BMJ  2004;329:245-246 (31 July), doi:10.1136/bmj.329.7460.245

Editorial

The future of psychotherapy in the NHS

More evidence based services are taking shape to meet growing demand

The first 150 words of the full text of this article appear below.

The demand for psychological therapies in Britain has never been greater,¹ yet their claim on scientific legitimacy and therefore on public resources has never been under greater scrutiny.^{2 w1-w4} At a meeting held by the UK Council for Psychotherapy in November 2003 to address the future of psychotherapy in the NHS, the clearest messages were conflicting ones—that although the taxpaying public demands increased access to psychological therapies and the government espouses both patient choice and user centred services,¹ the evidence on the efficacy and cost effectiveness of the many different psychotherapies is patchy. Randomised trials cover only a limited number of treatments, and many treatments remain unevaluated in relation to many conditions.³ Exclusion rates of 40-70% of presenting patients limit their generalisability to the treatment seeking population,⁴ and a dearth of long term data, data on quality of life, non experimental evidence, user perspectives, and evidence of the generalisability to NHS . . . [Full text of this article]

BMJ (sgoldbeck-wood@bmj.com)

Psychoanalysis Unit, University College London, London WC1E 6BT (p.fonagy@ucl.ac.uk)

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