Talking Therapies and the NHS

Abstract

psychotherapy, the principal types are psychotherapies derived from psychoanalysis, family/systemic therapies, cognitive behaviour therapies (CBT), and humanistic psychotherapies. Despite these differing approaches, reviews of the research evidence have consistently suggested that the different psychotherapies have equivalent outcomes. Nevertheless, CBT is being promoted as the preferred treatment in the NHS. The Layard report (2006) describes dramatically the social and economic costs of people suffering from anxiety and depression and promotes CBT as the treatment of choice to improve the under-resourced out-patient mental health service. But I believe that there are reasons for caution in accepting that the NHS should devote a large part of the much needed new investment in psychological therapies to investment in CBT and I also contend that there are other psychotherapies that should be further developed. When considering evidence, I think it should be borne in mind that the psychological understanding of people and how to apply that knowledge is not as well developed as Layard’s proposals would seem to assume. He calls for the implementation of the National Institute for Health and Clinical Excellence (NICE) guidelines for mental health, but it was a former editor of the BMJ who pointed out that the NICE guidelines are far from objective decisions based on evidence ‘and the suspicion is that political clout is as important as evidence in the final decision’ (Smith, 2000).