The NHS, as we know, are committed to providing health provision free at the point of delivery to all people who need it - but it must also provide a cost-effective health provision.
National Institute for Health and Clinical Excellence
The National Institute for Health and Clinical Excellence (NICE) is responsible for guiding the NHS and it does this by recommending treatments that are cost effective and those that minimise the burden for the client. The guidelines it produces are based upon the current best evidence available.
Improving access to psychological therapies
The government funds an initiative called IAPT (improving access to psychological therapies). This program is not only about improving access to therapies, but also it is about improving the quality of therapy (as well as ensuring that they meet the NICE guidelines).
The processes for finding evidence that a particular kind of therapy has a high quality is slow as it requires a lot of research over a number of years.
Cognitive Behavioural therapists have always used evidence-based research
Cognitive Behavioural therapists have always used evidence-based research as part of their therapy model, and so there are already many years worth of empirical data to support the effectiveness of CBT (and this is widely promoted by people who use CBT with clients - including me!).
The therapists that work in other models of therapy (including me, again) now know that they have to provide evidence of effectiveness of their models of therapy, too (otherwise, people can say that CBT is the only therapy that can be evidenced to be effective - and some therapists actually imply that means that the other types of therapy are not effective! Tut, tut, very naughty!)
So, for other models of therapy to be able to prove that they meet the NICE guidelines evidence needs to be provided. And to get the evidence, research has to be done. And research takes a long time.
Some of the areas that I would like to see be researched are the presuppositions:
- ‘It is the therapeutic relationship that heals, not the particular model of therapy’
- ‘All therapies have an equal effect’
- ‘Outcomes largely depend on the therapist’
Berne Institute to fund University research on TA
The Berne Institute, in Kegworth at junction 24 of the M1, is a training centre for psychotherapy. They are funding a research study on Transactional Analysis therapy to be carried out in the University of Nottingham.
Professor Patrick Callaghan, is experienced in examining various approaches to psychotherapy and counselling. His research into TA therapy will include questions such as
- What makes TA work?
- With what client groups?
- What systematic evidence is there on which to judge TA’s effectiveness?
Research is now all part of it
The people who make up the bodies that influence governments and make decisions about public policy believe that empirical data proves that therapies are effective. Hence research now has to become part of the whole system of the therapy model (research, training, practicing, clinical supervision) if a model of psychotherapy is to survive. This is good, though, in terms of clients having confidence that the particular model of therapy is proven to work.
IAPT can have long waiting lists
The IAPT initiative has promted a new wave of thought regarding evidence-based decisions about what is effective. When NHS patients are given the choice they commonly prefer psychological therapy over medication. Due to long NHS waiting lists, many people are not benefiting because they are not getting referred or because they have ‘patched over’ the problem by the time their therapy sessions become available.
Private Practitioners can see clients immediately
A lot of people look for a therapist in private practice, where they can be seen immediately. Sometimes, as a therapist in private practice, I see clients who are on NHS waiting lists, and they tell me that they want therapy or counselling just for while they are waiting to be seen. I am happy to do that, if it is made clear from the start of our time together. Sometimes I see clients who have had their allocated amount of sessions via NHS or IAPT, and that has started them on a journey to a better life, and then they wish to continue, and pay for that themselves. That is very encouraging, and I am happy to see clients in those situations, also.