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A multi-million pound strategy to increase access to psychological therapies in England is flawed, a group of therapists has warned.

The government has earmarked £173m to increase the number of cognitive behavioural therapists in the NHS.

But delegates at an international counselling conference heard it was a "myth" that CBT was more effective than other types of therapy.

NHS advisors recommended CBT for depression and anxiety in 2004.
When resources are limited, surely the NHS should focus on treatments that have established efficacy
Professor David Clark, Kings College London

The National Institute of Health and Clinical Excellence (NICE) said the evidence supported its use ahead of antidepressants in mild to moderate cases.

The Scottish Executive is also planning to train more therapists to improve patient access to CBT, which aims to help patients to pinpoint - and then change - thoughts and actions that cause emotional problems.
Restrict access

Professor Mick Cooper, an expert in counselling at the University of Strathclyde, told the conference at the University of East Anglia that although he welcomed the increased funding for psychological therapies, the focus on CBT was not logical.

He and three colleagues from the UK and US issued a statement saying there had been more studies on CBT, but that did not necessarily mean it was more effective than other types of therapy.

"It is scientifically irresponsible to continue to imply and act as though CBTs are more effective, as has been done in justifying the expenditure of £173m to train CBT therapists throughout England.

"Such claims harm the public by restricting patient choice and discourage some psychologically distressed people from seeking treatment," he said.

Professor David Clark, a clinical advisor to the government's Improving Access to Psychological Therapies programme and professor of psychology at Kings College London said NICE had put together their guidance on the basis of the evidence available to them.

He added that NICE had also recommended some other psychological treatments where there was evidence of benefit.

"Counselling is recommended for mild and moderate, but not severe depression. Couple therapy has the same indication," he said.

"The government's 'Improving Access to Psychological Therapies' initiative is not a CBT-only programme.
"When resources are limited, surely the NHS should focus on treatments that have established efficacy," he said.

Dr Tim Kendall, co-director of the National Collaborating Centre for Mental Health said it was correct to point out that a lack of evidence did not mean something was ineffective but the government has to invest money in treatments that are proven.

He added: "NICE has recommended a host of different psychological therapies where there is evidence."

 

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