yes; the history of persuasion teaches us, doesn't it, that (at least in the west) new expert based approaches to psycho -social distress come and go as times and fashions change, and have roughly comparable levels of (in) effectiveness . There is no reason to think that CBT will be any different. But as you say penny, I too don't see changes in current government thinking happening any time soon, especially given our current pre-occupation in the west with standardisation and bureacratic control
What remains disappointing is the lack so far of much realisation of community psychology's potential for contributing to a public health approach to psycho-social suffering, in the way that public health approaches have addressed some aspects of physical health suffering (contagious diseases in particular). What are the connections and inter-actions between fundamental/ causal processes and various malaises in western capitalist societies/ environments ( and our export of our economically and socially oppressive processes to other cultures) including selfish global capitalism, global warming, climate change, ecological damage, depression and anxiety, loneliness and reductions in social support and naturally occuring social buffering of distress, bullying, the hedonic treadmill, excessive consumption, obesity and social inequality - and how can a really social critical psychology could contribute to understanding and transforming those processes. At the moment we seem in danger ( are we?) of going back on all the socially progressive changes that the trade union movement and various human rights movements (including feminisms, disability rights, gay rights etc etc ) contributed to, and instead entering a world dominated by various aspects of fundamentalist thinking.
In the face of social/ environmental stressors are we losing our resilience and capacity to act in solidarity and to be be creative/ innovative/ exploratory and ( pace david Fryer) empathic and compassionate?
The space to develop innovative alternative preventative actions informed by critical and really social psychology seems to be shrinking as (some of us) become ever more pre-occupied with mind numbing bureacracy and accounting ( quality management...), the seductions of amelioration (and in particular with increasing access to psychological therapies) alongside wrangles/ struggles with professional competitiveness and status ( fuelled by various processes including competitive tendering and Universities' domination by competititive accountancy based evaluations of research for RAE purposes and, within applied psychology (esp clinical) narrow medical model views of what consititues evidence based practice), while at the same ttime our promotion of expert based solutions ever further undermines community based naturally occuring processes of cameraderie, collective resistance, mutual listening, social support etc . Or, was it ever thus in psychology, and perhaps there are some indicators that psychology in britain is looking up ( out): eg the existence of this network, and of the new BPS social inclusion discussion list, our links with European community psychology, david's work and that of others on climate change with the BPS, and the change in emphasis from diagnostic models to formulation models in clinical psychology and 2 chapters on social inequalities approaches to formulation in the Dallos and Johnston book etc etc ?
As others have said, I wonder though whether our current pre-occupation with Layard et al on this list is a distraction from perhaps more fundamental and disturbing issues ( including those that Karolyn raises in her letter re state security) ?
Annie
________________________________________
From: The UK Community Psychology Discussion List [[log in to unmask]] On Behalf Of Penny Priest [[log in to unmask]]
Sent: 03 December 2007 19:42
To: [log in to unmask]
Subject: Re: This Month's 'The Psychologist' - Layard and state security
The next issue of Clinical Psychology Forum is a special issue featuring a
lead article about the Doncaster pilot. Graham Turpin invited various people
to respond to the main article. The Midlands Psychology Group responded with
two articles, one which will appear alongside the Doncaster pilot article
and one which will appear probably in the next issue. I can attach the
articles to this list when they appear. There seems to be a steady trickle
of people questioning Layard and the Increasing Access to Psychological
Therapies experiment, but I think it is unlikely that this will lead to any
great waves in the short term, but maybe I'm just too pessimistic.
Penny
----- Original Message -----
From: "Mark Burton" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, December 03, 2007 11:34 AM
Subject: [COMMUNITYPSYCHUK] This Month's 'The Psychologist' - Layard and
state security
This email covers 2 things - the Layard CBT issue, and the
torture/interrogation issue.
1) Layard
List members might like to comment on the first news item in this month's
'Psychologist' magazine (the BPS monthly).
http://www.bps.org.uk/publications/thepsychologist/extras/pages$/2007/more-funds-for-mental-health.cfm
It mention's the new money and the emphasis on CBT. It interviews Graham
Turpin (one of the BPS experts on the Improving Access to Psych therapies
reference group). Turpin's main concern seems to be the usual craft union
interest that, to quote - 'These new CBT therapists shouldn't threaten job
prospects for psychologists'. He also gives a response to suggestion that
this initiative is motivated by getting people back to work (there is no
mention that the argument is actually that this isn't a problem, the
problem is the idea of cutting benefits for those who are chroniclly
sick).
Although our press release http://www.compsy.org.uk/changing%20minds.pdf
was sent to The Psychologist there is no mention of our critique of the
whole approach.
There is, however this letterfrom James Japp, Dunblane and list members
might like to use this as a hook for a response:-
Layard's folly
Lord Layard is obviously a capable and well-meaning individual but does
any psychologist, regardless of discipline, really believe that an average
of 10 sessions of CBT is sufficient input as a strategy for returning
those with a mental health condition on long-term incapacity benefit back
into work? Lord Layard puts forward well-argued and perfectly valid points
for CBT as a health solution to alleviate anxiety and depression in the
sizable population who unfortunately suffer from a mental health
condition. However, he then skips to CBT as a solution to long-term
intransigent unemployment without any supporting evidence or logical
rationale for the therapy itself. Counselling (CBT or any other form) can
be excellent as an early intervention, particularly for job retention but
what it is not is 'evidence-based practice' for long-term intransigent
unemployment.Individuals fail to progress from incapacity benefit to
employment for a whole host of practical reasons that cannot be moderated
by counselling including: poor literacy skills, a low general skill base,
contentedness with current position in life, low stamina levels, lack of
opportunity, employer prejudice, a second disability, cultural attitude,
being less well off working than on incapacity benefit, and inability to
identify job sources to mention a few. Furthermore, a number of
psychosocial issues not necessarily related to the mental health condition
including: low confidence, poor social skills, socialised low
expectations, or fear of failing may also need addressed.The long-term
unemployed require holistic intervention with active support on a number
of fronts and which is sustained long after employment has commenced. The
actual mental health condition comes fairly low in the list of priorities;
there are plenty of examples of individuals with chronic mental health
problems holding down employment. CBT is not the solution to reducing the
numbers on incapacity benefit, but holistic and supportive intervention
that identifies and addresses all the needs of the individual can be, and
if the patient buys into it, this may well include CBT.
James Japp
Dunblane
2) Psychologists and State security / torture / interrogation
You can also see our letter on torture on the same page (723)
Here it is for those who aren't members and therefore can't access -
Psychologists and national security
Karen Carr from the Defence Academy of the UK (Letters, October 2007)
perhaps not surprisingly contends that 'psychology should be used in a
controlled way to help with our very difficult security and defence
problems'. But as the events we outline show, the control will not be by
democratic institutions, nor by professional bodies, but by the
institutions of state security themselves. Involvement in them implies the
kind of Faustian pact in which the leadership of the APA has now been
exposed. In that case it was the professional body itself that was
corrupted, but the same pressures and processes will operate
elsewhere.That is why psychologists should not be present in the military
and in secret prisons - presence in these organisations legitimates their
existence and they stand no chance of ameliorating their regimes. Of
course, we do not know if psychologists are working in the secret services
(we have to assume they are), but their practice there is not subject to
the kind of democratic scrutiny that Karen calls for. Thus it lacks
safeguards, the accountability being to unfettered State interests and not
to the public interest that, however muted, is still present in, for
example, the prison service and other criminal justice settings. Because
our democracy is so conditional and flawed it cannot serve as the
safeguard that substitutes for a self-imposed ethical practice, including
refusal to engage in the undemocratic structures of institutional
oppression that are the more secretive parts of the State's apparatus.
Mark Burton
Carolyn Kagan
Manchester Metropolitan University
Mark Burton
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For any problems or queries, contact the list moderator Rebekah Pratt on [log in to unmask] or Grant Jeffrey on [log in to unmask]
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