem, poor self confidence etc.) that can be dealt with successfully using hypnotherapy. Great!

As part of that discussion the topic of what medications the 'would be' client is taking will be raised. So it will become clear at this point that the GP has diagnosed depression and very likely written a prescription for Prozac or something similar. Unfortunately it seems to be all too easy to reach this conclusion and attach the depression label.

In an ideal world the therapist might write to the GP asking if there was any medical reason why the client/patient should not use hypnotherapy to deal with the root cause of their problems. Hopefully the GP says "it's ok" and we work towards a positive outcome.

Sadly life is rarely that simple. GPs will often refuse to sign anything from outside their office and since as therapists we have a duty of care to client, we probably should not go ahead with any hypnotherapy.

I say probably because the reason most often used by the Doctor for not signing is that they don't understand hypnosis or hypnotherapy. I look at the style of work I have adopted bits of it look like CBT, bits of it involve an element of counselling and of course the use of hypnosis.

If I referred to what I did as Psychotherapy & CBT then I guess life would be easier all round. Perhaps I should forgo the letter to the GP; the Hypnotherapy Society Code Of Ethics does not explicitly call for this but is often considered good practice.

At the moment the outcome is a Doctor's patient who is dealing the symptoms by medication instead of getting to the root cause of the issue.

There has to be a better, more effective way to work than this and perhaps part of that better way forward could be improving the education of GPs as to the usefulness of hypnotherapy.

Anyone out there got some useful ideas to contribute?