How to best confuse yourself when you are already stressed…

In a few words… start googling, binging or ask Alexa !

If I knew nothing at all about ‘mental health‘ and googled for some help with my stress or anxiety levels, I would probably end up focusing on the only criteria I can understand – money ! What is the cheapest therapist out there or how do I get the best value for my money. Nothing else on Google makes any sense, when it comes to psychotherapy, unless you have a degree in research methods.

The answer to the ‘value for money question’ however, is relatively simple: NHS is by far the cheapest service, because… it is actually free. However, since getting any kind of mental health support from your GP is like pulling teeth, you have no choice but to go private. Unless you are a high risk, it is unlikely that you will get anything else besides leaflets and SSRIs ¹ via your local general practitioner.

Incidentally, I am a big supporter of antidepressants and the work GP’s are doing on a daily basis is simply award worthy. I know too many cases where lives have been saved by SSRIs and an outstanding GP support however, I am not a big fun of random prescribing without a thorough MSE (mental state examination ²). GP’s are not psychiatrically trained and nor should they be – this is a highly specialist area reserved for mental health specialists; though what is worse is that, most are not provided with any mental health support on site.

Now… on the other hand, therapists are not making life any easier for their patients with endless squabbles over supremacy and the never ending ‘which school of therapy is more effective’ competition. In this process, we tend to lose track of our patients’ needs and instead we focus on offering them what we were told in training that works best. All the while, the poor victims of mental illness cannot even tell the difference between psychiatry, psychology, psychotherapy or hypnotherapy and wait… there is at least one more… of course, counselling ³ … and life coaching… and mindfulness therapy.. or perhaps existential coaching.. and it goes on and on…and on. Everyone out there seems trained to come to the rescue. But Thank Goodness for Google! Because when it comes to creating even more confusion it wins the prize. One of my least favourites Googles is self-diagnosis ! Simply too many patients come to their assessment with an already Google-made diagnosis. As such, here are just some of the problems that I have with that:

• It is far too easy to misinterpret physiological symptoms and identify with the incorrect diagnostic criteria; e.g. mood swings do not necessarily equate with a manic-depressive illness !
• Patients can throw mental health assessors off with their perception of a medical history which could have been at best influenced, if not completely constructed with assistance from Google or its competition Alexa !
• The issue of chronic medical problems. Patients often think they have panic disorder (a very common self-diagnosis) and miss the diagnosis of hyperthyroidism or irregular heartbeats. On the other hand, heart racing does not (necessarily) means that one is having a heart attack.
• Confusing one psychological disorder with another. For example, some patients may think they are overwhelmed by agoraphobic reactions which would explain their tendency to socially isolate when in fact, social anxiety or depression or both or even asperger syndrome could be the more likely diagnosis responsible for their social isolation.
• Self-diagnosis can also create mistrust and may undermine the all essential therapeutic relationship between therapist and patient.
• Self-diagnosis can precipitate and perpetuate health anxiety.

2023 UPDATE ! If things were not complicated enough, now we have AI to worry about… Hopefully, some of my videos will bring more clarity… or even more confusion, I will let you decide !

Glossary:

1. SSRIs: Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder and anxiety disorders, Citalopram, Fluoxetine or Sertraline are just three examples of SSRIs that can be prescribed in UK by the GP or a psychiatrist. Even though clinical psychologists, CBT therapists and mental health nurses have extensive training in pharmacology and psychopathology, prescribing falls under the responsibility of a qualified psychiatrist
2. MSE – mental state examinations: a clinical assessment process in the psychiatric practice. The purpose of the MSE is to obtain a comprehensive cross-sectional description of the patient’s mental state, which, when combined with the biographical and historical information of the psychiatric history, allows the clinician to make an accurate diagnosis which is subsequently required for coherent treatment planning.
3. There is no agreed hierarchy of “knowledge” or “expertise” implied by the titles counsellor, psychotherapist, psychologist, or hypnotherapist; these roles often differ most in scope of practice, training route, and regulatory status.
4. In the UK, many commonly used titles (including counsellor and psychotherapist) are not legally protected, and there is no statutory requirement that someone using these titles must be registered with a professional body. For this reason, the most meaningful marker of professional accountability is often membership of a reputable professional register, particularly one that is accredited by the Professional Standards Authority (PSA), which evaluates standards, governance, and complaints processes.
5. Professional bodies such as BACP and UKCP maintain registers with defined training, ethical, and supervision expectations, though requirements vary by modality and route. By contrast, British Association for Behavioural and Cognitive Psychotherapies (BABCP) accreditation for CBT practitioners requires substantial postgraduate-level training, supervised CBT practice, and typically a recognised core profession, alongside ongoing supervision and clinical governance requirements. Fully Accredited BABCP therapist earned the equivalent of a post-graduate or doctoral level training. As a result, the CBT therapist designation is comparatively better protected—though also frequently misused. It is therefore advisable for clients to ask explicitly whether a practitioner is accredited and by which body.
6. Hypnotherapy in the UK is also not statutorily regulated, and training standards can vary considerably across organisations and training providers. Some bodies (including those linked with GHSC/GHR) publish training standards and learning outcomes, those tend to be significantly lower than psychotherapists, prospective clients should carefully check training depth, supervision arrangements, and complaints procedures.
7. Coaching is a separate field: it typically focuses on performance, goals, and behaviour change rather than the assessment and treatment of mental disorders. Some coaches may also have mental health or psychotherapy qualifications, but coaching itself is not a substitute for regulated clinical care when a diagnosable disorder or significant risk is present.
8. Psychiatrists are medical doctors specialising in mental health assessment, diagnosis, and pharmacological treatment; some also undertake psychotherapy training.
9. Finally, clinical psychologists are trained at doctoral level in psychological assessment and evidence-based talking therapies, and the title Clinical Psychologist is among the protected practitioner psychologist titles requiring professional registration.

Disclaimer: this site and article are not intended as a self-help manual or workbook; the intention with all NA-CBT articles is to help by developing knowledge about the subject. All case studies described are a combination of facts and very little fiction from different sources including personal clinical experiences. Similar work and other great resources for inspiration, can be found on Ted – education, Brene Brown, Roz Shafran, Christine Padesky, Donald Meichenbaum’s research on resilience, and others.

It is important to clarify: this article (like most articles on this site) contains what could be described as ‘real life case scenarios’ for learning and authenticity purposes… this is all part of a series of free handouts offered to psychotherapy trainees or students with a particular interest in evidence-based psychology, NeuroAffective-CBT or Integrative-CBT– any personal details identified are a pure coincidence – us humans are all rather similar in many respects I am afraid – real client details would have been changed significantly in order to maintain anonymity.