A couple of mental health-related queries, pretty please (UK-based)

Los Pollos Hermanos

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Thanks - when I first saw ROI I had to Google it as ROI means Republic of Ireland to me!!!

When I said positive, I meant Therapist says something like Character is attending and engaging, but doesn't give any other info to Employer. Sorry, should have been clearer!

Again, big thanks for the goodies!!! :)
 
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EMaree

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UK reporting in, Scotland with lots of experience with English-majority companies and companies with big healthcare infrastructures.

I would definitely steer away from any framing that has the employer declaring the employee 'unfit to work' -- in my experience, it just doesn't happen. Only an employee (and their doctor, usually, who provides a medical 'fit note') can sign themselves off. And they'll still get company sick pay for a set term, if applicable (since they're paying private CBT I would assume they would), and statutory sick pay afterwards.

If the employer wants to look good -- and private CBT makes me think this is true -- they'd give the employee a week or fortnight's leave on full pay, or assign them to work-from-home only if possible, and send a private therapist to visit the employee's house. Most companies would do phone therapy to cut costs, though.

Something to consider -- a 'caring' dodgy boss could give a distressed employee the afternoon off work, as long as before they leave they go into a private meeting room and use the phone there to speak to the company's therapy line to discuss the issues. Boss frames it as ensuring the employee isn't leaving the office in a state of distress or upset, and ensuring they receive trained support after a bad day at work. Dodgy boss could then pull the phone recordings and listen to the call.

Character continues to be gaslighted, but isn't fooled and is told that for a return to work to be considered they have to attend an initial appointment with Therapist

This really wouldn't fly. A return-to-work is an act done by the employee, the employer can't block it or set terms. They can do a 'return to work' interview, be condescending dicks, and really really push the necessity of continuing therapy for the employee's own good, but they can't block the return.

Actually, can Employer deem Character fit to return to work based on the fact that they're (pretending to - ha!) engage with the CBT, or does this authorisation have to come from Therapist? Would Therapist deem Character fit to return to work if they appeared willing to engage, and/or would Employer-related doctor need to get involved here? I think I know what I'm trying to ask?!!

If the employee states they're fit to work, the employer really has to take that. A dodgy company could request a 'fit note' showing fitness to work from the doctor, just to inconvenience the protag and stall for time -- it isn't standard but it feels believable.

Therapists don't authorise anything like that here as far as I know.

Assuming Character arrives for first CBT session, are there any baseline assessments Therapist will do first?
If so, what are they so I can do some additional Googling to add to the relevant scenes?
Also, what sort of answers could Character give that may alert Therapist to a whiff of BS?


These sort of Qs would be well worth e-mailing actual UK therapists about.

From experience, CBT therapy in the UK is often used as a 'low cost' solution -- the NHS pushes it as a first step, arranging for patients to get sent CDs and giving them website URLs while they're added to the long queue of folks waiting for face-to-face therapy.

I struggle to think of answers that would make therapists call BS. They've seen it all, and a patient refusing to talk won't really phase them. They're still getting paid, at the end of it.
 
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Los Pollos Hermanos

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Massive thanks for taking the time to share all the tartan-flavoured goodness! ;-) ;-) Know what you mean about the tea as well.

Due to the dodgy stuff and recent gaslighting, Character has been suspended on medical grounds, despite assuring Employer that they are genuinely fit for work. Could this affect Character's right to assert they are fit to be at work?

Employer is having none of it, sends Character to Employer-associated (private) doctor, who is in cahoots with Employer (hmmm... could add in something about splitting the £££). Doctor makes appointment with Therapist (more £££ splitting?), despite Character being adamant they don't need a shrink. Employer says in an indirect way that failing to attend Therapist's appointment means a greatly delayed return to work. Therapist works out of fancy private hospital linked to Doctor's private practice.

Apologies if that's even more confusing! xx
 

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A sticking point for me is that, as your employee isn't currently in the office, the boss loses a lot of their power. Bosses have power in the workplace. They can have meetings, bring in people, control the narrative.

An employee in their own space becomes the one in control of the situation. Most employees suspended for dodgy reasons, once at home, would pull their socks up and get on the phone to lawyers/go visit Citizens Advice/go see their local GP/visit relatives and draft a plan of action.

(The 'go see their local GP' thing is something to watch for, now that I think of it. No matter what the corporate healthcare people do, the OP could counter it using their regular GP. If the local GP thinks the protag is fit for work, how will the office fight it?)


How is your boss maintaining his control over the protagonist? You mention that they need the money, but nothing so far about them deciding the employee is unfit to work would threaten their financial stability.(If the employee's job was really at stake, making them redundant would feel more likely. It gets hard to argue discrimination if you're 'downsizing' or dismissing lower-performing employees..)



Due to the dodgy stuff and recent gaslighting, Character has been suspended on medical grounds, despite assuring Employer that they are genuinely fit for work. Could this affect Character's right to assert they are fit to be at work?

Oooh, this is a good question and I don't know how to answer it. I honestly didn't think it was possible. I'm going to ask a managerial acquaintance, stay tuned...

Employer is having none of it, sends Character to Employer-associated (private) doctor, who is in cahoots with Employer (hmmm... could add in something about splitting the £££). Doctor makes appointment with Therapist (more £££ splitting?), despite Character being adamant they don't need a shrink.

Bribing a medical professional seems plausible to me, though I think bribing two would be pushing believability, maybe? I'm not sure. I don't have a good feel for how corrupt the private medical industry in the UK could be.

Also, I know you mentioned earlier that the employer isn't *that* dodgy and doesn't want to risk bad press. Bribing two medical professionals seems unlikely for them, given that.

----

Honestly, there's a loooottt of this plotline that is really going to stretch believability. Every time you explain in, new things jump out that feel impossible.

This seems like a very, very complicated set-up to orchestrate. It might be worth examining the overall goals of this and seeing if there is a simpler way.
 
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Los Pollos Hermanos

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Again, big thanks for such a detailed reply. I'm kind of thinking on my feet and throwing different scenarios around until I manage to fit as many pieces as possible together without the aid of a hammer. I've got so many ideas, but they won't all fit together at present, so some will have to be cast aside (I did this years ago when I stared the crime trilogy I'm currently submitting to agents) to enable a feasible sequence of events to take shape.

Character currently isn't at work, despite wanting to be (it's complicated!) and I'd certainly be interested to know if Character's own usual NHS-based GP can state Character is fit to return to work, therefore overriding Employer and Employer-associated private doctor. That could facilitate an interesting twist!

I'll also get Character to work on their battle plan during their enforced time off work - thanks for that idea.

Employer is behind the scenes dodgy; in public, they appear squeaky clean. I've worked for a similar set-up in the past - corrupt isn't the word and I eventually managed to escape.

Cheers! :)
 
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bombergirl69

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Just to address one other thing, what a referral sources gets is something like progress report (no idea what they call it in the UK, NOT a progress note!)
As far as suspicious, any mandated client who reports ecstatic progress would be viewed a little skeptically-oh wow that that is so helpful! Yes, no more anxiety/depression/psychosis for me--all healed! Damn you're really good! No, no more drinking for me. Just gave it up--no problems! Thanks for all the help!

Just as would the reverse - yeah, i'm psychotic and I have horrible PTSD and terrible mood swings--been diagnosed with bipolar but I also have terrible depression on top of that! It's the worst!! Then I have this Tourette's thing, it's a fucking nightmare! I can't sleep at all--I mentioned the voices, right? And my ADHD? Yeah, just can't focus at all... Truly, people do say things like that!
 

bombergirl69

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Just adding, why a referral to the doc and not straight to the therapist? That would cut out one professional! :)
 

Los Pollos Hermanos

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Haha! That first reply made me chuckle - I can imagine some clowns saying stuff like that and thinking you'd be fooled. Even I wouldn't be fooled!

Employer sent Character to private OH (occupational health) doctor, who then "recommended" Character see private CBT Therapist (a psychiatrist, rather than a psychologist), who is in cahoots with Employer. In a nutshell: No shrink = No return to work. Employer is doing all this to continue to gaslight Character (i.e. hoping they'll eventually believe/accept they're mad (they're not, btw)) and also as an arse-covering exercise to look all kind and caring as part of their squeaky clean front.

Big thanks! :)

p.s. Would love to know if Character's own NHS GP can legally override the Employer and their associated private doctor...
 
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neandermagnon

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Haha! That first reply made me chuckle - I can imagine some clowns saying stuff like that and thinking you'd be fooled. Even I wouldn't be fooled!

Employer sent Character to private OH (occupational health) doctor, who then "recommended" Character see private CBT Therapist (a psychiatrist, rather than a psychologist), who is in cahoots with Employer. In a nutshell: No shrink = No return to work. Employer is doing all this to continue to gaslight Character (i.e. hoping they'll eventually believe/accept they're mad (they're not, btw)) and also as an arse-covering exercise to look all kind and caring as part of their squeaky clean front.

Big thanks! :)

p.s. Would love to know if Character's own NHS GP can legally override the Employer and their associated private doctor...

There are a whole load of things that I'm finding implausible about the whole scenario. Medical things, employment law things and also the motivation of the employer. Why would any employer want an employee signed off on long term sick? They're being paid, doing no work, and the employer has to get a temp to replace them or get someone else to do their job as well as their own. It's a huge pain in the arse. Doctors notes are to ensure people have job security in spite of being on long term sick. It's a legal protection for the employee. Not something an employer wants to enforce.

Employer's can't choose employee's doctors. They can't ignore sick notes (the official ones used to sign people off work) from an employee's GP.

I also think that you're taking the gaslighting thing a bit literally. Usually, gaslighting doesn't come from the intention of one person to make another think they're insane. More often it's when there's bad things going on (often bullying, but can be any bad thing that the employer wants to hide) and when the person that's being subjected to the gaslighting asks questions or makes complaints in relation to it, the employer (or whichever person is in power that's doing the gaslighting) responds by denying what's going on and implying that the person questioning/complaining about it is mistaken, being too sensitive, being paranoid, etc. It's an elaborate form of victim blaming in most cases.

It's done in subtle ways and the person doing the gaslighting may not fully realise they're doing it, i.e. they're so intent on covering up their own or colleagues shitty behaviour that they convince themselves that the person complaining really is just imagining it (paranoid, too sensitive, etc). When subjected to this kind of gaslighting for long periods, the person does start to question their own judgement, especially when it seems like the whole workforce is saying one thing and they're the only one that perceives it a different way... it often happens when there's a whole gang of bullying employees who are covering up what they're doing with victim blaming and gaslighting.

The deliberate kind of gaslighting, where person A sets out with the intention of making person B think they're going insane is different. Yes it probably does happen occasionally. A very controlling, abusive spouse/sexual partner may do this to have more control over their spouse/partner. An employer to an employee... not so much as the employee can just leave. Maybe the employer knows that the employee isn't in a financial position to find another job, but even in that case, they can control the employee when the employee's in the office, but not when they're at home, and if they're on long term sick, then effectively that employee has temporarily broken away from being controlled by them. This is probably the most important of all the reasons why your scenario seems implausible. It seems far more likely that the control freak employer wants the employee at work, and if the employee's doctor signs them off sick, they can't legally override that doctor's decision, however they might resort to telling the employee that they're a malingerer and they don't trust the doctor's opinion ("yeah you can pull the wool over your doctor but you can't pull the wool over my eyes" kind of response). Forcing them to not return to work? ... doesn't make sense.

Also, controlfreakery and gaslighting go hand in hand, and they go hand in hand with bullying. Not only does this kind of think make people think they're going mad, it can cause actual mental illness. Anxiety, depression and even PTSD in extreme cases, especially if the person has no chance to get away (e.g. they can't just go and find a new job) and they feel physically in danger from the bullying.

And if the therapist and employer are in on this together... what are they trying to achieve? The employer might be doing this because they're a total control freak, but what's in it for the therapist? Why put your entire professional reputation on the line for some control freak who's trying to convince an employee that they're insane?

The process of making someone question their judgement and sanity comes from the abuser pretending that reality is different to what it is (denying things have happened, claiming things happened that didn't, claiming things happened differently to what they did, claiming things are different to what they are (e.g. insisting that the walls are yellow and the victim is mistaken by saying they're blue... when really the walls are blue)) What is the therapist actually going to be doing in terms of gaslighting the patient?

Regarding the question of an NHS GP overriding an employer plus associated private doctor - the whole question makes no sense. The employer has no legal jurisdiction in determining if an employee's fit for work or not. If you're talking about things getting legal, the employer doesn't have a leg to stand on in this. The employee does not need a doctor's certificate to prove they are fit to return to work. No sane employer would try to prevent them from returning to work, and if they did, an employment tribunal would side with the employee and wouldn't need any doctor to prove that the employee is fit for work. The question of whether someone needs to be sectioned or signed off work rests with doctors. If employers are concerned, they can advise employees to see their doctor, or if concerned that an employee is so mentally ill they can't make rational judgements they can call the emergency services. Employers can tell you to go home if you're obviously ill at work, but this is for cases where the employee turns up in spite of having flu, because they're dedicated, then they get sent home as an act of compassion.

Apologies if this comes across as very negative... when you jam all your ideas together (with or without a hammer) it's important that they come across as plausible to the reader, especially in terms of characters having believable motivations, not just in matters of employment law and medicine. There's potential in your ideas and I hope you manage to get them all smashed together in a plausible yet exciting way. :)
 
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bombergirl69

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So, this does not apply to the UK!! But

here, an employer could certainly work to discredit an employee. When said employee feels or demonstrates instability, a company could say they pose a safety risk or something and as a condition of continued employment, have to get therapy of some kind (so...choice, therapy or leave.) The employee could go where they wanted for therapy, but they might use their EAP, which would get them 5-6 sessions with an EAP therapist who is contracted by the employer (meaning they'll accept whatever the reimbursement rate is from the company.)

I've never heard of a company mandating therapy with a particular therapist (can't do that). The onlyl thing I could see is it being worth it for the employee to either terminate (headache gone) or be busy with therapy (discredited, unable to ferret out what's really going on) I don't see a medical doc involved. The compromised therapist could apply for extended sessions because the guy is so "impaired." Never heard of that happening but then again, I dio't work with impaired therapists and I have certainly advocated for more sessions with certain (non EAP) clients, so I think it could.

So, you'll have a bit of an uphill climb to produce motivation as to why an employee would hang in there! Clearly, he'd just quit, skip therapy and find something--anything--else. so what I could imagine is (and really, excuse the horrendous writing, it's just to make the point) something like - Fuck this, Cedric said to himself as he read the referral to Dr.Janus. An anger management program? He'd call Clyde tomorrow and see about his old delivery job. But then he saw that boy's face, smudged and scared. He heard the small voice, "Please sir, help us." He dialed the number.

Just making the point that you'd have to come up with a really compelling reason for your MC to stay (abused children/animals! a bomb/gas/whatever that will take out London/the world--something with REALLY high stakes!
 

Los Pollos Hermanos

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Many thanks to both of you for the amount of time and detail you've put into your replies. I have the scenario which started all this, and I know how it will end (this is a sub-plot, btw); it's just tweaking the main part in the middle which is causing me a severe headache. Character has valid reason(s) not to quit and Employer is dodgy and trying to cover their arse. That's the long and the short of it.

Character gets medically suspended and told/made to see Employer-associated doctor (occupational health) rather than their GP. Working on a "suggestion" from Employer, this doctor tells Character they MUST see Therapist (the usual one Employer uses for any employee, if required) before a return to work can be considered. Character knows they're fine to be at work and is angry that they are, in effect, being blackmailed to see a shrink when they genuinely don't need one. Employer is hoping Therapist will somehow convince Character that they are indeed as mad as a box of frogs.

The gaslighting is of the insidious, discrediting variety - I've encountered myself it in the workplace and once they know you know what they're doing, they don't like it!!

I intend to print out this thread at some point and go through it with colour-coded highlighter pens - "Yes", "Maybe", "Iffy" and "Nope" could be a good starting point!

Cheers! :)
 
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bombergirl69

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Well people here have been so tremendously helpful with me as I had to sort out plot tangles - but what if? NO! But...NO. But..okay, how 'bout..THAT MIGHT WORK. :)

Character gets medically suspended and told/made to see Employer-associated doctor (occupational health) rather than their GPSo this is where, in the US, things could get sticky. I don't know that employees can be made to see any one particular doc. They can go where they want (as long as the person is licensed/credentialed in their speciality) or use their EAP. But usually EAPs offer several options and not just one person. I don't know anything about the UK!! :) Working on a "suggestion" from Employer, this doctor so this also might be a UK vs US thing, but usually an employee is given their choices, and are not sent to an MD for a referral. At least, I've never heard of that. I've gotten plenty of referrals from MDs but not as "middle men" for employers. If the employer suspects a disabling mental health issue (employee attempts suicide or threatens) they get a mental health professional. tells Character they MUST see Therapist (the usual one Employer uses for any employee, if required in the US, there would be a choice. Sometimes police but few companies have a company shrink. They have several with whom they contract, for their EAP. The employee would also have several available on their insurance plan. before a return to work can be considered. Character knows they're fine to be at work and is angry that they are, in effect, being blackmailed to see a shrink when they genuinely don't need one. Employer is hoping Therapist will somehow convince Character that they are indeed as mad as a box of frogs.So, there must be a very big payoff for the therapist., because employee who is angry, if they feel the therapist is sketchy, can file a complaint with the licensing board (of the therapist) which would keep them (the therapist) busy for quite a while. Fraud really is tricky business!!! That's why I was mentioning substance abuse, which gets you incompetence rather than corruption. Perfectly healthy, non-addicted people can get stuck in the system for a long time, at the mercy of someone with not even a college degree. And many of them are quite susceptible to client BS. that may be quite different in the UK! Anyway, hope any of that helps.

The gaslighting is of the insidious, discrediting variety - I've encountered myself it in the workplace and once they know you know what they're doing, they don't like it!!

I intend to print out this thread at some point and go through it with colour-coded highlighter pens - "Yes", "Maybe", "Iffy" and "Nope" could be a good starting point!

Cheers! :)
 

Beanie5

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A couple of things that often go hand in hand with cbt are becoming a Buddhist ( live in the moment) and yoga( control of mind and body), As for testing you can test for just about anything, it would require a specific request though most readily available tests only test for proscribed substances.
p.s. on shaky ground here but a lot of the normal rules go out the window where national security is involved. ( they could be given a sensitive contract and he is portrayed as a security risk)
p.p.s. you should also probably decide if the prescripton is for a serotonin based medication (prozac / or more likely zoloft or ) or a antipsychotic / sedative (seroquel)
 
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A couple of things that often go hand in hand with cbt are becoming a Buddhist ( live in the moment) and yoga( control of mind and body), As for testing you can test for just about anything, it would require a specific request though most readily available tests only test for proscribed substances.
p.s. on shaky ground here but a lot of the normal rules go out the window where national security is involved. ( they could be given a sensitive contract and he is portrayed as a security risk)
p.p.s. you should also probably decide if the prescripton is for a serotonin based medication (prozac / or more likely zoloft or ) or a antipsychotic / sedative (seroquel)

I've had several courses of CBT and have never felt the urge to become a Buddhist or take up yoga. Nor have these things been suggested to me. I'm not sure that a change in belief is part of a counsellor's remit.
 

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Here's another angle for you to consider if it's not too late:

You can have the employer also accuse the character of "being over-emotional". That one can be an insidious accusation and lead to eventual firing of the employee, and the employer can claim they didn't know about x issues, because the employee didn't confide in the employer.
 

Beanie5

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Hi the query was aimed at things that might show the person was engaged in their program A simple google search will throw up many authentic psychologists comparing Buddhism and Cbt and also yoga I have no alterior motives here the knowledge has been forced on me
here is an exert from wiki

Buddhist texts also contain mental strategies of thought modification which are similar to Cognitive behavioral therapy techniques.[19] A comparison of these systems of cognitive behavioral modification has been discussed by professor William Mikulas[20] and Padmal de Silva.[21]
p.s. I perhaps should have mentioned it is to an extent endemic that people feign interest in programs or taking psyche drugs and psychologists have a reasonable ability to detect this ( but they get fooled all the time)
 
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Helix

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Hi the query was aimed at things that might show the person was engaged in their program A simple google search will throw up many authentic psychologists comparing Buddhism and Cbt and also yoga I have no alterior motives here the knowledge has been forced on me
here is an exert from wiki

Buddhist texts also contain mental strategies of thought modification which are similar to Cognitive behavioral therapy techniques.[19] A comparison of these systems of cognitive behavioral modification has been discussed by professor William Mikulas[20] and Padmal de Silva.[21]


Just adding the link -- Buddhism and Psychology -- so the context is available.
 

EMaree

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The CBT materials and methods used be the UK medical industry tend to deliberately strip any religious references away to make it more universal. It is unlikely you'd be pointed to Buddism, more likely non-denominational 'mindfulness' programs instead.

p.p.s. you should also probably decide if the prescripton is for a serotonin based medication (prozac / or more likely zoloft or ) or a antipsychotic / sedative (seroquel)

Not your fault, Beanie5, but this is really bad advice for OP -- it's very USA-centric, these brand names and don't apply outside of America.

The actual non-branded name for Prozac is fluoxetine, which is commonly prescribed in the UK for depression. But without knowing the protag's symptoms it's hard to know if they'd be likely to get this--most doctors these days prefer for paitients to try unmedicated CBT for a while first, unless there's an urgent need for medication. And OP hasn't mentioned the details of their protag's mental health issues.

If fluoxetine is relevant to the story....
The dose prescribed to new patients in the UK is also very low, and gets scaled up gradually if required. A lot of media portrays 'Prozac' as a dramatic mood-altering substance, but fluoxetine in low doses is very gentle. It doesn't create the massive highs, zombie-like fugues or relaxed stoned states that you see in TV and movies.

If taken regularly as prescribed, it levels the brain out. When taken correctly, a person on fluoxetine is indistinguishable from a person not on medication. The aim is to restore a 'normal' emotional state.

Mental health medication gets a lot of undeserved bad press, but it helps so many people with neurodiverse brains live normal lives.
 
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bombergirl69

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Not "commonly linked" to Buddhism in US either! It can be consistent --ie use things mindfulness--but that's hardly one of the theory's tenets (it's consistent with the Native American sweat lodge too! I can't think of faiths with which it would not be consistent! Plenty of Christian psychologists use CBT. That fact that it lends itself to a variety of contexts makes it a powerful tool!)

CBT is a theory of behavior and as such can be applied to a HOST of things - addiction, depression, anxiety, pain management, sports performance, anger management, trauma, marital therapy, etc. Because it's an approach/theory about behavior, plenty of behaviors are consistent with it - owning a pet, taking up tennis, keeping thought records or a journal, going to church, learning nutrition- but they are not part of nor prescribed by the theory. Narrative therapy is one form of CBT.

I would NOT go down that road--linking CBT with a religion or practice--at all!!

:)
 
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bombergirl69

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The CBT materials and methods used be the UK medical industry tend to deliberately strip any religious references away to make it more universal. It is unlikely you'd be pointed to Buddism, more likely non-denominational 'mindfulness' programs instead.



Not your fault, Beanie5, but this is really bad advice for OP -- it's very USA-centric, these brand names and don't apply outside of America.

The actual non-branded name for Prozac is fluoxetine, which is commonly prescribed in the UK for depression. But without knowing the protag's symptoms it's hard to know if they'd be likely to get this--most doctors these days prefer for paitients to try unmedicated CBT for a while first, unless there's an urgent need for medication. And OP hasn't mentioned the details of their protag's mental health issues.

If fluoxetine is relevant to the story....
The dose prescribed to new patients in the UK is also very low, and gets scaled up gradually if required. A lot of media portrays 'Prozac' as a dramatic mood-altering substance, but fluoxetine in low doses is very gentle. It doesn't create the massive highs, zombie-like fugues or relaxed stoned states that you see in TV and movies.

If taken regularly as prescribed, it levels the brain out. When taken correctly, a person on fluoxetine is indistinguishable from a person not on medication. The aim is to restore a 'normal' emotional state.

Mental health medication gets a lot of undeserved bad press, but it helps so many people with neurodiverse brains live normal lives.

Yes to all this, although these days Prozac tends NOT to be first line (in the US) Interestingly here, people's GPs (docs) tend to be the prescribers as finding a psychiatrist or nurse can be next to impossible in small communities! Actually many people stroll into their doc's office, mention they feel down or blue, and walk out with a script! And yes yes yes to meds being a Godsend to so many people - life changing, like the sun coming out! They do indeed help many live normal happy lives!! :)
 

Bolero

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A lot of CBT therapists are not MDs - they can't prescribe medication. Presumably would make a recommendation to a GP if they thought it needed.
 

Los Pollos Hermanos

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Again, big thanks for so much help in trying to iron (hammer?) out a feasible sequence of events.

Character does not have mental health issues, but has a condition recognised as a disability under the Equality Act 2010. Employer is trying to wriggle out of making recommended reasonable adjustments, knows Character knows they're doing this, and has tried to gaslight Character into thinking they're cracking up. Character calls out Employer when the penny drops. Employer twists this to say Character is unhinged, medically suspends them and sends them to OH doc, who's in cahoots with Employer (a whole other sub-plot in itself!) and says Character needs CBT (or similar) in order to return to work. Employer covertly blackmails character by implying "No shrink = No work".

Character has a Big Dilemma because whilst they want/need to return for work (again, a whole other sub-plot in itself!), they don't see why they should see Therapist because there's nothing "wrong" with them. I'd feel exactly the same way, so I can't see it being too much trouble writing Character's PoV when I get to that part of the story. Hypothetically, say my boss pulled a similar stunt (although I'm sane - honestly!!!), what could I say or do during CBT to convince a shrink that I was engaging with it enough for a back-to-work recommendation? I know if I was in that situation and they recommended happy pills I'd play along by pretending to accept the prescription, take it to the chemist, pick up the pills and then at "dosage time" drop each pill in the bin - unless one of you lovely people has a better idea for my story?!

Thanks for all the suggestions and hopefully it'll all come together and make sense soon! :) xx
 
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neandermagnon

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I've been thinking about this, and thought I'd just throw in a suggestion. Feel free to use or ignore completely or adjust to fit or whatever you need.

If the idea is that a manipulative boss wants to make an employee believe they're mentally ill and see a therapist who is also in on the manipulation*, then rather than the boss signing the employee off sick and refusing to consider them fit for work (which strikes me as very implausible for all the reasons mentioned in my previous post), maybe have the boss frame the whole thing in terms of performance management. Bosses have no jurisdiction over sick leave, beyond ensuring that employees aren't malingering (more than 4 days absence requires a sick note from the doctor). However, performance management is very much their jurisdiction and most companies will expect line managers to do regular performance appraisals (once a month where I work), i.e. what you're doing well, what you need to improve on, setting SMART goals/targets etc etc etc.

If your boss character wants to be a gaslighting control freak but at the same time look like they're the epitome of compassion, they can do performance management meetings like this: 1. discuss the employee's shortfalls in performance (if they're gaslighting the employee, these don't need to be real... they could be setting unachievable goals or pretending problems exist when they don't), 2. voice concerns (in a concerned tone) about the employee's mental health and imply this is the reason for the "poor" performance. 3. Imply that they're being oh so compassionate and caring by not firing the employee over this and 4. recommending the therapist in question as someone who's really good at helping employees whose mental health problems are affecting work performance. Phrased like this, if the employee's afraid of losing this job and isn't in a position to start looking elsewhere, then the implied threat of "see this shrink your you'll be fired" would probably result in them seeing the shrink. If the employee's already been influenced by the gaslighting to the extent of starting to question their own judgment, then they'll probably start to believe that it's them that's got the problem and their boss really is compassionate - or at least be questioning their own judgement enough to be unsure whether they believe themselves or their boss. At which point your therapist can do whatever he or she's going to do to continue with the gaslighting.

*you need to have some very good motives developed for this though, both the boss's motives and the therapist's motives
 
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Los Pollos Hermanos

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Ooooh! That's really good and a far sleeker version of what I'm trying to achieve!! I can certainly fit some of my ideas around this so big thanks for the time you've spent sharing your ideas. However, Character KNOWS they're being gaslighted and that they're not what Employer says they are, but needs to ensure they convincingly play along with the CBT, all whilst silently seething inside.

A humungous thank you! :)

p.s. Motives are all taken care of...
(does a Montgomery Burns impression)
 
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cornflake

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Again, big thanks for so much help in trying to iron (hammer?) out a feasible sequence of events.

Character does not have mental health issues, but has a condition recognised as a disability under the Equality Act 2010. Employer is trying to wriggle out of making recommended reasonable adjustments, knows Character knows they're doing this, and has tried to gaslight Character into thinking they're cracking up. Character calls out Employer when the penny drops. Employer twists this to say Character is unhinged, medically suspends them and sends them to OH doc, who's in cahoots with Employer (a whole other sub-plot in itself!) and says Character needs CBT (or similar) in order to return to work. Employer covertly blackmails character by implying "No shrink = No work".

Character has a Big Dilemma because whilst they want/need to return for work (again, a whole other sub-plot in itself!), they don't see why they should see Therapist because there's nothing "wrong" with them. I'd feel exactly the same way, so I can't see it being too much trouble writing Character's PoV when I get to that part of the story. Hypothetically, say my boss pulled a similar stunt (although I'm sane - honestly!!!), what could I say or do during CBT to convince a shrink that I was engaging with it enough for a back-to-work recommendation? I know if I was in that situation and they recommended happy pills I'd play along by pretending to accept the prescription, take it to the chemist, pick up the pills and then at "dosage time" drop each pill in the bin - unless one of you lovely people has a better idea for my story?!

Thanks for all the suggestions and hopefully it'll all come together and make sense soon! :) xx

Again though, I can't imagine requiring a specific type of therapy, especially something like CBT (as opposed to an Anger Mgmt course or whatever) is in any way legal.

Also, if a psych recommended meds and you didn't want to take them, why wouldn't you just discuss that with the psych? Like, why you didn't want to take them, why they thought you'd benefit, what alternatives they'd recommend, etc. Why play along and go through some weird throwing-away-a-pill-a-day ritual? It's not like you're an inpatient with a court order requiring you to take meds (which is very rare -- requiring anyone to take medication is a serious thing that will usually require a judicial order) hey're doctors - cannot report this stuff to anyone.

Even if you know the employer is in cahoots with an unethical dr., the character wouldn't know that, so...?