Medium and longer-term therapy services in the NHS are under grave threat, and cutbacks are already increasing the amount of negative outcomes for clients, a national survey by leading professional bodies has found.
A survey of some 800 NHS members of the British Psychoanalytic Council (BPC) and the UK Council for Psychotherapy (UKCP) painted a worrying picture for the sector. For instance, more than three quarters (77%) of therapists reported negative outcomes for clients as a result of cuts to psychotherapy services such as longer waiting lists, premature ending of treatment and reduced choices around therapy types.
Waiting too long for therapy or getting the wrong type of therapy or not enough of the right type could lead to increases in clinical symptoms, therapists warned.
The survey also found that there is a greater need for services, but less of them. While more than two thirds (68%) reported that they are being relied upon to deal with increasingly complex cases, at the same time there is increasing pressure to use much shorter-term (cognitive behavioural therapy-informed) interventions that are not suitable for all clients.
In addition, it seems that fewer psychotherapy services are being commissioned, with 48% noting decreases in the number of services bought, with only 5% reporting increases. The number of psychotherapy posts also appears to be falling, with 63% of therapists reporting decreases in the past year.
Meanwhile, service users are increasingly seeing less experienced therapists. In the survey, 47% of therapists noted a decrease in the clinical experience of those providing psychotherapy, with only 8% reporting increases.
Additionally, 39% of therapists noted decreases in the qualifications of those providing psychotherapy with only 10% seeing increases.
Gary Fereday, chief executive of the BPC, said: “The Government promised to expand access to talking therapies through its Increasing Access to Psychological Therapies scheme. Funding for this was to provide additional therapy services and not replace existing ones. This survey shows that this is not what is happening as many existing non-IAPT services, which are often best placed to help those in most need, are seeing posts cut and downgraded while dealing with increasingly complex cases.
“IAPT services are helping many people, but the service was intended to be a way of improving access, and not become the only service available, particularly when for some it's not a suitable service at all. We want to ensure real choice for patients to ensure the best patient experience, outcomes, and cost effectiveness for the taxpayer.”
Janet Weisz, chair of UKCP and an NHS psychotherapist, said: “This joint survey confirms what our members are reporting from across the country – NHS psychotherapy is under grave threat.
“Government and commissioners must recognise that we need a variety of therapy services to deal with the needs of different people – one size does not fit all.
“The IAPT scheme specialises in helping those with mild anxiety and depression to improve. That has shown signs of success.
“But those with deep psychological traumas relating to things like abuse, neglect and bereavement need the time, space and trusting relationship that psychotherapists can provide.
“That need cannot be met within the current IAPT scheme and we must ensure that these specialist NHS psychotherapy services are protected and expanded.”