Getting into the ACT with Psychoanalytic Therapy: The Case of "Daniel"

Cohen, Robert

doi:10.14713/pcsp.v12i1.1944

Cited by 5 publications

(1 citation statement)

References 41 publications

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“…Recent literature also includes a qualitative metasynthesis of the experiences of people caring for partners or family members with depression (Priestley & McPherson, 2015) which could have informed the current guideline. There have also been many case studies published (for example Cohen, 2016;Roberts & Sedley, 2016).…”

Section: Undermining Subjective Experiencementioning

confidence: 99%

Epistemological flaws in NICE review methodology and its impact on recommendations for psychodynamic psychotherapies for complex and persistent depression

McPherson

Rost

Town

et al. 2018

Psychoanalytic Psychotherapy

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The UK draft NICE guideline on depression in adults was sent out for stakeholder consultation between July and September 2017. The final guideline publication date currently remains 'to be confirmed'. This paper sets out key concerns with the methodology employed in the guideline and its impact on recommendations for psychodynamic psychotherapies for complex and persistent depression. The draft largely ignored the subjective experiences and voices of service users, carers and members of the public, using out of date limited evidence of service user and carer experiences. The guideline fails to incorporate what limited qualitative evidence it reviewed into any treatment recommendations. The Guideline Committee created its own method for categorising depression by longevity, severity and complexity. This has resulted in erroneous and unhelpful classifications of research studies under groupings which do not match clinical and service user experiences or US and European approaches, rendering analyses and conclusions unreliable. We also outline instances of incorrect classification of psychodynamic treatments (such as inclusion of non bona-fide treatments or exclusion of relevant bona-fide treatment studies) which enables the omission of a recommendation for psychodynamic psychotherapy for complex and persistent depression. Depression is often a long-term condition or can become so if immediate care is inadequate; yet the draft recommendations are all made on the basis of short-term outcome data (with often less than 8 weeks between baseline and outcome). NICE guidelines for longterm physical conditions would treat this evidence as inadequate. Finally, the draft guideline used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system of assessing methodological quality in such a way as to produce a systematic bias in favour of drug trials, selectively omitting trial data with long-term follow up points and those which used non-symptom outcomes. Herein we consider the increasingly evident limitations of the paradigm NICE works within for ensuring patient choice and equity of access to a wide range of therapies.

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Section: Undermining Subjective Experiencementioning

confidence: 99%