Academics recommend that the HG model be adopted by the NHS as a bona fide model of therapy in its own right
In September 2012 the Mental Health Review, published two peer-reviewed academic papers showing the effectiveness of the human givens approach; one involving the treatment of mild to moderate depression and the other to the therapeutic value of the HG Emotional Needs Audit (ENA) tool.
The research work was done by a distinguished team of academics, Dr Anna Tsaroucha, Professor Paul Kingston, Director of the Centre for Ageing and Mental Health, Dr Ian Walton, General Practitioner and Professor Tony Stewart, Professor in Public Health. It was also independently peer reviewed.
The Mental Health Review is an influential, high quality source of information and intelligence for researchers, managers, commissioners, purchasers and practitioners working in the field of mental health, so the content will be noticed. We hope it will also be acted upon, especially since it reveals that huge savings could be made if the human givens approach was more widely adopted.
You can read the original papers on the Mental Health Review website by clicking the following links:
- Assessing the effectiveness of the “human givens” approach in treating depression
- The emotional needs audit (ENA): a report on its reliability and validity
The abstract, conclusions and recommendations of the main paper on treating depression are below:
Purpose: This paper aims to present the findings of research commissioned by a Primary Care Trust in the UK to assess the implementation of a new pilot Human Givens mental health service (HGS) within primary care.
Method: Participating General Practitioners practices were designated as either ‘Human Givens’ or ‘Control’ practices. The study focused on service users with mild to moderate depressed mood measured using HADS. The well-being of these participants was examined at the point of referral, and after four, eight and 12 months using three well being questionnaires.
Findings: The results revealed that emotional well being significantly improved during the first four months following referral for both groups and this improvement was maintained up to and including one-year post referral. Compared to the Control group Human Givens therapy was found to be of shorter duration, lasting 1–2 sessions compared to standard treatment, which lasted on average four sessions.
Originality/value: Apart from the psychological insight and emotional support, it is suggested that Human Givens therapy might help the client to better function in society and maintain their sense of social integration. This has benefits to other providers of social care.
Conclusions and recommendations
The main recommendations of our work in this paper are threefold:
That the HG model be officially considered by the NHS as a bona fide model of therapy in its own right. This would greatly hasten the implementation of further studies and ease commissioning from managers acquainted with, and confused by, the variety of therapeutic models to choose from.
That NICE should be made aware of some of the techniques used by this approach. The most obvious candidate for this would be the imaginal exposure technique known as ‘rewind’, which has much in common with established imaginal exposure techniques used in CBT and already approved by NICE.
That training in the HG methodology and concepts be formally accepted as a mainstream option for CPD within the mental health community.
Emotional Needs Audit
The conclusions for the study on ENA are as follows:
Griffin and Tyrrell (2004)* in the human givens book proposed that to live successful and fulfilling lives we need to have certain needs met and are born with the resources to do so. The needs and resources, they called the Human Givens. The needs are listed in the Emotional Health Audit. They further propose that if any needs are seriously unmet or if our innate resources are damaged, missing or used incorrectly we suffer distress, typically anxiety depression or anger. Human Givens therapy therefore aims to discover the areas where needs are unmet or where the patient might not be using their innate resources correctly and help a person to create ways to meet previously unmet needs.
The correlation of the ENA to already validated wellbeing and depression scales would support the Human Givens proposals that quality of life and mental ill-health and well-being is proportionally related to how well we are able to meet our emotional needs and getting those needs met should be the goal of therapy. Unmet emotional needs can discovered with the ENA and further, effectiveness of treatment may be monitored by doing the ENA before and after sessions, without the need to perform other previously validated measures.
Our findings show that the Emotional Needs Audit is acceptable in the domains of internal consistency, concurrent validity, discriminant validity, predictive validity, sensitivity and specificity. This suggests that it is a valid instrument for measuring emotional wellbeing, quality of life and emotional distress.
While the ENA seems to be able to measure similar domains to the SWLS and CORE-OM effectively, we suggest that the ENA scale has additional advantages. Firstly, the CORE-OM measures symptoms and the SWLS measures overall satisfaction with life. Neither scale, however, offers insights into the causes of symptoms or causes of dissatisfaction and distress. Our observations suggest that when faced with a patient in distress, it is necessary to evaluate not only the level of distress but also the causes of distress. The ENA allows the practitioner to evaluate such causes. Indeed, it allows the practitioner to focus down on the following areas:
- Security — safe territory and an environment, which allows us to develop fully
- Attention (to give and receive it) — a form of nutrition
- Sense of autonomy and control — having volition to make responsible choices
- Emotional intimacy — to know that at least one other person accepts us totally for who we are, “warts ‘n’ all”
- Feeling part of a wider community
- Privacy — opportunity to reflect and consolidate experience
- Sense of status within social groupings
- Sense of competence and achievement
- Meaning and purpose — which come from being stretched in what we do and think.
We conclude that in addition to measuring symptoms and satisfaction with life, the ENA is capable of providing greater understanding of the causes of any problems, and therefore has the potential to be the more useful instrument in clinical practice. Indeed we would argue that the results from ENA might allow a practitioner to develop a level of communication that might therapeutically assist the start of treatment.
Our hope is that HGI members will also use this material to advance the cause of better mental health, improved schooling and greater sanity in all spheres of work.
*Griffin, J. and Tyrrell, I. (2004) Human Givens: The new approach to emotional health and clear thinking. Human Givens Publishing.
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