Do you think we deserve effective psychotherapy in the NHS?

I’ve been very helpfully informed about a petition (which is running until 3rd March 2007) on the Government’s website which anyone interested in effective therapy should sign. Pass this around if you agree and get as many signatures as possible

The motion is this:

“We the undersigned petition the Prime Minister to consider other psychotherapy approaches, not only cbt, in the proposed expansion of psychotherapeutic services within the NHS, instead of restricting choice for members of the public to one only model of therapy.

The proposal by Lord Layard to increase by 10,000 the number of CBT therapists in the NHS ignores the benefits to people of other forms of therapy. Relationship based therapy, such as the Person Centred Approach, and others, have a proven record of helping to alleviate distress and to change lives.

‘We Need To Talk’ , a July 2006 report into NHS availability of mental health treatment supported by MIND, The Mental Health Foundation, Rethink, TheSainsbury Centre for Mental Health and Young Minds highlights the need for more organisation and consideration of therapies other than CBT in this area.

They recommend that “The Department of Health should investigate the current bias in research priorities and address it by supporting more research into psychological therapies.”

The more signatures this petition gets before 3rd March 2007 so it receives the Priministerial attention it deserves, the better.

Sign the petition here.

Posted by: Eleanor

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7 responses to “Do you think we deserve effective psychotherapy in the NHS?

  1. Thanks for bringing this to my attention. This is the first time I have signed an on-line petition, and I’m curious to see what response there is from Government, individuals, and other organisations.

    I hope that this starts a new and more open debate about the provision of effective therapeutic services available to the general public.

  2. Anyone know what “other therapies” have been proven effective to the extent that CBT has?

    I saw mention of the “Person Centered Approach,” but is that actually a “therapy” comparable to CBT?

    I don’t know, but I would guess that there is a difference between an approach and a therapy. For example, an approach might be a theoretical framework, useful for the therapist to keep in mind while conducting a therapy, which would be an actual something the therapist does.

    Isn’t CBT a therapy that would be used by some therapists in a Person Centered Approach?

    Are there any other therapies that have any where near the evidential backing of effectivenss that CBT enjoys?

  3. To chime in with David here – if the petition is about “effective” therapies and a “proven record of helping to elleviate distress” then isn’t CBT the gold-standard at present?

    This is not to say that other therapies may be helpful but to claim that an approach is effective means demonstrating this: something CBT researchers have done. Just saying your approach is effective is not enough if you have no evidence to back it up.

    While psychotherapists of orientations other than CBT may not agree with the approach and have their well-thought out reasons for this, the area that is not in dispute is the evidence base.

    And this is how CBT is being judged as potentially helpful in the way Lord Layard is suggesting.

    If there is going to be an expansion of the provision of psychotherapy then aren’t the decision makers going to go with something that has some evidence, instead of an approach that may have anedotal evidence and good intentions, but no controlled research behind it?

    It might be a bitter pill to swallow but funding approaches that have no evidence does not make sense in a healthcare environment where consumers expect some promise of results.

  4. In response to David and Mervyn the article you responded to doesn’t dispute that trials have shown CBT to be effective, or ask for approaches to be funded, it is asking whether there is a need for funded RESEARCH into alternatives that may enable equal or greater efficacy. I refer you to the original article;

    ‘We Need To Talk’ , a July 2006 report into NHS availability of mental health treatment supported by MIND, The Mental Health Foundation, Rethink, TheSainsbury Centre for
    Mental Health and Young Minds highlights the need for more organisation and consideration of therapies other than CBT in this area.

    They recommend that “The Department of Health should investigate the current bias in research priorities and address it by supporting more research into psychological therapies.”

  5. Thanks Ezra, you make a good point.

    But, (and it’s not minor) the petition is not to “support research,” it’s asking the government to “not restrict” treatment to the only approach that has been shown to be effective.

    I was just wondering if those supporting the petition knew of any other therapies that have been shown to work.

    I’m all for further research. Who should pay for it?

  6. Good question. As I understand it the original stance held by the pioneers of the Human Givens approach was that they were happy to leave it to independent parties to test their theories out. They were getting effective results and that was all that mattered to them, which seems to me reasonable. Perhaps inevitably the government wish to standardise psychotherapeutic approaches and so now the onus is on practitioners to provide evidence that their approach is up to par. I might be completely wrong but I seem to remember somebody claiming that the average cost of drawing up a protocol for randomised control trials alone was in the area of £150,000. If that figure is correct then imagine the cost for example, of trialing a range of techniques as used by HG practitioners. There are also questions to be asked about standardisation in therapy sessions. I have recently seen a number of CBT programmes designed to be delivered to prisoners and young offenders which in one case, had to be videoed to ensure that the teachers delivering the courses didn’t deviate from the scripted lesson. This would enable the two cognitive psychologists who designed it to provide evidence of the efficacy of their course beyond the influence of other factors, for example the personal style of the teachers. This completely ruled out the possibility of exploring issues brought up by students, their individual needs or connecting with their existing models of reality, and struck me as a very unnatural dictatorial approach. The governments recent initiative to introduce computer based CBT programmes was in a similar vein.
    I’ve gone off on a slight tangent but in answer to the question, I suppose either the tax payer or private funding from therapists or collective bodies who wish the approach they use to be taken seriously.

  7. Ezra – I couldn’t have said it better myself!

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