Year: 2009
Type: book
Abstract: The National Institute for Health and Clinical Excellence (NICE) this year updated The NICE clinical guideline for the treatment of depression in adults. The British \nPsychoanalytic Council, Association for Psychoanalytic Psychotherapy in the NHS, \nAnna Freud Centre, and Tavistock and Portman NHS Foundation Trust as a group contributed to the consultation, cautiously welcoming the draft, but disagreed with \nthe way that NICE had assembled its evidence, favouring CBT at the expense of other psychological therapies. \nThe NICE Guideline on Depression in Adults makes clear the complex nature of depression and its clinical and social importance.It highlights the important role of psychological therapies in the treatment of depressive disorders. \nIt recognises the importance of maintaining a plurality of treatment and not withdrawing established psychotherapies. \nThe scope of the guideline is limited by a narrow, undifferentiated and simplistic conception of depression. It unhelpfully restricts itself to randomised controlled \ntrials, and excludes naturalistic trials despite their advantages in assessing psychotherapeutic treatments and treatments in the real world. \nThe evidence of the lasting effects of long-term psychotherapy in depression is not reviewed despite the evidence that depression is frequently chronic or recurring \nand the evidence of the limited effect of short-term treatments. The guideline fails to consider the importance of individual patient preferences or different types of depression, leading to restrictive and misleading one-size-fits-all recommendations. The evidence presented, in keeping with the scientific literature, demonstrates \nequivalence between Cognitive Behavioural, Interpersonal, and Short Term Psychodynamic Psychotherapies. \nThe guideline misleads by recommending CBT based on the number of studies supporting it. \nCBT for depression provided through the Improving Access to Psychological Therapies services has not to date shown itself more effective or acceptable to patients in the real world than non-CBT therapies. \nThere is an urgent need for well-funded trials to explore if those who do not respond to CBT can benefit from other forms of treatment including psychodynamic psychotherapy and the extent to which long-term treatments have superior \noutcomes in the medium or long-term.
Author: Daniel McQueen
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2891696481