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NHS Talking Therapies Claim To Parity Of Effectiveness With Clinical Trials – Fantastic Marketing, But Totally Bogus

The Service has never been evaluated with the rigour, comparable to that employed in randomised controlled trials i.e using blind independent assessors. NHS Talking Therapies has only ever marked its’ own homework. To compound matters further it has only taken a PHQ-9/ GAD-7 snapshot of  the person at their last contact with the Service. With nothing to indicate the duration of any gain or whether the change on these measures is clinically meaningful. 

Despite this the Service’s Manual cautions:

‘most referrals to NHS talking therapies will have elevated scores on the PHQ-9 nine and GAD-7. But this does not necessarily mean that they are suffering from clinical depression or generalised anxiety disorder. Unless the assessment process for all the NHS talking therapy relevant conditions, there is a risk that people will be started on the wrong treatment”

But the Manual also states that the Service treats 11 conditions and excludes 4 from its remit. Thus we are invited to believe that its clinicians screen for 15 conditions, but is silent on the mechanism by which this is achieved!  The assessors are for the most part by the least qualified (Psychological Wellbeing Practitioners). It is simply not credible that they have wherewithal to conduct such a comprehensive assessment and conduct it on the telephone, in the at most 1 hour assessment. 

The Service digs a deeper whole for itself when the Manual states ‘Focused supervision that starts by looking at the patient questionnaire scores and any changes on these’. The Tests are completed at every session. Clinicians can be called to task for not reaching a 50% recovery ate on the measures. Clearly the two questionnaires are expected to be central to the sessions leaving  little space for the alleged comprehensive screening. The authors of the Manual clearly suspect that things are going badly awry with treatments but their response is akin to that of the Post Office hierarchy with regard to sub-postmasters.

Dr Mike Scott

 

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