Wednesday, 29 June 2011

NICE and psychotherapy ... part 2

Okay, back to the "NICE Under Scrutiny" document from UKCP....

The report from Roehampton also looks in some depth at NICE's use of research. In these days of "Evidence-based Practice", the so-called Gold Standard for research is the Randomized Controlled Trial, or RCT.
Now, there has been so much intelligent and scholarly analysis of RCTs, and their drawbacks when applied to psychotherapy, that the debate is now well and truly 'out there'. The fact that NICE continues to hold up RCTs as sacred - the 'only' research that can really be considered 'evidence' is frankly a bit crazy. In TA terms, we might think of this as a contamination. (This suggestion was made some time ago in the TA community - if I can find a reference, I will post it!)

Contamination though it may be, this is a vivid demonstration of how NICE is still steeped in the medical model and the machinery that goes with it. Politically, NICE is colluding with the over-sanctification of medicine and adding to the mystification (see my previous post around Radical Psychiatry). In basic terms, NICE is holding a hammer in its hand and looking at everything like it's a nail. (Hat-tip to Abraham Maslow).

NICE is practically and psychologically bound up with the economics and politics of the day, and unfortunately this translates into an unhealthy attachment to politically useful forms of 'evidence'.

Qualitative research, for instance, is much harder to sell to voters, and even harder to use if one wants to inform policy. But it is still a hugely valid and rich form of research in psychotherapy.


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