CBT à la Française

When I finally plucked up the courage to go and see my GP about the obsessive thoughts and rituals that were ruling my life, I was diagnosed with OCD, offered medication and referred for CBT. I was given a phone number to call and was offered an appointment that same week.
To many of you, this would sound like a fantasy situation – no months or even years sitting on waiting lists, no struggling to get the help that you so desperately need. So how did I do this? I didn’t go private nor did I have to blackmail the mental health team – I simply live in a different country, France.

Here, therapists must be registered with the AFTCC (Association Française de Thérapie Comportementale et Cognitive) in order to practice. They must, naturally, be either a practicing doctor or psychologist (although there are exceptions – midwives who are trained specifically to deal with post-natal depression etc.) - I have been seen by a GP who had specialized in mental health, a psychologist and a psychiatrist.

Although it sounds as if the system is perfect, it certainly isn’t. You must be referred by your GP in order to be reimbursed the total cost of your treatment, and in some cases it is your private health insurance that is expected to pay up. Living in a rural population the CBT practitioner, although trained in CBT (TCC), may be out of practice and not used to applying it – I was the first case of OCD (TOC) that my psychologist had seen, which didn’t exactly instill much confidence in me! There is also the issue of continuity of care – as you are able to self-refer (if you are prepared to pay up), you can have many courses of CBT, and even be offered medication (by a psychiatrist) without the knowledge of your GP. When my psychiatrist went on a long holiday without any prior warning, my GP was required to trust me when it came to prescribing medication, as he had no idea what I was taking.

No system is ever going to fulfill all expectations, but I think that although the French model has its problems, they are nothing compared to the horrific stories that I have heard through other message boards. From people having to wait up to a year for CBT to those who have been refused a course of the aforementioned therapy as their condition is not judged severe enough, or because they have not yet tried medication in an attempt to control their OCD. I also know that there are success stories – people who have had the treatment and support that they need on the NHS, but the regional variations are just not acceptable.

I'm about to hop back on to the CBT train... but more of that later.

Obsessively compulsively yours,

Bellsie