It may be good to talk - but it makes no difference who's listening, a new study shows. Jeremy Laurence reports.
These are difficult times for psychotherapists. They may be feeling in need of a little post-traumatic stress disorder counselling. For research is accumulating showing that the talking cures they peddle are no better than traditional GP care.
The evidence is far from conclusive and there are good reasons why, instead of being downcast, therapists should take heart. But the findings are significant, they are a set back and they cannot be ignored. Too many counsellors and therapists are inclined to dismiss criticism as evidence of professional rivalry or deep-seated hostility rather than taking a clear-eyed look at the way forward. The latest study, by psychiatrists at the Royal Free Hospital, London, suggests that the success of the talking cure lies in the talking - not in who you talk to. They compared two groups of about 70 patients, most with depression, who were given either up to 12 sessions of psychotherapy or routine GP care. They all improved significantly over nine months but there were no differences between the groups. Psychotherapy, in other words, is no more effective than chatting with your GP. At least a third of general practices offer counselling or therapy to help patients with emotional difficulties and thousands of therapists offer their services privately. The number of organisations offering training for counsellors has risen from 76 in 1990 to 545 in 1997, and the number of trained counsellors is estimated to run into tens of thousands. More than 100,000 people are estimated to be "in therapy" of one kind or another but the boom has happened in the absence of hard evidence that it works. In a commentary on the findings of the latest study, published in The Lancet last week, Dr Andre Tylee, a GP and lecturer on mental health at the Institute of Psychiatry, says that the study provides "compelling evidence" that the psychotherapy offered by a counsellor is no better than the sympathetic ear offered by the GP. This was the broad conclusion of a controversial report by the NHS Centre for Reviews and Dissemination at the University of York in August which concluded that counselling of the sort offered to people undergoing divorce, bereavement or redundancy was useless when practised on its own. That report was based on a review of existing research and was sent round the NHS by the centre, which is funded by the health department, to encourage best practice. …