NHS Talking Therapies and the Forgotten Art of Conversation

It is a paradox that NHS Talking Therapies is dominated by psychometric tests and not by conversations with clients. In a study of the telephone exchanges of Psychological Wellbeing Practitioners, Drew et al’s (2021) principal findings were that only rarely were patients asked open questions, early in the interaction, about why they had approached a mental health service for support. PWPs prioritised the routine outcomes measures questionnaires and other proforma question banks. There was evidence of a routinised approach and lack of flexibility in treatment delivery. In similar vein Faija et al (2022) noted that the psychometric tests we’re always administered at the start of a treatment session, and were seen by the PWPs as an encumbrance and the results did not influence the sessions at all. These authors called for a more conversational style but also noted that this would put extra time pressure on the PWP.

The Organisation itself appears to suffer from social anxiety disorder, steadfastly refusing to interact with its critics. Preferring the holy huddle of like-minded zealots in ‘best-practise’ gatherings.It is xenophobic.


Dr Mike Scott