Everyone is talking about cognitive behavioural therapy, but do most people understand it?
It’s important for plan sponsors to fully understand what they’re paying for when they decide to provide mental-health benefits, said Peter Gove, innovation leader in health management at Green Shield Canada, in a session at Benefits Canada‘s 2019 Vancouver Benefits Summit at the Fairmont Waterfront Hotel on May 24.
“I’m up here public speaking, and let’s say in the middle of my talk five people get up and leave. I can interpret that in a number of different ways,” he said. “I can say, ‘Holy cow, I’m a failure, my presentation is terrible. I’m going to be a failure for the rest of my life. I’m going to lose my job and my life is over.’ That’s one way to interpret it. Another possible way to think about it is, ‘Too bad those folks are going to miss a good talk, they must have something else to do.'”
Ensuring people are in touch with how they’re feeling and their automatic reactions to what’s happening around them is what CBT is all about, said Gove. It breaks modes of thinking down into schema. For example, the downward spiral of negative thoughts he explained would be an example of the catastrophizing schema.
“So we develop interventions, tools to help people think more rationally with their thought patterns, connect these thought patterns to their behaviours and moods and shift them,” he said.
CBT, unlike many more traditional forms of therapy, can be tailored to many different mental-health issues, including depression, anxiety, post-traumatic stress disorder and even psychosis in some cases, said Gove, noting other forms of psychotherapy have a tendency to focus on a specific disorder.
CBT programs also differ from traditional therapies in that they require users to complete a lot of tasks between sessions, he said. But this can be a drawback for some people, since action items or homework mean the patient needs to take their own initiative, he added.
When it comes to measuring outcomes, CBT programs can actually provide more transparency for plan sponsors that want to know exactly what they’re paying for. “Only about 20 per cent of psychologists in Canada measure outcomes,” said Gove. “It’s hard to believe, but true, especially in this age of value-based health care.
“If you’re seeing a psychologist for CBT, it’s going to cost about $250 an hour. It’s going to take about 15 sessions at that rate. That’s a lot of dough. These [CBT programs] give you a complete course of psychotherapy and synergized treatment for less than $500. We had a lot of plan sponsors with only $500 coverage for psychology . . . and we really needed to find something that produced a quality intervention at that price point.”
Read more stories from the 2019 Vancouver Benefits Summit.