Scrutinising NICE: The impact of the National Institute for Health and Clinical Excellence Guidelines on the provision of counselling and psychotherapy in primary care in the UK

General practice counselling amidst the ‘audit culture’: History, dynamics and subversion of/in the hypermodern National Health Service

“…The policy-makers responsible for imposing the scientifically flawed NICE ideology (Guy et al, 2010) on to NHS therapy practitioners seem unable to grasp the psychodynamic and postmodern subtleties of our work. There exists a pressing need to deconstruct and lay bare the erroneous assumptions of the 'roles and competences' ideology (e.g.…”

“…I wrote earlier about the legitimacy of resisting and subverting a stultifying system which deprofessionalises and straightjackets practitioners (King & Moutsou, 2010), chronically narrows the kind of therapeutic help that patients/clients have available to them (Guy, Thomas, Stephenson, & Loewenthal, 2010), inappropriately diagnoses and psychopathologises clients (Parker, Georgaca, Harper, McLaughlin, & Stowell-Smith, 1995;Stein, 1985), intrudes into the therapy room with politicised economistic agendas (Pilgrim, 2008;Proctor, 2008) and privileges certain therapeutic approaches based on methodologically flawed research procedures and epistemologies (e.g. Rogers et al, 2011).…”

Beyond Evidence-Based Practice: Rethinking the Relationship between Research, Theory and Practice

“…(NICE, 2006, p.34) Once a topic has been selected, NICE then sets up Guideline Development Groups (GDGs). Guy et al (2011) has criticised the composition of these groups, noting that the membership of the GDGs for the 2004 guidelines for anxiety and the 2009 guidelines for depression and schizophrenia were composed of: 6.7% psychological therapists; 10.7% service users or carers; 33% representatives of the medical profession; and 36% staff from the National Collaborating Centre for Mental Health (NCCMH) led by a partnership between the Royal College of Psychiatrists and the British Psychological Society's Centre for Outcomes Research and Effectiveness. Winter (2010) notes that, of the psychological therapy professionals included on mental health-related GDGs, the 'majority were cognitive behavioural in their therapeutic orientation' (2010, p.6).…”

“…treatment as usual -a weak comparison -or a potentially powerful alternative therapy); and the length of follow-up. Guy et al (2011) point out that RCTs tend to be very expensive to run and thus this puts constraints on who can conduct trials (often large university-based collaborations). Davey et al (in press) note that many RCTs focus on symptomatic change in individuals rather than the second order changechange within the system (e.g.…”

Is the UK government’s improving access to psychological therapies promoting individualism at the expense of the common good?

“…For example, NICE is aware that randomised controlled trails (RCTs) are inappropriate for the psychological therapies (Rawlins, 2008in Guy, Loewenthal, Thomas, & Stephenson, 2012, they know the limitations of choosing a classification like depression, including that the outcomes of psychological therapists who do not work with such diagnoses are excluded. Also, didn't NICE realise at the time of our study of how NICE works (Guy et al, 2012) that the Guideline Development Group (GDG) for depression consisted of psychiatrists and those promoting CBT, with one CBT psychotherapist and one psychological therapist, who was employed to promote IAPT nationally?…”