Half of 10,000 new therapists should be clinical psychologists

June 23, 2006
By Angela Hussain

Half of a possible 10,000 new NHS psychological therapists to treat depressed people should be clinical psychologists, according to an influential government adviser.

The government last month took its first step on realising a plan for the NHS to employ more counsellors and therapists by launching two pilot cognitive behavioural therapy (CBT) centres for people with depression and anxiety in Doncaster, Yorkshire, and Newham, London.

Health economist Lord Richard Layard, credited with providing the idea behind the initiative, is the lead author of a new report on depression which states that 5,000 extra clinical psychologist could be brought into the NHS if the current intake of 550 yearly trainees was expanded temporarily to 800. Other psychologists could be recruited from outside the NHS.

If the pilot therapy centres are effective, similar centres will be rolled out to the rest of the country, the government has promised.

Ironically, the British Psychological Society, which accredits clinical psychologist training courses, last month complained that funding for clinical psychologist training in England and Wales has been slashed by 20 per cent.

The LSE report - entitled Depression Report - A New Deal for Depression and Anxiety Disorders - was last week backed by four of the UK’s most influential mental health charities - Mind, Rethink, The Mental Health Foundation and the Sainsbury Centre for Mental Health.

In a joint statement, the chief executives of the four charities said: “We call upon the NHS to implement NICE guidance on mental health and to invest urgently in sufficient capacity to offer people the treatment they need in a timely manner and to high quality standards.”

The government's eagerness to follow Lord Layard's advice is largely driven by a desire to slash incapacity benefit payments by finding ways for the 1.3 million people with a mental health problem who claim such benefits to return to work.

The report, compiled by LSE's mental health policy group headed by Lord Layard, states that there should be 250 new psychological therapy centres in England, each serving a population of 20,000 by 2013.

A course of therapy costing £750 would pay for for itself in the reduced expenditure on incapacity benefits from people being able to go back to work, said the report.

Read for yourself:
Depression Report, by the London School of Economics' mental health policy group (pdf)

See also:
May 11, 2006: Government takes first step to bring in thousands more counsellors and therapists into health service - Patricia Hewitt (left) announces launch of two pilot cognitive behaviour therapy centres in Doncaster and London
Feature:
Oct 11, 2005: Family fortunes - If a West Midlands family therapy programme is as good as it claims in reducing"relapse" rates for family members diagnosed with a mental illness why has it not been rolled out to the rest of the country?

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Clinical psychologists - expensive and no more effective

Comment from: Nick Serieys, CBT therapist, GP practice
Date: June 27, 2006

Could someone please explain why 50% of the proposed 10,000 new therapists should be clinical psychologists?

They are the most expensive therapists and, as I understand it, there is no evidence that they are more effective than CBT therapists who are counsellors, nurses, occupational therapists or, indeed, from any other discipline.

Surely it would be more sensible and cost effective to recruit or train appropriately experienced personnel regardless of professional discipline?

The British Association for Behavioural and Cognitive Psychotherapies is currently piloting the registration of trained CBT therapists who are not nurses, counsellors, OTs, or indeed psychologists. It is to be expected that they will be just as effective therapists as those who are psychologists, counsellors or from other health professions. Surely these therapists should also be incorporated into these new proposals?

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The 'mentally ill' don't need therapists...do they?

Comment by: Phil Barker, professor of health sciences, Trinity College, Dublin, Ireland
Date: June 27, 2006

There is no doubt that a radically different 'solution' is needed for the overwhelming (economically) problem of people who are unable to deal with 'life and its constant travails' - commonly referred to as 'mental illness'. Drugs, clearly, do not 'work'. So, it seems reasonable to look for some alternative. CBT - which has no specific meaning, but means virtually anything to anyone with a 'psychological' bent - is the flavour of the day. Lord Layard has bought this particular ice cream and now, no doubt courtesy of tea at Chequers, has issued an 'authoritative set of recommendations'.

I have spent more than 30 years working in close proximity to clinical psychologists. I have also been a psychiatric nurse for almost 40 years and, I fear, that clinical psychology would struggle to find adequate numbers within its ranks to fulfil Layard's ambitions, such is their dependent relationship to medicine and bioscience.

People who find the going is 'getting tough' need the counsel of people who have experienced similarly difficult terrain. What they don't need is 'advisers', far less 'therapists'.

Is it too much to ask that even a handful of psychminded's tens of thousands of visitors might give some thought to 'what is actually needed', as opposed to what some government lackey insider views as politically expedient?

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A national scandal

From: Jane Leary, NHS psychotherapist
Date: April 29, 2008

I completely agree with Prof Barker. I have worked with emotionally troubled individuals in the NHS for many years and Layard's recommendations and the ensuing tidal wave of funds now being given for the training and employment of CBT-ists and clinical psychologists is nothing short of a national scandal.

Clearly, Layard - an economist - has opened up a gold mine for these two groups of elites under a facade of egalitarian concern that is paper-thin at best. The real concern is, of course, money and power.

The NHS is well on its way towards the back-door privatisation that many NHS employees and patients fear. CBT and clinical psychology are - as Prof Barker states - 'virtually anything to anyone'. Meaning, they can masquerade as any 'flavour of the month' under a veneer of scientific credence wholly undeserved of either. Neither reference nor credit their sources, plaigerising everything from Gestalt methods to Buddhist meditation. Today it is CBT, tomorrow it will be some other money-saving series of techniques which further devalue the content of our patients' experiences, whilst bolstering the vanity needs of many psychologists and psychological 'therapists'.

I personally work as a non-psychologist psychotherapist taking an anti-establishment, non-psychological model perspective. I entered the profession as a mental health survivor myself, having been sickened by the shocking dearth of understanding and compassion within psychology. Consequently I avoid the self-aggrandisement so common to the psychology profession.

People with mental or emotional troubles should not be made the scapegoats and exploitees of those elites in government and the NHS who merely serve their own egos rather than the real needs of suffering persons we call 'patients'. These people need to be cared for, respected and valued, not railroaded into compliance with models of 'normality' handed down by psychologists and cognitive behavioural therapists.

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