Untrained practitioners delivering psychological therapies

Therapists are delivering psychological therapies they are not trained to provide to people with anxiety and depression, according to a national audit published today by the Royal College of Psychiatrists.

While audit findings, covering England and Wales, on the whole were positive, the report said 30% or more of therapists delivered specialist therapies with no specific training in the therapeutic approach in question.

This includes therapies such as couples therapy, arts psychotherapies and lower-intensity services such as computerised cognitive behaviour therapy.

The college said this issue needed to be addressed by professional bodies and training providers and that service managers should consider the skills mix of their therapists.

Ninety per cent of patients surveyed reported positive relationships with their therapists. The college also found that therapy was provided in line with guidance from the National Institute of Health and Clinical Excellence (NICE) for 83% of patients with a diagnosis covered by the guidance.

However, where 70% of patients who had high-intensity therapy did not receive the minimum number of treatment sessions recommended by NICE. About one-half of these patients had not recovered by the time therapy was discontinued, the report said.

The waiting time standard, both from referral to assessment and from referral to treatment, was met for 85% of the patients surveyed. However, the performance of services varied widely, however, and long waiting times were repeatedly flagged as a patient concern. One in seven patients reported waiting more than three months for their first appointment.

There was also concern that not all services routinely measured how well patients were before and after therapy, making it difficult to draw conclusions about the effectiveness of therapies. Fifteen per cent of services surveyed for the audit did not have any patients with a pre- and post-score for at least one outcome measure.

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