Anxiety and depression – new report 2020

Sly Saint

Sly Saint

Senior Member (Voting Rights)
The National Clinical Audit of Anxiety and Depression (NCAAD) has published a new report following an audit of psychological therapies provided in secondary mental health care settings.

The audit was carried out by the Royal College of Psychiatrists in partnership with the British Psychological Society between 2018 and 2019.

The report was co-produced with our Service User and Carer Reference Group, clinical advisors, the NCAAD team and the McPin Foundation, an independent mental health research charity.

It evaluates the following key performance areas:

  • Access and waiting times
  • Appropriateness of therapy
  • Service user involvement
  • Outcome measurement
  • Therapist training and supervision
The audit found that most adults who received psychological therapy rated their therapists highly and felt helped by the treatment they received.

However, access was poor with almost half of adults waiting over 18 weeks from referral to the start of treatment.

Many service users also reported a lack of choice in key aspects of their therapy. It was also found that outcome measures were not routinely used to assess change.

Fifty NHS Trusts participated and registered a total of 232 services. 4 ,462 service users’ case notes, 662 service user surveys and 1453 therapist questionnaires were analysed.

The full report, data tables and online appendices can be found on the NCAAD webpages.
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https://www.rcpsych.ac.uk/members/y...ression-report?dm_i=3S89,13323,2H3J22,3SCFB,1

cbt watch on the report:
..it is impossible to gauge from it what proportion of those with anxiety or depression recovered with psychological treatment. There was no reliable methodology employed to determine what constituted a ‘case’ of anxiety or depression and there was no independent evaluation of outcome.

No evidence is provided that psychological therapy made a real world difference to client’s lives. The authors reported that 75% of service users agreed that their therapy helped them to cope with their difficulties, with 88% agreeing they were treated with empathy, dignity and kindness. The average number of treatment sessions attended was 13. Having made such a time investment clients are unlikely to be critical of the service they received particularly, as was usually the case, the therapist was judged a nice person.
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There is a legitimation of current practice, with implicit claims for more funding and better training, all horribly reminiscent of the failed IAPT service. The National Audit Office needs to not only re-ignite its’ inquiry into IAPT but also determine whether secondary care psychological therapy is value for money – the NCAAD provides no evidence of the latter.
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http://www.cbtwatch.com/
 
It evaluates the following key performance areas:
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Outcome measurement
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It was also found that outcome measures were not routinely used to assess change.
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Hey, if you don't measure it, no one can claim it's been shown not to work.
The audit found that most adults who received psychological therapy rated their therapists highly and felt helped by the treatment they received.
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You would find the same thing in most alternative medicine and various pseudosciences, this is not a valid reason for clinical services. Liking something is not the same thing as being effective or even a reason for funding such a service. If that's the metric, might as well just create a service where people go to be complimented. People would like the crap out of that. And so what?

I would say the same of my experience with a therapist. One of the first things I tried after meeting the wall of "we don't know what to do here". It was a nice enough experience. Utterly useless, though. It was pretty cheap but still too expensive because it was utterly useless at addressing my medical needs. I'd say about a 3/5 on the likeability scale. But it's a plain 0/5 on the effective and relevance-to-the-actual-issues scale.

There isn't even a proper reliable test for either so any claims of being effective are worthless anyway. It's a bunch of guesstimates scrambled through mathemagics. The biggest issue remains being able to identify you are actually dealing with something relevant to mental health. All evidence shows that even the thought leaders in this field are not capable of that, in fact seem utterly incapable of doing that because of ideological anchoring.
 
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