This is the take home message of a just published study in the British Journal of Clinical Psychology. Capobianco et al (2023) The authors conclude “Significant questions must remain concerning how effective the treatment element actually is and how much time is needed to realise an adequate dose”. With mean improvements of 2-3 points on the PHQ-9 between 1st and last session and a mean 3 point improvement on the GAD-7 between 1st and last appointment, whether or not treatment was conducted remotely or face-to-face. They further add “however, we are not arguing the treatment was effective and therefore the cause of the changes observed. Such changes could be accounted for by a range/ combination of factors including regression to the mean or spontaneous recovery over time…….. It seems that clinical improvement was slow, and patients do not appear to be receiving the required length of time in order for outcomes to reach the required cut of”.
Their data reflect the failure of NHS Talking Therapies to engage clients thus, “between March 2020 and September 2020, 5515 patients attended at least one session, with 2553 (46%) patients attending at least two treatment sessions. Similarly pre Covid19, 9199 patients attended at least one session, with 4625 patients (46%) receiving at least two treatment sessions. Participants attended a median of two remote therapy sessions and a median of three in person therapy sessions’. By anybody’s reckoning the median dosage of therapy is sub-therapeutic.
Dr Mike Scott