Controversies in Management Psychotherapy - a luxury the NHS cannot afford? More expensive not to treat

BMJ 1994;309:1070-1071 (22 October)

Education and debate

Controversies in Management Psychotherapy - a luxury the NHS cannot afford? More expensive not to treat

J Holmes

Northern Devon Healthcare Trust, Barnstaple, Devon EX31 4RT.

Psychotherapy is "the systematic use of a relationship betweentherapist and patient - as opposed to physical or social methods- to produce changes in cognition, feelings and behaviour."¹Psychotherapy, or perhaps more usefully "the psychotherapies,"is a generic term covering a spectrum of treatments that canbe grouped under four main headings: analytic therapy, cognitivebehavioural therapy, systemic (or family) therapy, and creativetherapies such as psychodrama and art therapy. Each of thesecan be brief or long term and delivered to individuals, couples,or families and groups. I shall consider the case for the psychotherapiesunder three main headings: empirical, economic, and ethical.

Controversy about the empirical evidence for the value of psychotherapycontinues, although the debate has moved on considerably sinceEysenck's ill fated attempt to discredit it in the 1950s. Meta-analysishas provided overwhelming evidence for the usefulness of psychotherapy,which produces "effect sizes" of . . . [Full text of this article]

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