Human givens therapy research projects

Research

The human givens approach to psychotherapy is rapidly growing in popularity because it appears to often be both fast and reliable.

However, despite the evident abundance of anecdotal reports of the effectiveness of the approach — which practitioners and their clients experience time and again — the importance of formal research into the human givens (HG) approach is well recognised by the HGI and its members.

All human givens therapists are encouraged by the HGI to work in an outcome informed way, and the results contributed by HG therapists to-date are very promising.

----------------------------------------------------------------------

NEWLY PUBLISHED RESEARCH:

Academics recommend that the HG model be adopted by the NHS as a bona fide model of therapy in its own right.

Followers of the HG approach know that people who lack confidence in their own observational power and ability to think straight often use the ‘lack of evidence’ challenge for people wishing to adopt the HG approach in institutional settings. This has frustrated HG therapists for years for, as Dr Aric Sigman pointed out: “In discussing any sensitive subject nowadays, the intellectual coward always regurgitates the default mantra: the need for 'evidence-based conclusions'. Yet any true scientist realises that beyond the real politic of research grants and the 'publish or perish' confines of their intellectual ghetto lies the human condition, which is often difficult to measure and where we have to use good judgement to draw conclusions.”*

Be that as it may, the Mental Health Review, has in press 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.

Here follows the abstract, conclusions and recommendations of the main paper:

Abstract

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.

ENA

The conclusions for the study on ENA are as follows:

Griffin and Tyrell (2004)** 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.

The HGI board are obviously pleased that these papers have been published. The MHR 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 trust it will also be acted upon, especially since it reveals that huge savings that could be made if the HG approach was more widely adopted.

Of course, predictably there will be those who will attempt to pull this work apart, but no one can argue that this 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 by a highly respected mental health journal.

Our hope is that you will use this material to advance the cause of better mental health, improved schooling and greater sanity in all spheres of work.

*	Sigman, A. (2009) The Spoilt Generation. Piatkus.
* *	Griffin, J. and Tyrrell, I. (2004) Human Givens: A new approach to emotional health and clear thinking. Human Givens Publishing.

----------------------------------------------------------------------

Ongoing research

Ongoing monitoring by the HGI Practice Research Network of these results indicates that where clients choose to remain in treatment to an agreed ending they typically stay in therapy with HG therapists for an average of only 3.6 sessions (with the most common number of sessions being 2) and that 90% of our clients see their HG therapist for 6 visits or fewer.

Huge potential savings

As well as being highly beneficial for our clients, this obviously means that the HG approach has the potential to save huge amounts of money for resource-starved organisations. The continuing emphasis on formal research will help the HG approach to become even more widely known and available to the people that need it.

With this in mind, one of the main objectives of the registered charity, the Human Givens Foundation (HGF), is to promote research into the human givens approach, as well as raise the funds to carry that research out. As a result of the charity's hard work there are now numerous significant research projects completed or in progress.

They include:

NHS Practice Research Project

A partially HGF-funded study of HG efficacy within an NHS practice in Luton was carried out by Dr Gina Johnson, with the help of three HG therapists. The findings from this study were written up by an international research team and published in the British Psychological Society journal, ‘Psychology and Psychotherapy, Theory, Research and Practice’.

----------------------------------------------------------------------

Reference citation:
Andrews, W., Twigg, E., Minami, T., & Johnson, G,. (2011). Piloting a practice research network: a 12-month evaluation of the Human Givens approach in primary care at a general medical practice. Psychology and Psychotherapy: Theory, Research and Practice. Advance online publication. doi:10.1111/j.2044-8341.2010.02004.x
Copies of the paper, which is ‘in press’ can be obtained by emailing the 1st author, Bill Andrews (wandrews22@mac.com)

----------------------------------------------------------------------

This robust example of a study using highest quality practice based evidence suggested that the HG therapy was very effective and very well accepted by the majority of clients. Furthermore, the results compared very favourably with the results from the Improving Access to Psychological Therapies pilot site data.

The HGI Research Practice Network

The HGI Research Practice Network was set up in association with the HGF by Bill Andrews to both raise awareness of the need for formal research and develop the use of progress and outcome measures in practice. The CORE system of measurement has been adopted as the research tool of choice as CORE is already well established within many UK primary care settings and is acceptable to the Department of Health as a validated reliable system.

Multi-site Human Givens Institute Practice Research Network
(HGI PRN – www.hgiprn.org) study

The Luton study above acted as the pilot project for a wider six-month study involving 30 HG therapists working in a wide variety of settings up and down the country (in either private practice or publicly funded practice), conducted between October 2007 and March 2008. Participating practitioners committed to monitor outcomes for all clients seen over the six month period using the valid and reliable CORE outcome measures and shared annonymized data across the internet using the sophisticated online CORENET system (www.coreims-online.co.uk) as the research tool. The results from this study were found to compare very favourably with the Luton study results and are in the process of being written up for publication.

Ongoing HGIPRN study

From April 2008 to the present, many of the practitioners involved in the original six month evaluation have carried on to contribute their data and many others have joined the network. All new practitioners are invited to contribute their data on an ongoing basis. The results are kept up to date on an annual basis and published on the network website at www.hgiprn.org.

3 years data analysis

The first three years of data collected within the network is currently being processed by an independent international team led by Takuya Mainami from the University of Madison, Wisconsin. Takuya is a leading expert in the field of benchmarking and the findings from this study will be a major contribution to the knowledge and evidence base for the HG approach. Publication is expected towards the end of 2012.

HG and Trauma Treatment

While the HG approach appears anecdotally to be effective in trauma treatment this is now being investigated in detail with a cohort of over 200 serious psychological trauma cases. This is work in progress and will hopefully be ready for publication in 2012.

HG and wellbeing of adolescents

Yvonne Yates and Cathy Atkinson from Manchester University explored the detail of the HG approach in working with teenagers and recently published their findings in ‘Pastoral Care in Education’. This beautifully written paper really conveys a lot of detail about the approach. Copies of the paper can be obtained by emailing Cathy at: Cathy.Atkinson@manchester.ac.uk

----------------------------------------------------------------------

Reference citation:
Yates, Y and Atkinson, C. (2011) Using Human Givens therapy to support the well-being of adolescents: a case example. Pastoral Care in Education, 29, 1, 35-47.

----------------------------------------------------------------------

MA Research through Nottingham Trent University

2010 saw a cohort of 11 students participate in a wide variety of research projects for their research dissertations. This work is in progress and in time will lead to more peer reviewed publications. An additional cohort commenced this January 2011 and a further cohort will commence in 2012.

The Network Expands

Just as the Luton study formed the pilot for the development of the HGIPRN, after four years of leading by example in how to approach the gathering of robust practice based evidence, the HGIPRN has itself now widened its remit to encourage many others on the international arena to also set about gathering evidence of the effectiveness of their approach in similar ways. The HGIPRN now sits within this expanded structure that is known as the Pragmatic Research Network. It is to be hoped that others can learn about the HG research journey and more about HG in this way and a spirit of collaboration will be fostered. More about the new developments can be found on the Pragmatic Research Network blog at www.pragmaticresearchnetwork.blogspot.com

If you have completed the HG Diploma and are interested in participating in the work of the network then please read about it on the blog and at www.hgiprn.org and contact Bill Andrews at wandrews22@mac.com.

Further information:

There are many more case histories and examples in the book 'An Idea in Practice: Using the human givens approach ' which was shortlisted for MIND's Book of The Year award in 2008.

In addition, lots of case histories and examples of the human givens approach in practice are included in the wide variety of articles in our archive.

Return top