The New Savoy 10th Anniversary Conference on Psychological Therapies in the NHS took place in March and was attended by our ACP Chair, Heather Stewart and Media and Communications Director, Alison Roy.The conference this year had an impressive line up of speakers to debate the future of Psychological Therapies and IAPT, whilst also focusing on the implementation and impact of the 5 Year Forward View for Mental Health so far.
Delegates were encouraged to take part in the discussions to ensure their voice was heard and the results of the annual staff wellbeing survey were announced and where a petition was shared demanding psychological therapies to be freely available on the NHS. It was a conference of action and challenge and with the intention of making change possible.
After a warm welcome from Jeremy Clarke, CBE, Conference Chair, Professor Bruce Wampold from the University of Wisconsin-Madison USA and the Research Institute, Modum Bad Psychiatric Centre in Norway, spoke about improving outcomes by understanding how psychotherapy works. The title, Forget Brand Names was a reminder of the prominence of the therapeutic alliance over and above technique or modality. This hypothesis was evidenced and reflected on with helpful illustrations and diagrams. The presentation style was engaging and animated and we were reminded time and again that the best results come from the best therapeutic relationships. The choice and access agenda therefore, took on a different meaning when thinking about access to good relationship building therapists from a range of modalities.
There were a number of surprising findings, including the impact of the “best” and “worst” therapists and how some therapists don’t appear to be able to help people get better, no matter how long they practise for, whilst others appear to have very successful outcomes throughout their careers. Not all therapists or approaches are helpful and knowing when something isn’t working, and having the capacity to acknowledge it, was central to “success”, as was training and good supervision and space to think. Questions about supervision and reflective capacity were raised and pondered on in today’s climate of urgency, but also training which includes understanding about the therapist's own issues.
The discussion later with professionals who shared their struggle with mental health difficulties and challenge of being open in the work place about them, developed these themes, which were continued by a panel chaired by Mark Easton, Home Editor for the BBC and mental health experts to consider the topic, Why is Depression still Britain’s Biggest Social Problem? And - What can government do to tackle it more effectively in the next decade?
It was disappointing that no-one from the DoH attended the panel discussion and the audience seemed resentful of this. Norman Lamb plugged the gap but seemed weary of the IAPT agenda, which had perhaps taken on a different focus since his early ideas about how to widen access to the right therapies for those who needed them. The panel also kept their focus on IAPT rather than the more interesting title about the prevalence of depression in our society. There was little focus on the plight of children and young people with mental health problems, despite Sarah Brennan’s presence on the panel although she referred to the lack of resources. The stress experienced CAMHS professionals and those working with children and young people with mental health problems in the community, came across when one of the questioners highlighted the huge demands and expectations on depleted services.
Miranda Wolpert’s paper on Thursday, Reducing the burden of depression for the next generation: Report on the outcomes and experience from child and young people’s mental health services 2011 – 15, reported on her research and approaches to gather data and to improve service delivery and outcomes. She talked through the report published by the Child Outcomes Research Consortium, Child and Parent Reported Outcomes and Experience from Child and Young People’s Mental Health Services 2011 – 15. This was an impressive report with a huge range of data, including both outcome measures and feedback measures. However, it all came with a health warning from Miranda that the data was FUPS: Flawed, Uncertain, Proximate and Sparse. From an ACP point of view it was concerning that in the list of practitioners there were child psychotherapists, psychodynamic psychotherapists and psychoanalytic psychotherapists, all separate from each other so that each looked as if they made a very marginal contribution to therapies with children and young people. It was a reminder of the need for clinicians to ensure that they have the right titles and that their Trusts have an effective and transparent way of recording data.
Miranda’s lively presentation enabled us all to use our phones to make immediate responses to questions that she asked and for us to ask her questions online as she talked. It was clear that children’s presenting problems aren’t as straightforward to categorize as adult mental health symptoms but that this work was helping to clarify the main areas of need in provision for young people.
Other conference topics included in workshops and panel discussions:
- Improving Staff Wellbeing
- Commissioning for patient choice
- Focus on
- Forget ‘command & control’, forget ‘symptoms’: improving recovery by understanding what that means and how behavioural change happens
- Integrated commissioning
- Welcoming openness and transparency and protecting whistleblowing
- Results of the 2016 staff wellbeing survey
The conference was a lively and welcome opportunity to think about the value of different approaches to treating mental illness and the importance of a relationship focused approach to treatment. However, real choice and access to a range of treatments for mental health sufferers, is still a long way from a reality.
If ACP members would like to see transcripts for any of the presentations then please contact the ACP office.