Pseudo-diagnosis is rampant. Psychological therapists in NHS Talking Therapies are expected to generate a diagnosis for each client. But the Service states[Manual 2024)] that its’ diagnostic labels should not be used for medico-legal purposes! If they are not reliable enough for the Courts, how can they be reliable enough to guide treatment decisions? Confusingly, the Service states that its’ clinicians are not trained to diagnose.
I have signed up to attend the BABCP annual jamboree in Scotland this September. I can confidently predict that the outcomes of much vaunted treatments will not be based on pre and post ‘gold-standard’ diagnostic assessments. Much less will they be based on independent blind assessment. Enthusiasm for interventions will greatly outstrip evidence. For whose benefit is the evangelical fervour for CBT?
- those seeking employment as CBT practitioners
- providers of NHS Talking Therapies Services
- beleaguered NHS staff
- politicians concerned to ‘prove’ ‘that at least they get some things right’
- integrated Care Boards
No one in their right mind is going to publicly dissent. The likelihood is that the deafening silence of the past 17 years will continue. “Repeat a lie often enough and it becomes the truth”, is a law of propaganda often attributed to the Nazi Joseph Goebbels.
As with all propaganda, the losers are the person in the street. This is not to say that people cannot benefit from CBT but that they do not do so routinely [Scott (2018)].
Dr Mike Scott