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tonyplant

November 7, 2006 - 14:54

Duncan and Miller's Heroic Client and Wampold's Great Psychotherapy Debate are interesting for their discussion of the competing therapy models.

Phillip Hodson's recent Junk medicine: cognitive behavioural therapy was in line with the argument in the above books.

Stunningly, the largest body of evidence into counselling outcomes, the 35,000 cases comprising the CORE Survey, has been totally ignored by NICE and Layard alike. Looking at the figures just for depression, CORE shows there is no significant difference in the long-term success rates for CBT over traditional forms of therapy such as “person-centred” or “psycho-dynamic”: CBT works for 75 per cent of patients; the rest for 76 per cent.

So a summary of the evidence tends to show that alll talking treatments are roughly equal in effectiveness because it is the relationship with the therapist that counts.

Useful, but it doesn't address the issue of whether or not Layard and NICE are supporting it because it is cheaper than the other therapies with which it is comparable. I assume that you must be talking about different studies (other than the CORE survey) in which CBT has demonstrably worse outcomes and therefore less value?

I find it unlikely that CBT would be suitable for all. But I do expect more of a discussion in the public debate. The public is being told that CBT is the only option to remedy the common absence of talking therapies. Some mental health professionals decry this as misleading and over-simplistic. It may well be - but it behoves Oliver James and similarly well-placed psychologists to write more informative articles. This is one of the major strengths of the internet - it allows fuller discussion than articles in a newspaper.

How would you set about providing appropriate education for "professionals and patients alike in the wealth of old and new ways of working in this field"? And what would the content be?

Tony Happystance



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