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Dear Mark and All, Re "this is a helpful statement of the issues and it would be a good outline for a statement . . . we do need a reasonably simple message" Here is a simple, perhaps overly crude, draft made by amalgamating some of the points made which seem relevant and slightly developing some of them. Please feel free to edit / add / critique/ knock it into shape and develop it. How much we support the points made depends in part on how long we will permit it to become? It is already perhaps too long Draft: CBT: a community psychological perspective The government has recently announced £170m is to be made available by 2010 to increase the availability of CBT. However, 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 the other individuals in distress one at a time with therapeutic techniques such as CBT. But even if we could train enough CBT 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. Indeed classic community psychology research suggests that untrained volunteers are usually more effective than professionals in delivering help through talking and listening. CBT is overrated as a treatment, is impossible to apply in many situations and its effectiveness is exaggerated. Even if CBT were effective, it is ideologically objectionable because it individualises social problems, draws attention away from the more important social economic and material causes of distress and positions individual cognitive dysfunction as both the cause of the person's problem and the locus for intervention. It is thus another form of victim blaming: 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 and having to undergo irrelevant therapeutic rituals on top of societal oppression. Even if CBT were not ideologically objectionable and if it were successful, if those successfully treated had to 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 will soon become distressed again. Even if they did not go back into those psychological toxic contexts, there would be an epidemic of newly damaged people coming on stream due others being subjected to the ignored social causes of distress. CBT is comprehensively problematic and primary prevention the only way to make a substantial difference with regard to socially, economically and materially caused distress. That primary prevention must involve social not cognitive change. If we agreed a statement I am not sure who it could be claimed to be made collectively by: clearly we can not make it on behalf of the members of this list (well over a hundred of us?) without some way to ensure list members are in agreement. David ________________________________ From: The UK Community Psychology Discussion List on behalf of Mark Burton Sent: Sun 14/10/2007 18:26 To: [log in to unmask] Subject: Re: The CBT announcement - who is going to tell them they've been had? Thanks - this is a helpful statement of the issues and it would be a good outline for a statement. The debate in the other posts has been interesting, but we do need a reasonably simple message. Mark > Four list members have already indicated an interest in a UKCP statement > contesting the recent bout of CBT-itis. To try to clarify the arguments > emerging, when the emails are distilled it seems to me that the following > are the key community critical psychological points made so far: > > * CBT is overrated > * CBT is ineffective > * CBT is impossible to apply in many situations > * CBT individualises social problems > * CBT distracts attention away from the pressing socio-economic causes of > trouble > > I think the following points, maybe implied, are worth making explicitly: > > The scale of socially caused distress is so vast and growing so rapidly > that it is impossible to treat it better by training indviduals to treat > others one at a time: primary prevention is the only way. But even if we > could train enough 'treaters' (which we cannot) and even if their > treatment were effective (which it isn't) and even if it were not > ideologically objectionable as a form of victim blaming (which it is) and > even if those successfully treated did not go back into the > psychologically toxic causal nexuses which had made them distressed in the > first place (which they will mostly have no alternative to doing), there > would be a tsunami of newly distressed people coming on stream due to the > unprevented social causes of distress. > > David > > > ________________________________ > > From: The UK Community Psychology Discussion List on behalf of David Fryer > Sent: Sun 14/10/2007 13:49 > To: [log in to unmask] > Subject: Re: The CBT announcement - who is going to tell them they've been > had? > > > I agree that a brief accessible community critical critique of the CBT > bandwagon is required and am willing to put some work into that. > > David > > ________________________________ > > From: The UK Community Psychology Discussion List on behalf of Mark Burton > Sent: Sun 14/10/2007 11:08 > To: [log in to unmask] > Subject: The CBT announcement - who is going to tell them they've been > had? > > > > The CBT announcement - who is going to tell them they've been had? > > So far there has been silence form community/critical/really social > psychologists about the governments announcement of £170m by 2010 for CBT. > > I propose a press release from the CPUK network making something like the > following key points: > > CBT is overrated, its supposed effectiveness being based on the flawed RCT > strategy that under-researches other less treatments less capable of > reduction to a manual, uses short term timeframes, ignores those who don't > improve, uses a restricted sample, excluding complex 'cases'. When a > broader methodology is used, (e.g. as in Seligman's Consumer Reports study > of treatments in practice see > http://horan.asu.edu/cpy702readings/seligman/seligman.html ) the evidence > for specific treament modalities disappears - the key factors seem to be > treatment duration and competence of the therapist. This is probably not > to say CBT has no place, but the claims for it are inflated. > > We all know that CBT is ineffective and impossible to apply in many of the > situations that trouble Layard - multiple deprivation and associated > problems of everyday life (see the work of the W Midlands critical > psychology group on this). > > An approach that individualises social problems and treats the casualties > does nothing to deal with the underlying causes in our profoundly unwell > social system. > > The problem is I'm not particularly expert in this area so would need > others to contribute, work up the statement. > We could also link it to some of the work in the Birmingham /York > statements. > > Quite a good article in Saturday's Guardian: > http://www.guardian.co.uk/comment/story/0,,2190258,00.html > > See also > http://www.dcu.ie/health4life/conferences/2007/resources/Health4Life2007_Keynote_Paul_Verhaeghe.pdf > for the talk referenced in the Guardian article. > > ___________________________________ > COMMUNITYPSYCHUK - The discussion list for community psychology in the UK. > To unsubscribe or to change your details visit the website: > http://www.jiscmail.ac.uk/lists/COMMUNITYPSYCHUK.HTML > For any problems or queries, contact the list moderator Rebekah Pratt on > [log in to unmask] or Grant Jeffrey on [log in to unmask] > > > -- > > The University of Stirling is a university established in Scotland by > charter at Stirling, FK9 4LA. Privileged/Confidential Information may be > contained in this message. If you are not the addressee indicated in this > message (or responsible for delivery of the message to such person), you > may not disclose, copy or deliver this message to anyone and any action > taken or omitted to be taken in reliance on it, is prohibited and may be > unlawful. In such case, you should destroy this message and kindly notify > the sender by reply email. Please advise immediately if you or your > employer do not consent to Internet email for messages of this kind. > > ___________________________________ COMMUNITYPSYCHUK - The discussion list > for community psychology in the UK. To unsubscribe or to change your > details visit the website: > http://www.jiscmail.ac.uk/lists/COMMUNITYPSYCHUK.HTML For any problems or > queries, contact the list moderator Rebekah Pratt on > [log in to unmask] or Grant Jeffrey on [log in to unmask] > > > -- > The University of Stirling is a university established in Scotland by > charter at Stirling, FK9 4LA. Privileged/Confidential Information may > be contained in this message. If you are not the addressee indicated > in this message (or responsible for delivery of the message to such > person), you may not disclose, copy or deliver this message to anyone > and any action taken or omitted to be taken in reliance on it, is > prohibited and may be unlawful. In such case, you should destroy this > message and kindly notify the sender by reply email. Please advise > immediately if you or your employer do not consent to Internet email > for messages of this kind. > > > ___________________________________ > COMMUNITYPSYCHUK - The discussion list for community psychology in the UK. > To unsubscribe or to change your details visit the website: > http://www.jiscmail.ac.uk/lists/COMMUNITYPSYCHUK.HTML > For any problems or queries, contact the list moderator Rebekah Pratt on > [log in to unmask] or Grant Jeffrey on [log in to unmask] > > > ___________________________________ COMMUNITYPSYCHUK - The discussion list for community psychology in the UK. To unsubscribe or to change your details visit the website: http://www.jiscmail.ac.uk/lists/COMMUNITYPSYCHUK.HTML For any problems or queries, contact the list moderator Rebekah Pratt on [log in to unmask] or Grant Jeffrey on [log in to unmask] -- The University of Stirling is a university established in Scotland by charter at Stirling, FK9 4LA. Privileged/Confidential Information may be contained in this message. If you are not the addressee indicated in this message (or responsible for delivery of the message to such person), you may not disclose, copy or deliver this message to anyone and any action taken or omitted to be taken in reliance on it, is prohibited and may be unlawful. In such case, you should destroy this message and kindly notify the sender by reply email. Please advise immediately if you or your employer do not consent to Internet email for messages of this kind. ___________________________________ COMMUNITYPSYCHUK - The discussion list for community psychology in the UK. To unsubscribe or to change your details visit the website: http://www.jiscmail.ac.uk/lists/COMMUNITYPSYCHUK.HTML For any problems or queries, contact the list moderator Rebekah Pratt on [log in to unmask] or Grant Jeffrey on [log in to unmask]