Says Will Self talking on Radio 4 this morning, a must listen on BBC i-player. He was distressed at his friend who had been sectioned, his visit to her on a locked ward resembled still, ‘One Who Flew Over the Cuckoo’s Nest’. When she questioned the appropriateness and mechanism of action of the drugs prescribed for her bipolar disorder the psychiatrist became defensive. After discharge no therapy was on offer.
He is absolutely right we do need good quality talking therapies but we have not got them, rather we have a 10% recovery rate for those undergoing treatment with IAPT http://journals.sagepub.com/doi/pdf/10.1177/1359105318755264. I very much doubt that IAPT or anyone has an evidence based psychological treatment for a person with bipolar disorder and it would be disingenuous to pretend we have. Nevertheless IAPT has trespassed into providing treatment for medically unexplained symptoms, which is an unfortunate precedent for claiming more than we can deliver.
Will Self makes the excellent point that we need small communities to support people like his friend. But it is very difficult to create them for people who are isolated, charities, churches etc do what they can but it is a tough road to make a real world difference
Dr Mike Scott
One reply on “‘What We Need Is Good Quality Talking Therapies’”
The problem is that ‘good quality talking therapies’ may not always equate with NICE’s recommendations and preference for the so called ‘evidence based treatments’; It’s this bastardised interpretation of an evidence base that is at the root of much of this . For instance many of the so called disorder specific Cbt models for SMIs in secondary care settings are I believe are on dodgey ground when it calls to a legitimate evaluation of their evidence base. Yet I fear it won’t be long before an quasi IAPT aka CBT dominated approach is introduced to secondary care.