NHS Talking Therapies Builds Sandcastles on The Beach At Low-tide

NHS Talking Therapies for Anxiety and Depression provides snapshots of clients at each therapy session, using two psychometric tests. But these ‘pictures’ provide no indication as to whether the client would regard themselves as having returned to normal (or best ever) functioning for a meaningful period. Despite this NHS Talking therapies claims a 50% recovery rate!  The time-frame used in the tests is the past two weeks, but remission in epidemiological [Bruce et l (2005)] studies and DSM-5-TR [American Psychiatric association (2022)] is defined as having no significant signs or symptoms for 2 months. NHS Talking Therapies has never used the 2 month real-world window, as the minimum period necessary for declaring recovery from an episode of anxiety or depression. Even this period would be insufficient for declaring lasting recovery. The changes depicted by the trajectory of the two psychometric tests, used without a reliable diagnostic context, have no more significance than an NHS Talking Therapies Flag stuck on top of its’ sandcastle, soon to be washed away.

The Service has this year made two switches that have not enhanced its’ credibility. The first, is to say its’ focus is now on the provision of ‘talking therapies’ and not ‘psychological therapy’. The latter term has historically been applied to psychological treatments that have been examined in randomised controlled trials (rcts).  But there are no rcts of ‘talking therapies’, they are not evidence-based. The term can be taken to mean whatever the user wants it to mean. Is a person’s conversation with their hairdresser/barber a ‘talking therapy’, was my meeting, an hour ago, with an old school friend in a coffee bar ‘talking therapy’?

The second switch is to append the descriptor for ‘Anxiety and Depression’ to the Services’ role. But the Service takes no steps to ensure that established diagnostic gateway criteria for anxiety and depression are met. NHS Talking Therapies, is it seems dedicated to obscuring what it does, thereby ducking accountability.