Does cognitive therapy work; should the NHS provide more of it for depression?

Excel­lent arti­cle in the UK’s news­pa­per The Inde­pen­dent on the grow­ing adop­tion of cog­ni­tive-behav­iour­al ther­a­py (CBT) by the Nation­al Health Ser­vice (NHS). Very rel­e­vant to the US too, giv­en that a grow­ing num­ber of insur­ers are offer­ing com­put­er­ized CBT. Quotes:

Why are we ask­ing this now?42-15315934

There is grow­ing frus­tra­tion among GPs at the dif­fi­cul­ty they face in pro­vid­ing psy­cho­log­i­cal ther­a­py for patients with men­tal prob­lems includ­ing depres­sion. A sur­vey by the Roy­al Col­lege of Gen­er­al Prac­ti­tion­ers (RCGP) pub­lished at the week­end found almost two-thirds of respon­dents said they were “rarely” able to obtain treat­ment for patients with­in two months. Get­ting help for chil­dren who had suf­fered abuse or trau­ma was even more dif­fi­cult. Pro­fes­sor Steve Field, the pres­i­dent of the RCGP, said: “Peo­ple should have access to approved treat­ments, and this has to be a wake-up call.”

What does this mean for patients?

Where­as in the past, GPs might have pre­scribed Prozac or oth­er anti­de­pres­sants, cog­ni­tive-behav­iour­al ther­a­py (CBT) is now the treat­ment of first choice – where it is avail­able – for the mil­lions who turn up com­plain­ing they can­not cope. In 2007, the Gov­ern­ment ear­marked £173m to train 3,600 extra ther­a­pists by 2010.

So why the short­age of therapists?

The cash is no longer ring-fenced and has alleged­ly been siphoned away to pay for oth­er projects. The RCGP and Mind, the men­tal-health char­i­ty, are cam­paign­ing for a com­mit­ment from all three main polit­i­cal par­ties to ring-fence cash for talk­ing ther­a­pies. The Nation­al Insti­tute for Health and Clin­i­cal Excel­lence (Nice) says CBT should be the first-line treat­ment for mild to mod­er­ate depres­sion, fol­lowed by drugs only if it proves unsuccessful.”

Keep read­ing  The Big Ques­tion: Does cog­ni­tive ther­a­py work – and should the NHS pro­vide more of it for depres­sion? (The Independent)


  1. Abbey on March 25, 2010 at 9:39

    I guess you can say that like any oth­er treat­ment known to man, it’ll all depend on how the patient responds to it. I find cog­ni­tive behav­iour­al ther­a­py to be very use­ful, but it did­n’t work for my friend.

    • Alvaro Fernandez on March 30, 2010 at 11:55

      Good point, Abbey. Yes, it is impor­tant to think of med­ical and psy­cho­log­i­cal inter­ven­tions as use­ful “tools in the toolk­it”, not as “mag­ic pills”.

  2. Dr Jamie Wilson on April 1, 2010 at 1:07

    Unfor­tu­nate­ly one of the prob­lems in the NHS is that bod­ies such as NICE rub­ber­stamp ther­a­pies such as CBT as cost effec­tive, only for there to be par­tial take­up by the Pri­ma­ry Care Trusts. There are con­sid­er­able bar­ri­ers to adop­tion in the NHS, but par­tic­u­lar­ly in men­tal health which has always been under­re­sourced. Ultra­sis, which has a Com­put­er­ized CBT plat­form called “Beat­ing the Blues” has had real dif­fi­cul­ties get­ting trac­tion despite being the only ther­a­py of its type to be NICE approved. In the­o­ry this should mean a scal­able and cost effec­tive treat­ment should be avail­able to every­one, but the post­code lot­tery persists.

    • Alvaro Fernandez on April 6, 2010 at 4:01

      Dr. Jamie — thank you for a great com­ment. Indeed, progress is often slow­er than we’d like, but in fact adop­tion of CCBT in the UK is advanc­ing very well (com­pared to the US), and we see Ultra­sis has become a very promis­ing com­pa­ny — we are includ­ing them in our next annu­al mar­ket report so that providers and insur­ers in North Amer­i­ca can per­haps emulate/ partner.

About SharpBrains

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SHARPBRAINS es un think-tank y consultoría independiente proporcionando servicios para la neurociencia aplicada, salud, liderazgo e innovación.

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