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Being enthusiastic about psychology in difficult times

15 March 2017 | by Peter Kinderman

Psychological ideas are attractive to citizens, scientifically valid and make economic sense.

This evening, I will be speaking at the New Savoy Partnership conference on psychological therapies. And I have to say that I am finding it difficult to maintain my naturally optimistic outlook.

The past 25 years has seen much to be positive about. There has been a clear swing towards a more psychosocial perspective in mental health, with well over £1bn invested in evidence-based psychosocial approaches and, even more positively, these approaches now incorporated in mainstream services.

And, perhaps most significantly, we have seen quality and access standards – for psychological therapies as well as medical approaches – now extended to mental health services such that we have the beginnings of the much vaunted, but elusive ‘parity of esteem’.

But despite all that, I cannot be perfectly happy and optimistic.

At the national level, we continue to have major funding challenges; for the NHS, for social care and for mental health services more specifically.

It’s true that the recent Budget announced funding for social care and for people at risk of domestic violence, but the promised £2bn for social care is, in truth, somewhat short of what is needed for the NHS and merely offers a sticking plaster for the shortfall in social care.

In my own profession of clinical psychology, it remains true that we are still seeing the NHS (or, more precisely, Health Education England) prepared to support the workforce by supporting people entering the profession.

But, with the continuing and increasing pressures of an austerity economy, and recent regrettable decisions about the support for nurses and other health, I fear for the future training routes for my profession.

We’re also hearing frequent reports of psychological professionals having their grades of employment down-banded and increasingly sidelined in terms of organisational influence.

I’m more than proud of my profession and my colleagues. And it’s important to remain enthusiastic.

From the perspective of the British Psychological Society, we need to ensure that everyone has the knowledge of and access to a range of psychological services so that they can choose the method, modality and time for a psychological intervention, or to choose no intervention.

There is no ‘one-size fits all’ in psychology and no single intervention will be appropriate in all cases.  Current services can be overly focussed on certain interventions that lend themselves to delivery at a large scale, whereas psychologists know that it is important to offer a range of interventions in every setting, so people can find what works best for them.

We need to build the evidence base for these alternatives. At the same time, people must be free to refuse the intervention – psychological support must never be seen as coercive or contingent.

To achieve that, psychological evidence must routinely be translated into accessible, comprehensible and practical guidance. All psychological practice must be based on the latest evidence, and it is our responsibility to ensure the most effective mechanisms are in place so that our evidence base is interpreted and used in a valid unbiased way.

To do all that we will need effective and engaged professional bodies. But we should be under no illusion; not only are we battling in a very challenging economic context (which is almost certain to get worse under Brexit) but the very ideas themselves are challenging for some.

In the long term, I remain optimistic – these ideas are attractive to citizens, are scientifically valid and make economic sense. Right now, however, we are living through difficult times.

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