NHS Psychotherapy

Dear Editor

You were kind enough to publish my paper ‘Training and outcome in supervised individual psychotherapy’ in 1992 (British Journal of Psychotherapy 8(3):237-46). We have continued to collect information on cases seen since then. However, changed circumstances in the new NHS will prevent further study of these cases. Your readers may be interested in a brief summary of recent cases.

A total of 87 referrals were made, with two consultant psychiatrists responsible for almost half of them. 9 patients had hyperventilation disorder, 17 were referred for solution-focused brief therapy or other forms of psychotherapy, 30 refused psychotherapy or were unsuitable and 31 were referred for treatment. Follow-up data are available for 23 treated cases but information comes only from contacts with the mental health services (unlike the previous study where all regional agencies and general practitioners were contacted).

The mean age of the sample was 34.13 years [SD 9.45, range 19-48 years]. 6 were male and 17 female. 8 patients presented with anxiety and 6 with depression and there were 2 who complained of both. 5 patients reported major relationship problems complicated by anxiety or depression. 1 patient had post-traumatic stress disorder and 1 was anxious and abused alcohol. Patients attended for a mean of 39.17 sessions [SD 20.66; range 10-79 sessions]. The follow-up period ranged from 1 month to 69 months after finishing treatment [mean 34.17; SD 20.37].

17 patients [74%] have had no further contact with mental health services. 2 patients [8.7%] had much reduced contact, 1 patient [4.4%] had as much contact as formerly and 3 patients [13%] had much increased contact with mental health services. Therapists predicting outcome at discharge were correct in only 10 of the 23 cases.

These results on a limited follow-up can be compared with our previous detailed analysis of 25 cases in which 17 [68%] had no further contact with any other agency and less contact with their GPs w