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Human givens: the evidence so far

Academics researching practice-based evidence are privately becoming convinced that, with the advent of IAPT and its evidence on outcome data collection, there will be an increasing shift away from reliance on randomised controlled trials (RCTs) as the gold standard for psychotherapy treat ments – and a move towards high-quality practice-based evidence instead.(5) HGIPRN will quite clearly be at the forefront of this and it makes sense for all human givens therapists who are not yet measuring data to start joining in. Not only is outcome-informed prac tice mandatory for IAPT services, it is also a National Occupational Standard and looks set to become a govern ment requirement. Again, we are leading the way, as learning how to use, and then to start using, outcome measures is an integral requirement of the MA programme in human givens psychotherapy, run in conjunction with Nottingham Trent University. Training in how to incorporate outcome measures into therapeutic practice, whether as a private practitioner or within a public service, is now also offered by MindFields College in a stand-alone workshop.

As we know, the therapeutic approach that has amassed most of the ‘right’ kind of evidence (RCTs), thus leading to its recommendation by NICE for most psychological conditions, is CBT. Yet one of its leading proponents, Paul Salkovskis, pointed out, several years ago, the dangers of going too far down the RCT route as a means of judging effec tiveness. In a paper in Behavioural and Cognitive Psychotherapy, which he edited at that time, he wrote, “The risk inherent in the current practice of evidence-based mental health is that the field will degenerate into a parody, a kind of one-dimensional science, and there are signs that this has already occurred to some degree. … CBT was an evidence-based approach to mental health problems long before the term ‘evidence-based’ was coined, but it was and is much more than the current meaning of the term. CBT is best de scribed as a set of empirically grounded clinical interventions, carried out by clinicians who seek to operate as scientist-practitioners.”(6)

We are making the case that the human givens approach also comprises “a set of empirically grounded clinical interventions”. Although there have been no RCTs of it as a therapeutic app roach, most of its individual elements have been validated through clinical trials. Indeed, almost all the research evidence cited in the newly up dated NICE guidelines for depression concern techniques that are routinely used in human givens therapy.(7) Clinical psychologist and human givens therapist Shona Adams and her psychology assistant Becci Roberts are currently mapping elements of human givens (eg cognitive-beha vioural approaches, guided imagery, reframing, etc) to the evidence-based findings already recognised by NICE for each of these interventions. This should establish the empirical basis of the human givens techniques, while acknowledging the difference in the underlying organising ideas.

In an earlier paper, Salkovskis described what he called the hourglass model of psychological therapies research (see below).(8) This shows how clinical observation, exploratory research, theory development, other forms of re search, uncontrolled trials and case studies must all be execut ed before it is appropriate to carry out an RCT to consolidate findings gleaned up to that point. As can be seen from the illus tration, much must precede the RCT and much must follow it, when a method that is found to be effective is put to further test in real-world settings. By show ing that the human givens approach uses empirically validated methods, we should be able to flow through the RCT area of the hourglass, straight on to effectiveness. The question then becomes, “Does the package that makes up the human givens approach work in real-life settings?” The sooner every therapist using this approach undertakes to gather outcome evidence, the sooner we will be able to demonstrate a resounding “Yes!”

To learn how to get started and to get up-to-date results, visit www.hgiprn.org. For details of the MindFields workshop, ‘Incorporating outcome measures into your practice’, visit www.mindfields.org.uk

References

© Bill Andrews 2009

This article first appeared in Volume 16, No, 4 (2009) of the Human Givens journal.

BILL ANDREWS is a human givens therapist and the director of Effective Therapy, a private practice in Sheffield. He has a special interest in research into therapeutic effectiveness in counselling and psychotherapy.

> More information on the human givens approach can be found in the following book, by Joe Griffin and Ivan Tyrrell

Human Givens: A new approach to emotional health and clear thinking

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