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BABCP Response - NICE Consultation January 2022

Soothing, Improvement and Recovery – vested interests in muddying the waters

The list of those with a vested interest in consciously or non-consciously muddying the waters of mental health outcomes (fake news) is staggering and include Charities, IAPT and Independent Practitioners. Consumers, Businesses and Clinical Commissioning Groups beware!

Most client’s of mental health services are glad of the help proferred, they find them ‘soothing’ but this is a far cry from recovery from identifiable disorder. I’ve just put ‘Voltarol’ on my sprained ankle it is soothing, less of a burning sensation, but it doesn’t actually speed up the rate of recovery or increase gait velocity (improvement). Recovery would be back to what I was before I crumpled getting out of the taxi. Blurring the distinction between soothing, improvement and recovery is good for the marketing of a product, analgesic/wares of a mental health service provider, but the ‘injured’ are not well served and ill equipped to protest. As a consequence the juggernaut of existing services continues. There is a pressing need to go beyond expressions of client satisfaction.

 

E-cigarettes look like a good way of helping people giving up smoking cigarettes, but the long term effects are unknown, a Parliamentary Committee has just been appointed to look at the matter. There is an understandable wariness about wide dissemination in the abscence of evidence.  But there is no such critical awareness when it comes to mental health.

 

Dr Mike Scott

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Current Psychological Therapy Issues

Warning Bell for Psychological Therapy?

If we continue as we are then psychology will diminish as a reputable science and could very well disappear’ so wrote Chris Chambers in his just published book The Seven Deadly Sins of Psychology: A Manifesto for Reforming the Culture of Scientific Practice (p. ix). Princeton University Press.

The problem is the widespread failure to replicate original positive findings, and the aversion of psychologists to independent direct replication, preferring instead the enthusiastic marketing of any novel positive finding. This is unfortunately also true of the clinical field where there are few independent direct replications.

Medicine and science are largely self- correcting. Until  the paper by Topiwala et al in this week’s (June 10th 2017)  British Medical Journal , 430-431 it was considered that studies suggested that a little drinking of alcohol was good for you  but it has been discovered that even moderate drinkers (up to 21 units for men) were three times as likely as abstainers to have hippocampal atrophy. Chambers (2017) cites a similar example of self-correction from the field of physics, were in 2012 a study was published that suggested a sub-atomic particle a neutrino was  found to have travelled faster than the speed of light, thereby upstaging Einstein’s theory. Within a few years there were 3 independent replications of the same study all with opposing findings. The original experimenter went back to the drawing board and found he had a faulty fibre-optic cable in the initial experiment. Unfortunately to ask for independent direct replication of bench-marking studies in psychological treatment is regarded as being negative and a fudge of conceptual replication is offered in which another study is conducted  with a key feature absent e.g a blind assessor using a standardised diagnostic interview.