A recent paper by Ost et al (2023) proclaims the good news that psychological therapy for the anxiety disorders can be effectively delivered in routine practice. But that is not to say that this ever happens as a matter of course. It only happens in the special circumstance were researchers take their wares to a non-academic site and deliver treatments as per protocol. Crucially, Ost et al (2023) make no comment on the external validity of their findings. To have raised such matters amongst CBT practitioners, would it seems be akin to debating the existence of Santa in front of the children!
It is the case that the results of effectiveness studies are comparable to those in efficacy trials, with a typically 50% remission rate. Leading Ost et al (2023) to advocate the wider dissemination of CBT. The findings and recommendations are likely to gladden the heart of NHS Talking Therapies Service providers, providing fuel for expansion. But it is an arbitrary inference to take the effectiveness studies as an endorsement of what happens in routine practice in the UK.
Children grow out of a belief in Father Christmas, adults it seems can create their own fantasy at the expense of other adults and children. But it would be more truly Christmas all-year round if contacts with client’s began with:
‘ In your own good time, tell me what has been getting to you’
Christmas is about hope. Have a good Christmas.
Dr Mike Scott