|September 18 2007 | LEGAL | ARCHIVE | IPN | CONTACT | HOME | CONTENTS|
Leakage from this recent conference, anticipated here in this eIpnosis prereview and this preview by Janet Low, has been hard to come by. The promised 'Savoy Declaration' as mission statement or portmanteau mainstream definition of what psychologicial therapy is, still hasn't materialized. Will it include 'love' and 'science'? The odds are on the second and against the first. We could be surprised.
When it appears, eIpnosis will check it for signs of life.
Apparently for anyone who hadn't been near health care for ten years or so the conference was likely to put them into culture shock. One of the stands was selling green belt land with optimistic profit-focused estimates of coming changes in planning permission. The Priory proudly claimed that 75% of its income came from the NHS.
Another thread of culture shock that reached us concerned the dubious equation of decanting large numbers of NHS employees into the private sector through out-sourced commissioning of IAPT related health care. That this was likely to produce a significant increase in unemployed ex-NHS personnel, or insecure employment related mental illness, seemed beneath the planning radar. A disimprovement, as my wife calls such phenomena. Improvements in health-care that deliver harm.
But not everyone was dismayed. As eIpnosis has found, actually meeting people doing indefensible research or following oppressive policies usually softens their impact, at least for that afternoon. And as you'd expect, this seems to have happened with the Savoy conference. A moving together of otherwise hostile modalities was noted, and CBT researchers adamantly declared that they could prove nothing and made no claims of overwhelming superiority. However in an adjacent room NICE, who had institutionalized such non-claims, apparently attracted the descriptor 'Stalinist'.
The closer contact between outsiders and people doing research that harvested effectiveness revealed to one visitor that it was no part of their research to look at the person doing the therapy. As though the therapist was an entirely predictable automaton without a life that might affect how they related to a client. Apparently huge differences in outcome have been observed from the same CBT practitioner. eIpnosis often wonders about the rationality of a 'research' universe where such a 'finding' would be surprising or unexpected. But then one of the professorial speakers on his web site, describes his findings that 'the origin of consciousness is the result of an interaction between the infant and carers'. (Let's hope he was paying for this research out his own pocket!)
The value of incorporating the clients voice in the delivery of metal health care apparently raised the temperature a little. A very articulate and experienced user of mental health services we know tried to get access to the conference to contribute her evidence but was told that therapists would be speaking from their experience as clients. So that's OK then. Some people were concerned that the inclusion of the Client Voice would install what eIpnosis has long thought of a positive feedback loop apparent in broadcast tv and elsewhere, where the more there is of some product or service the more that is produced. Property purchase and conversion is a current broadcast example. eIpnosis is inclined to subscribe to the allied notion that when therapists's authority shifts from vocation and calling to becoming a player in a scientized therapy market, harm will be iatrogenic. As we can observe with psychiatry, care will itself produce harm.
However it needs to be acknowledged that an enthusiast for public service told us he found the conference informative and helpful. And no doubt this was widely shared.
We liked (we would wouldn't we?) a line of questioning that came from Professor Del Loewenthal. After offering (what used to be a widely accepted) definition of therapy as intrinsically subversive, he asked what measures were in place in effectiveness research to detect that subversion was being implemented!
Neither the Minister Alan Johnson nor the Under Secretary of state for IAPT, Ivan Lewis showed up at the event, despite being billed. Perhaps just as well!
More on the 'New Savoy Declaration' that was presented to the Conference, presumably a definition of 'psychological therapy' if/and when we are able to obtain a copy.