"Excellence"...... it's ... umm... well, it's good.

Have you noticed how many organizations, government agencies, and managers these days are referring to "Excellence"?

In the healthcare and psychotherapy worlds, we are already familiar (perhaps too much so) with NICE (the National Institute for Clinical Excellence) and The Council for Healthcare Regulatory Excellence (CHRE).

A couple of thoughts.... firstly, I tend to flinch these days simply because "Excellence" seems to be bandied around now like just another bit of management-speak. Ducks in a row, blue sky thinking, etc.

Also, I frown a little at the hyperbole of it - like, what happened to "Awesome"?? It's mostly used now by people who haven't really experienced anything truly awe-some. The guy who told me that making a credit card balance transfer recently was 'awesome' clearly hasn't stood at the top of a mountain or met someone who lives with a terminal illness.

I think I'm most bothered about the notion of "Excellence" because it seems to suggest that good enough isn't good enough, and that anything short of Clinical Excellence is poor practice.

BACP have a policy/procedure document that is known as the 'gold book' .... I can't help wondering, what happens next - the platinum one...????

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Big on Bonuses, Short on Humility

Bob Diamond, the CEO of Barclays Bank, recently said in Parliament that he feels we should stop blaming the bankers for our financial crisis. He suggests that we have persecuted them enough, and the public needs to move on.

This is a switch on Karpman's Drama Triangle, from Persecutor to Victim. (The taxpayers have, and continue to do, the Rescuing) ... In order to avoid having to make any apology, or gesture, he simply points the finger back and says "you're persecuting me!"

The true position of those bankers like Diamond is, of course, the Persecutor. In bleeding society dry of its funds, they aren't considering whether their needs are sustainable - or moral. Instead, they continue to "Take It", with the grandiose sense of entitlement that is one of the hallmarks of narcissism.

I will feel much more positive towards bankers when I observe some change in the champagne-charlie-casino-royale largesse, and a more sustainable, socially responsible ethos emerges.

I won't hold my breath....

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Brian Thorne

.... "the work of the therapist is not essentially concerned with dispensing wisdom or expertise or even with the deploying of skills. It is more about embodying values..."

from "On Becoming a Psychotherapist" - Routledge - Dryden & Spurling (eds)

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The CBT surf-ride continues.... but for how long?

CBT (Cognitive Behavioural Therapy), on the platform of NICE, is riding the political wave of popularity... still.

I was interested, though, to listen to a segment on Radio 4 recently. A psychoanalyst took a rare opportunity to present a robust defence of non-CBT therapies. The fact is that the Evidence presented on CBT is matched by other therapies; additionally, the 'gold-standard' methodology of the randomised-controlled-trial is easily questioned by intelligent minds.

Why, then, do people still think of CBT as 'better' than other therapies?
Why do national services favour cognitively-based work (apart from the cost of short-term treatment, of course...!)

Think of the world of supermarkets. You can buy a product because you know it's what you need, or you can be told what you need by smart packaging, clever ad campaigns, and because everyone else says it's great.

Sooner or later, the hype might just wear off. Clients are smart, and will eventually vote with their feet.