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In September 1996, the NHS Executive published a document reviewing psychotherapy services in England (Parry & Richardson 1996). This followed an extensive review process which was originally set up to examine psychotherapy provision, and the role of the Tavistock Clinic. However, it has ended up as strongly endorsing the important role of psychotherapy and psychological therapies in the treatment of mental health problems and has adopted a broad approach to psychotherapy. It is the first time that a national report has been prepared which endorses psychotherapeutic work in such a comprehensive way.
The Review sets a framework of three types of psychotherapy delivery:
Type A: Psychological treatment as an integral component of mental health care
Type B: Eclectic Psychological therapy and counselling
Type C: Formal Psychotherapy
These types of psychotherapy do not describe levels of skill alone, but relate to the patient's needs and the setting. For example, Type A treatment will be a component of all mental health work, and, as such, every mental health professional should be able to offer this. At present, this is often not the case. Type B might involve a short course of structured therapy of a limited range, and this is commonly practised in the NHS. The quality of supervision and training will have a major effect on the outcome of this sort of work. Type C is specialist psychotherapy, such as practised by child psychotherapists, adult medical psychotherapists, etc.
The Review's survey found good evidence for the effectiveness of a range of psychotherapies which can help many mental health problems, including severe mental illness.
The research report (Fonagy & Roth 1996), published separately, endorses this, but points out the need for more research in the effectiveness of psychoanalytic psychotherapy.
The Roth & Fonagy review of outcome research has the drawback that it examines only a very limited range of research studies. These have to be randomised controlled trial