The British Association for Counselling and Psychotherapy (BACP) has called for the government to widen the choice of psychological therapies available to NHS patients.
In its response to the Department of Health’s (DH) consultation on Refreshing the Mandate for NHS England for 2014 to 2015, BACP has also investment in training to improve access to psychological therapies. The Mandate sets the government’s ambitions for the NHS as well the funding available to it.
In addition to cognitive behavioural therapy (CBT), the National Institute for Health and Care Excellence recommends four types of therapy, including person-centred counselling for depression (CfD), in which only 5% of the Improving Access to Psychological Therapies (IAPT) workforce has received formal training. BACP argues that by providing brief top-up training to 1,000 person-centred counsellors in CfD the NHS can reduce waiting lists and improve the effectiveness of therapy at a low cost.
BACP said this option would complement the now substantive CBT workforce in IAPT and would be about a third of the cost of recruiting inexperienced therapists and providing full CBT training, which takes at least a year to complete.
Patients who receive a programme of therapy that they have chosen are more likely to complete the course of treatment than those who have not, according to research. Further evidence shows that choice improves patients’ wellbeing and makes them five times more likely to report that therapy helped them back to work.
In its consultation, which closed on September 27, the DH proposed to require the NHS to take action on improving access and imposing waiting time standards for mental health services. BACP welcomed this but warned that the IAPT programme’s over-emphasis on the delivery of CBT leads to minimal choice for patients.
Laurie Clarke, BACP chief executive, said: “The government has failed to deliver on its 2010 promise to diversify the mix of evidence-based counselling available in the NHS. Their process to refresh the Mandate is a perfect opportunity to remedy this. By providing brief, cost-effective, top-up training in counselling for depression to 1,000 experienced counsellors, the NHS could make a significant impact on waiting times, and by widening the choice of therapy, outcomes would be significantly improved.
“Through implementing the IAPT programme, the government has made substantive in-roads to improving access to CBT, which is an effective form of counselling for some people and some presenting problems. CBT will not work for everyone or every situation, however, and there is evidence to suggest that giving patients choice can improve outcomes.”