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Mis-Guided NHS Talking Therapies

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)]:

  1. treatment for an identified disorder
  2. a matching of disorder specific targets  and treatment strategies 
  3. the utilisation of a protocol that is evidence-based, in that it was evaluated in a randomised controlled trial against an attention control condition
  4. 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)].

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