HGI E-newsletter January 2010

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'The rise of human givens'

For a still relatively new approach, the human givens is certainly gaining a higher profile these days. This was highlighted recently by its prominent position as the lead article on the cover of December's issue of the British Association for Counselling and Psychotherapy's journal, Therapy Today.

In her article Julia Bueno set out to investigate the appeal and development of the approach; why it has sometimes in the past unsettled those in the field; and why its ideas and framework for good mental health are steadily being adopted by both the public and private sectors.

If you haven't seen it already, the article is well worth reading - despite several inaccuracies. It states, for instance, that there are 120 human givens therapists when there are actually over 250 fully-qualified HG therapists and more than 800 people who have taken the HG Diploma and use the approach in their work.

Bueno also implies at one point that the HG approach says it can heal damaged resources – which we obviously don't. Rather, we help people who are misusing the resources they have (such as their imagination in the generation of depression) to use them more effectively and others to develop the potential resources they have but aren't using.

Click here to read the article online.

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Call for NICE to accept rigorous evidence-based practice research as acceptable high-level evidence of effectiveness

In January 2009, NICE commissioned Professor Sir Ian Kennedy to conduct a short study of valuing innovation in relation to new health technologies (including psychotherapy). Many HGI members were involved at various stages of his consultation, either in an individual capacity or representing the HGI; Bill Andrews (who runs the HGI's Practice Research Network) sent in a submission on behalf of HGI and several others attended consultation workshops.

In his final report, Sir Ian drew attention to the particular problems involved with assessing new psychological therapies:

"As regards psychological therapies, there are clearly differences, as against pharmacological therapies, in what might constitute evidence of clinical effectiveness and how such evidence might be generated. The RCT is most suited to establishing the effectiveness of drugs, not least because the trial can be properly 'blinded' and the role of the therapist in the effectiveness or otherwise of the therapy is less significant, compared with psychological therapies. That said, NICE cannot issue guidance without having some sound basis on which to proceed. Moreover, it is unlikely that a real understanding of the comparable effectiveness of a psychological therapy can be established without some form of trial. CBT (Cognitive Behaviour Therapy) has led the way in this acceptance of the value of trials and other forms of psychological therapy need to follow. NICE is conscious of the need not to privilege one form of therapy, simply because it can produce evidence from RCTs. What is needed is a systematic approach to evidence which is appropriately flexible and combines 'observed practice' with valid trials, moving from the former to the latter and then back to observed practice as further validation. Critical to the success of such an approach is both the need to collect data from practice and bring it together with data from other centres in the NHS, and the need to organise trials.

"NICE needs to emphasise the need for the development of evidence of effectiveness and work with others to ensure that a proper research infrastructure is put in place. NICE might well seek to work with the newly established Academic Health Science Centres (AHSCs), or Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) to make psychological therapies one of their research priorities, given the AHSCs’ mission both to conduct research and to take the fruits of that research into the NHS locally and beyond. I am aware also that NICE is working with the Medical Research Council on research into the use of different types of evidence in its appraisals, such as 'colloquial' evidence and non-experimental evidence from disease registers."

The NICE Committee's response to Sir Ian's recommendation (point 25) were as follows:

Sir Ian Kennedy's recommendation:
NICE should work with others, particularly academic health science centres, to ensure that a sound infrastructure for research in to the effectiveness of psychological therapies is established.
NICE's response:
Building research infrastructures is beyond the Institute’s remit. This is a matter on which the Department of Health may wish to respond.

Sir Ian Kennedy's recommendation:
NICE should work with others to develop a systematic approach to evidence regarding psychological therapies, including the place of RCTs and non-experimental evidence.
NICE's response:
The Institute recognises the value of different forms of evidence and sets out its approach to their interpretation in its Guide to the Methods of Technology Appraisal.

In the preamble to their response, NICE commented (3.11): "In proposing these arrangements the Institute is conscious of the need
to avoid placing an intolerable burden on the NHS especially at a time when resources are likely to be severely constrained."

NICE subsequently invited comments on Sir Ian's recommendations and the HGI and many of its members responded in support of his point 25 and to highlight the many benefits (including cost-effectiveness) of rigorous practice-based evidence (RPBE).

The response of HGI member Shona Adams, a chartered clinical psychologist, is particularly well argued and detailed – click here to read it - and we thank everyone who took the time and trouble to respond. We are all hoping that NICE will look again at Sir Ian Kennedy's recommendations in relation to assessing new psychological therapies and that they will widen their scope of acceptable forms of high-level evidence of efficacy to include robust practice-based evidence.

For more about the very positive evidence for HG therapy to date, see Volume 16, No 4 of the Human Givens journal.

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HG Presentations accepted for British Psychological Society's Annual Conference

Three poster presentations featuring research into different aspects of the human givens approach have just been accepted for presentation at the BPS's 2010 annual conference in April.

Bret Culham, of Banes PCT, will present his findings which validate the needs-based human givens approach and development of the Emotional Needs Scale (which was featured in Vol 16 No 1 of the Human Givens journal); Piers Bishop will present his research and findings about the effectiveness of human givens therapy for trauma when working with war veterans; and Bill Andrews will be presenting his poster entitled 'Evidence-based methodology: The Luton Study'.

Click here to read the abstracts of each poster giving more information.

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'Effective skills for identifying and meeting children's unmet needs' – new workshop

If the rises in anti-social behaviour, mental illness, family breakdowns and addictions are ever to be reversed, children need to be raised in environments where their innate emotional and psychological needs are being met. Miriam Chachamu's far-reaching new workshop for MindFields College clarifies how we can do this and provides new practical ways of helping meet these needs and improving behaviour. It also shows how we can create an environment in which not only children but also the rest of the family can thrive.

Click here to find out more.

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