One in three of those who attend NHS Talking Therapies sessions do so for only one session, this led to the title of my just published paper Scott (2024). Following a Freedom of Information (FOI) request, I obtained data on those attending just one assessment/treatment session. The Service has chosen to focus on those who attend two or more sessions and its’ recovery claims refer to this population. But this is an incomplete picture as there has been a ‘haemorrhaging’ before treatment.
The mean number of treatment sessions attended is 7-8, but this means that half of those treated have less than 7-8 sessions. But NICE recommended treatments for depression and the anxiety disorders are typically for 12+ sessions. Thus at least half those treated by NHS Talking Therapies have a sub-therapeutic dose of treatment. This makes the Services claim for comparable effectiveness (50% recovery) to randomised controlled trials, where there is no ‘haemorrhaging’, preposterous, pure marketing.
The paper also reveals that the Service has a claimed recovery rate for ‘mixed anxiety and depressive disorder’, that is comparable to other disorders. But there is no NICE recommended protocol for this disorder, it is therefore impossible for it to be NICE compliant. This suggests NHS Talking Therapies get the same ‘result’ however they label a disorder and whatever intervention they deliver. In Scott (2024) I suggest that the Service has capitalised on a placebo effect – the results reflect, simply a combination of: attention, raised expectations, improvement with time and the clients desire to please their therapist. Further the within subject effect sizes are identical to those found in the placebo arms of the most reliable rcts. My paper reveals that those with ‘mixed anxiety and depressive disorder’ and PTSD are the least likely to engage in treatment. With regards to the first it is likely because no credible rationale for the disorder can be given. For PTSD it is likely because of therapeutic insistence that trauma focussed treatment is the only way forward, when in fact there is a much more user friendly option Scott (2022).
Dr Mike Scott
Erratum: The publishers of the paper Wiley and Sons, missed out including the bottom 3 rows of Table One, they are:
8. 2929 11.9 14.3 9316 11.4 0.9 3.2
Hyp
9.
2030 16.1 14.9 4487 15 0.8 2.2
Ag
10.
1560 10.3 11.5 4717 11.5 0.8 3.0
Spec