NHS Talking Therapies [ IAPT Manual (2023)] claim that their Services are guided by National Institutes of Health and Care Excellence (NICE) guidelines. But the evidence for this is conspicuous by its absence. Embarking on a search for Guideline compliance, is like searching for the Holy Grail. The Services interventions are therefore mis-guided.
The hallmark of compliance is [Tolin et al (2015)]:
- treatment for an identified disorder
- a matching of disorder specific targets and treatment strategies
- the utilisation of a protocol that is evidence-based, in that it was evaluated in a randomised controlled trial against an attention control condition
- the protocol was evaluated by independent blind-raters.
None of the Services low intensity interventions meet the above criteria. It is possible that on occasion an evidence-based treatment might be delivered in high intensity NHS Talking Therapies, there, at least in principle, there is the space to deliver a therapeutic dose of treatment. But the quest is akin to searching for the presence of water on other planets. Just as one has to be wary of claims for extra-terrestrial life, so to with the suggestion that NHS Talking Therapies is the best model for other countries to adopt for the delivery of psychological therapy services. I have suggested a simpler way forward [Scott (2009)].