Dear David, Thanks for this and for the chance to have a final comment. It is looking good, and I like the title and summary statement. 2 points. . ( acknowledging I am maybe just being too picky now)
1) I don;t want to be make comparisons with clinical psychologists as if to imply that level of training is some sort of ideal ; I suggest change the wording at the end of sentence 1 under notes for editors to " by people who have some basic training" instead of " by people who have shorter training than clinical psychologists".
3) , my understanding is that the planned low volume high intensity interventions are to be based on what's called a stepped care model, starting with guided self-help, using techniques drawn from cognitive behaviour therapy , and leading from low level interventions to more complex interventions for those whose anxiety/ depressions is not helped by the less intensive interventions. Critics of our statement would say that the whole point of these low volume high intensity interventions are to deal with the very issue that there will never be enough people to go round 1:1 for everyone who "needs help". I don't seem to be able to find the concise wording needed to capture the argument here, but am aware tht our statement as it stands, unless it acknowedges this, risks being seen as insufficiently aware of what is actually intended. David, can you find a wording that would capture this.. sorry; too late at night now for my brain to work properly.
Annie
-----Original Message-----
From: The UK Community Psychology Discussion List on behalf of David Fryer
Sent: Mon 15/10/2007 21:52
To: [log in to unmask]
Subject: Re: The CBT announcement - who is going to tell them they've been had? Penultimate version?
Dear All,
Below please find the revised penultimate version of the statement as promised. I have tried to incorporate all the suggestions made which are consistent with community critical psychology as I understand it. I apologise in advance for the points I have missed or garbled.
6 preliminary points
1.
I revised my draft statement in line with posts posted before 1900 before looking at Mark's and Julie's suggested versions. I amended it again to accommodate some of Mark's points which had not already been amended (many had).
2.
I preferred to stick with the version which has been considered on this list rather than Julie's more popular version. It might seem just a matter of style but the version which has evolved below is a condensation of lots of quite carefully made points and I would personally prefer not to lose those.
3.
I think it has been important for this whole process to be open and I would prefer the final stages to done in public on the list too personally.
4.
I did not add in comments about 'self actualisation/realisation of human potential set in within the context of the communities and society we live in' or 'PSA 16 Agreement' because I see them both as critically problematic, think others might too and think we should stick with what has been generally agreed
5.
I have intended to append as signatories only and all the names of people who explicitly asked to have their names included. Some people may have thought that was implied. If your name is not there and you wish it to be, please make that clear ASAP.
6.
Apologies if the snappy 'title' is not snappy enough for you
David
For immediate release
Statement
Changing politicians' minds about changing our minds
"Cognitive Behaviour Therapy and associated approaches are comprehensively problematic. Primary prevention is only way to substantially reduce socially, economically and materially caused distress. To be effective primary prevention must involve social rather than cognitive change. Reducing income inequality in our society would be one of the most effective ways to reduce psychological distress and ill health" says the UK Community Psychology Network.
Notes for Editors:
The government has recently announced £170m is to be made available by 2010 to increase the availability of low intensity, high volume, interventions, of which Cognitive Behaviour Therapy (CBT) is currently the most favoured, to be delivered at primary care level to adults of working age by people who have shorter training than clinical psychologists.
We welcome the recognition of widespread emotional distress and the will to spend public money on it but the scale of socially caused distress is so vast and growing so rapidly that it is impossible to 'treat it better' by training enough individuals to treat all individuals in distress one at a time with any therapeutic technique.
Even if we could train enough of such practitioners, there is little reason to think that the one to one talking treatments by professionals are more than marginally effective in the hands of some practitioners for some people, especially those in the most difficult living circumstances
Whilst classic community psychology research suggests that untrained volunteers are usually more effective than professionals in delivering help through talking and listening, the effectiveness CBT and kindred interventions in any hands is widely exaggerated and they are impossible to apply in many situations.
Moreover these treatments individualise social problems, draw attention away from the more important social economic and material causes of distress and position individual cognitive dysfunction as both the cause of the person's problem and the locus for intervention.
It is bad enough to be depressed because you have been unemployed or to be anxious because you are subjected to regular domestic violence without being told your depression or anxiety are caused by your own dysfunctional cognitions. Blaming the victim like this imposes irrelevant therapeutic rituals on top of societal oppression
Besides, when those treated go back into the psychologically toxic contexts which had made them distressed in the first place, to which many or most will have no alternative, they are subjected to the same social causes of distress all over again and if those treated do not go back into those psychological toxic contexts, there will still be an epidemic of newly damaged people coming on stream due others being subjected to the ignored social causes of distress.
Cognitive Behaviour Therapy and associated approaches are comprehensively problematic and primary prevention is only way to substantially reduce socially, economically and materially caused distress. To be effective primary prevention must involve social rather than cognitive change. Contemporary research shows that reducing income inequality in our society would be one of the most effective ways to reduce psychological distress and ill health.
John Cromby
Bob Diamond
David Fryer
Annie Mitchell
Paul Moloney
Penny Priest
Mark Rapley
David Smail
on behalf of the UK Community Psychology Network
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