Mental health charity Mind has warned that new guidance for the
NHS on the treatment of depression could lead to cuts in
counselling services.
The National Institute for Health and Clinical Excellence today
issued revised clinical guidelines on the treatment of depression
in adults, alongside a new
guide to
treating adults with depression and chronic physical health
problems.
Previous guidelines on depression stated
that health professionals should consider counselling as one
option for people with mild or moderate depression.
Counselling not first choice
However, the revised guidance says counselling should only be
used for people with persistent sub-clinical or mild or moderate
depression who decline a range of other treatments, including
antidepressants and cognitive behavioural therapy.
It says the evidence for using counselling - which has been
defined as "a systematic process which gives individuals an
opportunity to explore, discover and clarify ways of living more
resourcefully" - was "very limited" in treating depression.
The guidance emphasises the importance of cognitive behavioural
therapy - in which patients are guided to recognise and re-evaluate
negative thoughts - for treating all forms of depression.
Antidepressants
It says antidepressants should not be used to treat persistent
sub-clinical or mild depression unless other treatments do not
work, the patient has a history of moderate or severe depression or
sub-clinical symptoms have persisted for at least two years.
Responding to the guidelines, Mind's chief executive, Paul
Farmer, warned: "We welcome Nice's recommendations to promote the
use of talking therapies over antidepressants, however we are
concerned that the stronger focus on CBT over counselling will be
interpreted by health services as an excuse to cut counselling
services."
Depression 'complex'
He added: "Depression can be a complex issue and while CBT can
bring huge benefits to many people, for others it isn't always the
right approach and there is no substitute for talking through
long-term issues with a counsellor."
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