Yes I pretty much agree - but if you won't define it David.....

> The various posts perhaps lead us to consider what we want a list like
> this to be and what we want to be able to do on it and with it. I am a
> member of the community psychology discussion list because I want to
> discuss community psychology rather than for example clinical psychology
> or positive psychology or psychiatry. It is not that I do not think
> discussion of clinical or positive psychology or psychiatry should not
> take place or are not worthwhile but there are lots of places to discuss
> them whereas there are very few places where one can discuss community
> psychology. I want to see how far we can get using community psychology
> and how we can develop community psychology to be able to do more less
> problematically.
> David
>
>
> ________________________________
>
> From: The UK Community Psychology Discussion List
> [mailto:[log in to unmask]] On Behalf Of richard pemberton
> Sent: 21 October 2007 13:20
> To: [log in to unmask]
> Subject: Re: Mental Health Policy
>
>
> I think this letter is very good. But continuing to plow my 'positive'
> theme. Just suggesting that takling income inequality is the best primary
> prevention measure begs all sorts of interesting questions. Its an
> ecomonic remedy for the human condition? What are we saying are the other
> effective ways? Layard and Johnson are surely just mirroring all sorts of
> interesting cultural norms and the sucess of psychology and psychiatry in
> giving a language and licence for new frameworks for understanding despair
> madness and fear. Whats obviously missing is the social context for all
> this. Just to reverse the polarity and say its all social and economic is
> equally strange and limiting? .
> The way I am manging this in my job is to ask what needs to be in place
> for this Layardism not to bounce? Hence step zero. How do we increase
> opportunities for solidarity based sense making? How do we set this in a
> reasoned public health agenda where the levles of 'social recession' in a
> particular locality are known and well understood. Layard himself really
> is trying to get into this. If people have been given a meaningful choice,
> I am pretty relaxed if people want help with their 'bad thinking'.
> Sometimes I need help with my own. When I was a therapist I surprised by
> how helpful people found it to learn to stand outside themselves. People
> who were very low benfited much more than I would have expected from for
> example keeping a diary. I dont think I was contributing to their
> oppression. What I think is important is the connectedness between
> individual and social spaces and experiences good and bad
> This involves changing the way we think about them and live within them.
> I wonder if people have read the royal college of psychiatry document
> recovery a common purpose. This invites a complete rethinking of practice
> and education. Its much more first person than third person and seems to
> me to be explicitly social model based.  One report doesnt represent a
> summer. Its dead interesting though that something as social as this is
> coming out of psychiatry.
> After I gave my talk on recovery wellbeing and positive psychology last
> week.  I was approached by a member of the audience to say that they were
> about to set up a local community psychology network! Something definately
> seems to be in water.
>
> Richard
>
> On 10/21/07, julie bird <[log in to unmask]> wrote:
>
> 	Mark (and all)
>
> 	..... 349 words... cut and paste.. but it might not be the cut and paste
> job that you would have done...
>
> 	(i'm getting caught up in wondering whether how we have signed suggests,
> however subtly, that you are either a 'service user'/survivor, OR an
> academic etc etc...  am i going off on one here, or does anyone else
> think this is what could be read?does it matter? would be nice to know
> what others think).  is it pedantic again? i'm not sure..
>
> 	Changing politicians' minds about changing our minds?
> 	We write in response to the Health Secretary's recent announcement that
> £170m is to be made available by 2010 to increase the availability of low
> intensity, high volume, psychological interventions. At present Cognitive
> Behaviour Therapy (CBT) is the preferred approach.   While we welcome the
> belated recognition of widespread emotional distress in our community,
> and applaud the government's willingness to spend public money on it, we
> have a number of serious reservations about the approach adopted.
>
> 	CBT, and all like treatments, individualise social problems, draw
> attention away from the more important social, economic and material
> causes of distress and propose individual cognitive dysfunction as both
> the cause of people's problems and as the most appropriate site for
> intervention.   Using a medicalised metaphor of 'illness' to describe
> human misery distracts attention away from the noxious effects on persons
> of structural poverty, unemployment, job insecurity, violence, abuse,
> racism, sexism, inequality and consumerism (among others) which are the
> root causes of human distress.
> 	Briefly, the scale of socially caused distress is so vast, and growing so
> rapidly, that it is impossible to 'treat it better', let alone 'cure' it,
> as Mr Johnson and Lord Layard have suggested, by training more
> therapists. It is, simply, not feasible to treat all of those in
> distress, one at a time, with any therapeutic technique.
>
> 	The approach announced is, we argue, not only conceptually misguided, but
> also likely to be socially and economically wasteful of scarce resources.
> Even assuming therapeutic success, when 'treated' many or most distressed
> people will return to the same psychologically toxic environments that
> produce distress and will be subjected to the same causes of distress all
> over again. CBT and associated approaches are thus comprehensively
> problematic. Primary prevention of distress at a society-wide level - not
> the 'cure' of individuals - is the only way to substantially reduce
> socially, economically and materially caused misery.
> 	Contemporary research shows that reducing income inequality in our
> society would be just one of the most effective ways to reduce
> psychological distress and physical ill health - not just for the
> disadvantaged - but across society in general.
>
>
> ________________________________
>
> 		Date: Fri, 19 Oct 2007 21:23:57 +0100
> 		From: [log in to unmask]
> 		Subject: Fwd: Mental Health Policy
> 		To: [log in to unmask]
>
>
> 		All
> 		Looks like I have a busy weekend.......
> 		M
>
> 		PS My affiliation and grandiose title not self-serving, all the papers
> seem to insist on a daytime phone number and address ;)
>
> 		---------- Forwarded message ----------
> 		From: [log in to unmask] < [log in to unmask]
> <mailto:[log in to unmask]> >
> 		Date: 19 Oct 2007 11:42
> 		Subject: Re: Mental Health Policy
> 		To: Mark Rapley < [log in to unmask] <mailto:[log in to unmask]> >
>
>
> 		Dear Mark
> 		Thanks. It's an interesting subject, but I'm afraid far too long at its
> current length; the letters we publish are a maximum of 350 words. If
> you would like to cut it and resubmit I'd be happy to look at it again.
> 		Jane
>
>
>
> "Mark Rapley" <[log in to unmask]> 19/10/2007 11:29
> 	To
> "[log in to unmask]" < [log in to unmask]
> <mailto:[log in to unmask]> >
> cc
>
>
> Subject
> Re: Mental Health Policy
>
>
>
>
>
>
>
>
> 		Dear Jane
> 		As requested.
> 		Best wishes,
> 		Mark
>
> 		                                                19th October 2007
>
>
>
> 		Dear Editor,
>
> 		Changing politicians' minds about changing our minds?
>
> 		We write in response to the Health Secretary's recent announcement that
> £170m is to be made available by 2010 to increase the availability of
> low intensity, high volume, psychological interventions. At present
> Cognitive Behaviour Therapy (CBT) is the preferred approach, to be
> delivered at primary care level to adults of working age, by people who
> have some basic training.
>
> 		While we welcome the belated recognition of widespread emotional
> distress in our community, and applaud the government's willingness to
> spend public money on it, we have a number of serious reservations about
> the approach adopted. Briefly, the scale of socially caused distress is
> so vast, and growing so rapidly, that it is impossible to 'treat it
> better', let alone 'cure' it, as Mr Johnson and Lord Layard have
> suggested, by training more therapists. It is, simply, not feasible to
> treat all of those in distress, one at a time, with any therapeutic
> technique.
>
> 		Even if we could train enough practitioners, there is good reason to
> believe that one-to-one talking treatments administered by professionals
> are mostly only marginally effective. While it is certainly the case
> that a wealth of evidence exists to suggest that
> professionally-delivered therapy, in the hands of some practitioners,
> for some people, may be of some benefit, effect sizes tend to be small.
> However, and the widely cited NICE Guidelines overlook this, the
> research base is also clear that not only may lay people be as effective
> as professionals in delivering help through talking and listening, but
> also that all talking therapies are effectively equivalent, and
> equivalently limited, especially for those in the most difficult living
> circumstances.  This is so even when delivery is organised through the
> stepped care model that runs from use of self help guides to full
> therapeutic interventions.
>
> 		That is to say, not only is the effectiveness of CBT and kindred
> interventions - in any hands - widely exaggerated, but they are
> impossible to apply in many 'real world' situations and with many
> people. Indeed the widely reported 'cure' rates in the studies relied on
> by the government and its advisers are, actually, quite likely an
> artefact of the highly controlled nature of the randomised controlled
> trials (RCTs) which purport to demonstrate their effectiveness. As with
> all such clinical trials, RCTs by their very design can not, and do not,
> reflect the 'real world' where treatment is actually applied. As such,
> framing policy via reliance on their artificially-inflated success rates
> is either scientifically naive or politically expedient, or both.
>
> 		Moreover CBT, and all like treatments, individualise social problems,
> draw attention away from the more important social, economic and
> material causes of distress and propose individual cognitive dysfunction
> as both the cause of people's problems and as the most appropriate site
> for intervention. We note that a compelling account of the factors which
> have produced the present, and remarkably recent, 'epidemic' of
> individual cognitive dysfunction seems to be absent from the analyses
> that government has offered to date. We also note that the relentless
> focus on the individual, and their supposed cognitive deficits,
> illicitly employs a medicalised metaphor of 'illness' to describe human
> misery and thus distracts attention away from the noxious effects on
> persons of structural poverty, unemployment, job insecurity, violence,
> abuse, racism, sexism, inequality and consumerism (among others) which
> are the root causes of human distress. It is, surely, bad enough to be
> depressed because of difficult living circumstances or to be anxious
> because you are subjected to regular domestic violence, without
> currently popular theory suggesting your depression or anxiety are
> caused by your own irrational thinking. Blaming the victim like this
> simply proffers therapeutic ritual as a cure for societal oppression,
> whilst at the same time placing responsibility for distress and its'
> resolution onto the individual.
>
> 		The approach announced is, we argue, not only conceptually misguided,
> but also likely to be socially and economically wasteful of scarce
> resources. Even assuming therapeutic success, when 'treated' many or
> most distressed people will return to the same psychologically toxic
> environments that produce distress and will be subjected to the same
> causes of distress all over again. If they do not go back into
> immediately toxic contexts, there will still be a flood of newly damaged
> people as a result of the persistence of the social causes of distress
> ignored under present mental health policy settings. CBT and associated
> approaches are thus comprehensively problematic. Primary prevention of
> distress at a society-wide level - not the 'cure' of individuals - is
> the only way to substantially reduce socially, economically and
> materially caused misery.
>
> 		To be effective, primary prevention necessitates social not cognitive
> change. Contemporary research shows that reducing income inequality in
> our society would be just one of the most effective ways to reduce
> psychological distress and physical ill health - not just for the
> disadvantaged - but across society in general.
>
> 		Signatories
>
>
> 		Julia Bird, Jan Bostock, Mark Burton, Julie Chase, Deborah Chinn, Paul
> Cotterill, John Cromby, Dawn Darlaston-Jones, Bob Diamond, Paul Duckett,
> Suzanne Elliott , Michael Göpfert, Dave Harper, Carl Harris, Carolyn
> Kagan, Valeska Matziol, Steve Melluish, Annie Mitchell, Paul Moloney,
> Moira O'Connor, Penny Priest, Mark Rapley, David Smail, Janine
> Soffe-Caswell and Carl Walker on behalf of the UK Community Psychology
> Network, a group which includes academics, campaigners, mental health
> service users and survivors, health and social services managers,
> clinical psychologists, students and volunteer workers.
>
> 		Mark Rapley, PhD,
> 		Professor of Clinical Psychology,
> 		Programme Director - Doctoral Degree in Clinical Psychology,
> 		School of Psychology,
> 		University of East London,
> 		London, E15 4LZ,
> 		U.K.
>
> 		Tel:   +44 (0)208 223 6392 (Direct)
> 		Tel:   +44 (0)208 223 4567 (Messages)
> 		Tel:   +44 (0)7951 908409  (Mobile)
>
>
> 		On 19/10/2007, [log in to unmask]
> <mailto:[log in to unmask]> <[log in to unmask]
> <mailto:[log in to unmask]> > wrote:
>
> 		Please could you resend this letter as an email; we are unable to accept
> attachments.
> 		Jane Campbell
> 		Letters
>
>
> "Mark Rapley" < [log in to unmask] <mailto:[log in to unmask]>  >
>
> 19/10/2007 10:40
>
>
>
>
> To
> [log in to unmask] <mailto:[log in to unmask]>
> cc
>
>
> Subject
> Mental Health Policy
>
>
>
>
>
>
>
>
>
>
> 		Dear Editor,
> 		I attach a letter for publication from the UK Community Psychology
> Network.
> 		With best wishes,
> 		Yours sincerely,
> 		Mark Rapley
>
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