Over the last few years BACP has been working to set up the BACP Research Foundation.  This new enterprise is an independent charity which aims to develop the evidence base for counselling and psychotherapy and to disseminate research findings to the public, practitioners and commissioners about what works in therapy.  Supported by the BACP Board and by staff, the BACP Research Foundation will commission robust research using a range of methodologies, from randomised controlled trials (RCTs) to single case studies, from cohort studies to qualitative research. 

We will begin fundraising for the Foundation over the next twelve months, but to show its upfront commitment to research, the BACP Board has recently approved pump priming for an RCT comparing CBT with counselling for depression in primary care. 

This is an important trial because, at present, CBT is recommended by NICE as the evidence based treatment of choice.  As a first line treatment for anxiety and depression under the IAPT Programme, CBT therapy services have expanded enormously, whereas counselling has been cut in some areas leading to less choice of therapy and limited access to counselling for clients.

The NICE guideline for depression (NICE CG90, 2009) states that if people with depression

"decline an antidepressant, CBT, IPT, behavioural activation and behavioural couples therapy, consider counselling" but that when recommending counselling "for people with persistent subthreshold depressive symptoms or mild to moderate depression..... discuss with the person the uncertainty of the effectiveness of counselling....in treating depression".

In the NHS, which collects routine outcome data from IAPT services, counselling appears to be as effective as CBT in treating depression (Glover et al, 2010).  But routine outcome data are not included as evidence in NICE guidelines; the focus is on RCTs.  And while BACP is working with other professional bodies to engage with NICE and to draft guidelines for robust observational data to be included in guidance, we need to address the lack of RCT evidence for counselling.

This is a much needed start and a huge commitment to an evidence informed profession.  

References

Glover G, Webb M, Evison F. Improving access to psychological therapies: a review of the progress made by sites in the first roll-out year. July 2010. http://www.iapt.nhs.uk/wp-content/uploads/iapt-year-onesites-data-review-final-report.pdf

National Institute for Health and Clinical Excellence (2009) Depression: the treatment and management of depression in adults (update). CG90. London: National Institute for Health and Clinical Excellence.