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NHS Talking Therapies Black Hole

Data is only publicly available on the 1 in 2 people who undergo treatment, those who have had just one assessment/treatment session have disappeared down a black hole for the past 16 years. This is hardly the transparent and comprehensive monitoring of outcome claimed in the NHS Talking Therapies updated Manual.

But following a Freedom of Information request (FOI) I have obtained data on those attending only 1 session. But the diagnostic status of almost a third (29.1%) was unknown, making the Services claim to follow NICE approved diagnostic specific protocols meaningless. 

 


The Manual 5.1.3  recommends ‘systematic screening for all the conditions that NHS Talking Therapy treats’.  But there are 11 conditions that the Service treats.There is no evidence that at assessment its’ clinicians employ a standardised screen for the spectrum of disorders that they claim are within their remit to treat. Nor that they use a screen to rule out the disorders that they do not treat: personality disorder, psychosis, bipolar disorder and eating disorder. In the foreword to the Manual it states that those who do not go on to treatment are given ‘advice and signposting (if appropriate)’. But there is no clarity about the content of this ‘advice’ nor of its’ evidence base.  Signposting it seems may not occur, but this could plausibly be because the assessing clinician (usually the most junior member of staff- a Psychological Wellbeing Practitioner) simply doesn’t know the way.  One has a strong suspicion that those who have simply an ‘assessment’ disappear down a black hole, only to possibly re-emerge in desperation, when their difficulties have not resolved.

NHS Talking Therapies published data is at best consistent with passing improvement, for disorders that largely wax and wane anyway. 

Dr Mike Scott

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Something Is Very Amiss In Routine Care – There Is No Evidence of Translation From The Evidence-Based Psychological Treatments Of Randomised Controlled Trials

according to a meta-analysis in the Journal of Affective Disorders. This echoes my own finding of only a significant minority recovering in NHS Talking Therapies Scott (2018). The results are a far cry from the 50% recovery rate claimed by NHS Talking Therapies.

“It makes little sense to conduct hundreds of randomized trials on psychological treatments when they do not lead to better routine practice.” For those in care as usual only 1 in 6 or 7 recovered.When care as usual is persistently failing, the punters are clearly not being listened to.  It is like Stalinist Russia proclaiming another successful 5 year plan, when in reality the peasants are starving .

Where did it all go wrong?

Dr Mike Scott