UKCP recently issued a press release urging NICE not to publish its guideline for depression in adults. They provide a bullet pointed list of highlighted concerns, including definitions of depression used, and the focus on Randomised Control Trials to the exclusion of other valuable evidence.
Of particular concern is the proposal to limit first-line treatment to CBT or medication:
Despite acknowledging the importance of offering a choice of treatments, the draft Guideline proposes Cognitive Behavioural Therapy (CBT) or medication as the first-line treatment for all forms of depression, denying adults with depression the opportunity to benefit from alternative talking therapy treatments.
I’ve written to my MP, from my perspective as a therapist, to ask her to support UKCP’s call, and am encouraging fellow counsellors and psychotherapists to do the same.
What’s also important is that people who aren’t practitioners of some sort, especially those with experience of accessing treatment for depression through the NHS, also contact their MP to share their concerns.
The end result of these guidelines will be less variation in the support available for people struggling with depression. Which will inevitably mean less effective support.
I have been practising gestalt psychotherapy for the past ten years. In that time, I have worked with many clients who have previously sought out counselling for depression via their GP, and who have received a few sessions of CBT through the NHS. In general, these clients have reported gaining much more benefit in gestalt therapy with me than from the CBT they received.
But that isn’t because I’m an amazing therapist. It’s because depression can’t be treated in a standardised way, and the CBT available through the NHS isn’t what a lot of people need. Which in turn isn’t to bash CBT; it’s equally valid to say some people do need that approach. The problem is the attempt to standardise something that can’t be standardised.
The key here is that therapy needs to be tailored to fit the client. And this is only possible if someone has access to a range of clinicians, coming from a range of traditions. Contemporary research in psychotherapy points to the client-therapist relationship being the biggest influencing factor in “successful” therapy.
If you want to write to your MP about this, and if you don’t already know who your MP is, you can find their details via Write To Them.
Documents from the consultation are still online here if you want to look through the draft guidelines yourself.
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