Intended for healthcare professionals

Clinical Review

ABC of mental health: Psychological treatments

BMJ 1997; 315 doi: (Published 20 September 1997) Cite this as: BMJ 1997;315:733
  1. Phil Richardson


The range of procedures that pass for a psychological treatment is broad. Over 450 distinct forms of psychotherapy have been identified, although many can be reduced to a narrower set of therapy types. The great diversity of available psychological treatments remains a potential source of confusion for referrers, service users, and purchasers. Confusion may also surround standards of training and practice. Training in psychotherapy and counselling abounds in Britain, which has no formal registration for either activity and no single professional accreditation body.

Psychological treatments most commonly available in NHS

  • Cognitive-behaviour therapy

  • Psychodynamic psychotherapy

  • Family therapy

  • Group therapy

  • Various forms of counselling

  • Eclectic and integrative approaches

The recent review of psychotherapy services in the NHS underlines the efficacy and importance of psychological treatments for mental disorders. A joint statement from the British Psychological Society and Royal College of Psychiatrists identifies the need to develop integrated psychological therapy services within the NHS that can offer assessment, treatment, and training in psychological treatments.

Referral to a coordinated psychological treatments service may obviate the need for general practitioners and others to make difficult referral decisions about particular forms of treatment. However coordinated treatment services are not yet widely available, and referrers may be left to find their way through a maze of local services.

Cognitive-behaviour therapy

Cognitive-behaviour therapy

  • Based on both behavioural and cognitive theories

  • Structured

  • Prescriptive rather than primarily exploratory

  • Uses formal techniques for behavioural or cognitive change

  • Focused on enabling patients to think and act differently

  • Individual or group

  • Short term or long term

  • Inpatient or outpatient

  • Typically, it is offered on an individual outpatient basis for a limited course (between 8 and 24 weekly therapy sessions)

The term cognitive-behaviour therapy refers to a group of therapies that include behaviour therapy, behaviour modification, and cognitive therapy in various combinations. Despite their theoretical distinctness, the dividing line between cognitive and behaviour therapies is …

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