In this issue
Meeting the demand for evidence-based practice
How can the counselling community come to terms with the need for RCT evidence to support the commissioning of counselling in the public sector?
Developed in Israel, nonviolent resistance is a model designed to help parents and carers deal with destructive behaviour in adolescents.
Choosing to change
A motivational approach to domestic violence and abuse work, based on the evidence-based Motivational Interviewing, is being piloted by Relate in Exeter.
My hometown swept away
A Japanese BACP counsellor based in the UK tells of her experience of the recent earthquake and tsunami and explores the mixed blessing of Japanese resilience and stoicism.
Kevin Chandler: A taste for intimacy
In the client's chair
Orla Murray: Going at my own pace
Alex Erskine: The drama of therapy
From the chair
Dr Lynne Gabriel: Celebrating our achievements
The money business
Day in the life
The Wednesday Group
I was at a meeting last week where priorities for counselling research were being discussed and someone suggested that the counselling community might be accused of ‘fiddling while Rome burns’ – Rome, in this case, being the future of counselling in the NHS and the fiddling being focusing on qualitative research which has no real influence on policymakers.
As Mick Cooper explains in his excellent article in this issue, policymakers are unlikely to suddenly do a U-turn and come to see the value of non-RCT research. Mick interviewed 25 senior figures in the psychological therapies field for a BACP briefing paper on developing an RCT of counselling for depression. Every one of these people told him that they thought RCTs were here to stay and that they would continue to play a key role in determining which psychological therapies were recommended and commissioned within the NHS. Currently, as readers will be only too well aware, counselling is barely recommended in any clinical guidelines because of its lack of RCT evidence. For example, NICE guidelines for the treatment of depression recommend counselling only for people who decline other treatments, adding that the referrer should ‘discuss with the person the uncertainty of the effectiveness of counselling’, while SIGN guidelines state that there is ‘insufficient consistent evidence on which to base a recommendation for counselling’. As a result, huge numbers of counsellors are losing their jobs in the public sector and being replaced by CBT therapists.
Being interviewed by Colin Feltham about his article for TherapyToday.net, Mick suggests that in some ways our refusal to engage with what we perceive as the hardheaded realists who are the proponents of RCTs shows a failure of empathy – an inability to see ourselves and our work from the perspective of commissioners and funders, and an assumption that others will see us as we do ourselves.