psychotherapy

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PSYCHOTHERAPY SHOULD BE SUBJECT TO RIGOROUS

REGULATION JUST LIKE DRUG TREATMENTS, SAY ACADEMICS



Los Angeles, London, New Delhi, and Singapore (January 14, 2008) – Psychotherapies such as cognitive

behaviour therapy (CBT) are under-regulated in the UK and should be subject to the same standards of

evidence as drugs, assert two experts in psychological medicine writing in the Journal of

Psychopharmacology (January issue published today by SAGE). They say the largely unrecognized potential

for serious adverse effects resulting from talking therapies means rules should be tightened, particularly in light

of the UK Government’s recent ￡150m investment in psychotherapy services for depression and anxiety, which

will result in many more therapists practising in the UK.



“While welcoming the increased profile that mental health problems have been given by the Government and

the expansion of scientifically validated psychological treatment…we wish to urge a note of caution,” says

Professor Michael Sharpe, Psychological Medicine & Symptoms Research Group, School of Molecular &

Clinical Medicine, University of Edinburgh, UK, who co-authored the editorial with Professor David Nutt of the

Psychopharmacology Unit, Department of Community Based Medicine, University of Bristol, UK.



“Our concern is about the tendency to consider psychological treatments less critically than pharmacological

ones. It is important that both are seen as having a place in treating depression and that both are subject to the

same standards of scrutiny and regulation.”



According to Nutt, few psychotherapy trials meet the requirements demanded of drug tests, and even those

that do frequently show that psychotherapy performs no better—and often worse—than pharmacological

interventions. What is more, he points out, many psychotherapy trials do not even consider the possibility that

their treatment could harm. Yet all therapists should be aware that therapy can have adverse effects on some

patients and a major part of psychotherapy training is how to deal with issues such as counter-transference that

can mediate these negative effects.



“We need a much more sophisticated view than ‘psychotherapy good; drug treatment bad’ if we are to

effectively and safely improve the mental health of the population,” says Sharpe.



Potential adverse effects of psychotherapy include worsening of the patient’s condition, the development of

psychological dependency on the therapist, and wastage of patient and therapist time when the treatment is

ineffective. In addition, the editorial cites evidence that a small minority of therapists take advantage of

vulnerable patients and exploit them emotionally, financially, and sexually.



“Given that psychotherapy is not necessarily always the benign yet efficacious therapy that seems to be

generally assumed, patients should be made aware of the risks as well as the benefits especially now we have

a government initiative to improve psychotherapy provision on the NHS,” write the authors. They suggest that

patients should be able to alert authorities to problems with psychotherapies they receive by use of a similar

scheme to the one through which adverse drug events are reported which Sharpe and Nutt suggest could be

administered by the Medicines and Healthcare Regulatory Agency, the body responsible for dealing with drug

reports.



Nutt and Sharpe urge therapists to ensure patients are aware of the risks as well as the benefits of

psychotherapy. In addition, they suggest that therapists should to commit to performance and practise

standards and agree to be monitored or audited on their professional records.



“Up-scaling the provision of psychological therapy to the degree [proposed by the UK Government] is a major

challenge for quality assurance. Bad therapy will not work and may harm. It will be essential therefore that the

increase in number of therapists is done incrementally with (a) rigorous monitoring of the quality of the therapy

given and (b) professional regulation of therapists to minimise the risk of exploitation of patients,” concludes

Sharpe.



###



Uncritical positive regard? Issues in the efficacy and safety of psychotherapy is published on SAGE

Journals Online today (Monday 14

th

January) at http://jop.sagepub.com/cgi/reprint/22/1/3. The article will be

free online for two months.



To arrange an interview with Professor Mike Sharpe regarding this article, contact contact Mithu Mukherjee:

[e-mail]/ Tel: [phone]/ Mobile: [phone]



The Journal of Psychopharmacology is a fully peer-reviewed, international journal that publishes original

research and review articles on preclinical and clinical aspects of psychopharmacology. The journal provides

an essential forum for researchers and practising clinicians on the effects of drugs on animal and human

behavior, and the mechanisms underlying these effects. The Journal of Psychopharmacology is published by

SAGE, in Association with British Association for Psychopharmacology



SAGE is a leading international publisher of journals, books, and electronic media for academic, educational,

and professional markets. Since 1965, SAGE has helped inform and educate a global community of scholars,

practitioners, researchers, and students spanning a wide range of subject areas including business,

humanities, social sciences, and science, technology and medicine. An independent company, SAGE has

principal offices in Los Angeles, London, New Delhi, and Singapore. www.sagepub.com