A couple of quick thoughts on reading this.
Firstly, I went to a talk at the Wellcome Institute last Monday, 26th. November, by John Forrester, who is the University of Cambridge's expert on the history of psychiatry. During the course of this seminar Professor Forrester stated, as I recall, that Lord Layard is the son of a Cambridge psychoanalyst. Can members of this discussion group confirm this and provide more information?
Secondly, in relation to the history of psychology again, it seems clear to me that there was a division between economics and psychology between the two World Wars. For instnace, in the 1920s the National Insitute of Industrial Psychology, which was just round the corner for LSE, ran a diploma course there; but this link between industrial psychology and economics at LSE was lost. Economists in recent years, apparently including Lord Layard, have realised the need to be more
sophisticated than their traditional behaviourist view of humans making optimal economic choices (Simon of course won the Nobel Prize in this area). However, economists like Layard seem to be starting from way back acadmically. "The Psychologist" has in the past published letters from me pointing out the comparative lack of economic psychology in the United Kingdom (research funding is focussed on one Psychology Department, at Exeter); but so far as I can see this state of affairs has not greatly changed.
Thirdly, Layard is politician as much as academic. He probably sees that to address wellbeing he has to propose a very specific programme, i.e. CBT. If this gets some more psychology graduates employed in a country where less than ten per cent of psychology graduates get jobs as professional psychologists, and a considerable proportion don't even get employment relevant to their degree, I would be pleased, given the large amount of
psychological distress that needs to be addressed. However, I have immense qualms about the pigeonholding of Psychology as a subject ancillary to medicine (e.g. for Research Assessment Exercise purposes), and the consequent skewing of psycholgiy towards health topics (clinical psychology, health psychology) that treat people as damaged and to be treated by a professional and bureaucratic establishement. I recollect seeing in "the Guardian" that the same is happening in relation to exercise: the Department of Health is trying to take over the provision of gyms in relation to the issue of obesity at the expense of the authorities concerned with sport. Has Frank Layard got involved in Department of health empire building, expanding to justify its existence even at the exprense of human freedom and dignity? And, as a minor point, recognition that thought and behaviour is part of all life rather than a health issue?
Frederic Stansfield
While I enjoy seeing most criticism of the good Lord and appreciated the
letter that was in the Psychologist the fact that he is (for want of a
better phrase) out of his ground on the CBT/employment literature I feel
that this is one of the weakest areas in which to criticise the LSE
depression report. I've read a couple of good trainee reviews of the
literature on employment and really Layard leaves some areas which can
be tested in this regard and evidence built up. The two pilot sites are
combining CBT with support to get back to employment.
I think the most potent criticisms of Layard in general are around areas
where variables which are apparently simple
and fixed. I think these
are: 40% of people on Incapacity benefit, the number of people who don't
access psychological treatments for cost reasons, 50% recovery from
anxiety and depression, a direct translation from RCT evidence to the
real world. Well you all are aware of these I'm sure. The issue for me
is that, when you look at these with anything other than a superficial
glance they become complex and uncertain variables and the whole thing
looks like rather weak science.
I did try and interest the quther of Bad Science in the Guardian but he
felt that his column inches were better spent on AIDS denialists and
homeopathy.
John McGowan
-----Original Message-----
From: The UK Community Psychology Discussion List
[mailto:[log in to unmask]] On Behalf Of Mark Burton
Sent: 03 December 2007 11:35
To: [log in to unmask]
Subject: 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/mo
re-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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