Future of psychotherapy in the NHS
http://www.100md.com
《英国医生杂志》
EDITOR—Goldbeck-Wood and Fonagy said that one of the key obstacles for psychotherapy has been a conflict of cultures.1 Differences in the training of psychotherapists also have a key role in hindering the recognition of psychotherapy as an independent profession. In addition to the various modalities of psychotherapy, the huge variation in psychotherapists' training backgrounds makes it difficult for anyone to understand what they do.
A psychotherapist can be a counsellor, a social worker, a general practitioner, a clinical psychologist, or a psychiatrist. No mandatory training or regulatory bodies exist for psychotherapists in general, and the term is often used loosely, so anyone with little training can call himself or herself a psychotherapist. Moreover, who practises what kind of psychotherapy is also influenced by social and political factors.2 3 Public resources are more likely to be allocated to psychotherapy if an individual claim is made for a specific kind of psychotherapy and therapist, rather than using a general term.
Although "general practice psychotherapy" has previously been debated, it has now been accepted as a legitimate and important health service provided by the public health system in Canada. Similarly, in Australia, a recent initiative has given five incentives for general practitioners to engage in psychosocial counselling and brief psychotherapy strategies for patients, with publications and courses being offered to practitioners who are interested in becoming general practitioner psychotherapists. In the United States, with the influence of health management organisations, much psychotherapy is now conducted either by clinical psychologists or social workers to reduce costs.2 This is the only way towards governments in any country allowing healthcare money to be spent on psychotherapeutic treatments.
Samuel Y S Wong, assistant professor 4/F
Department of Community and Family Medicine, Chinese University of Hong Kong, Hong Kong SAR, China yeungshanwong@cuhk.edu.hk
Competing interests: None declared.
References
Goldbeck-Wood S. The future of psychotherapy in the NHS: more evidence based services are taking shape to meet growing demand. BMJ 2004;329: 245-6. (31 July.)
Gabbard G, Kay J. The fate of integrated treatment: whatever happened to the biopsychosocial psychiatrist? Am J Psychiatr 2001;158: 1956-63.
Lieberman F. Psychotherapy and the clinical social worker. Am J Psychiatr 1987;41: 369-83.
A psychotherapist can be a counsellor, a social worker, a general practitioner, a clinical psychologist, or a psychiatrist. No mandatory training or regulatory bodies exist for psychotherapists in general, and the term is often used loosely, so anyone with little training can call himself or herself a psychotherapist. Moreover, who practises what kind of psychotherapy is also influenced by social and political factors.2 3 Public resources are more likely to be allocated to psychotherapy if an individual claim is made for a specific kind of psychotherapy and therapist, rather than using a general term.
Although "general practice psychotherapy" has previously been debated, it has now been accepted as a legitimate and important health service provided by the public health system in Canada. Similarly, in Australia, a recent initiative has given five incentives for general practitioners to engage in psychosocial counselling and brief psychotherapy strategies for patients, with publications and courses being offered to practitioners who are interested in becoming general practitioner psychotherapists. In the United States, with the influence of health management organisations, much psychotherapy is now conducted either by clinical psychologists or social workers to reduce costs.2 This is the only way towards governments in any country allowing healthcare money to be spent on psychotherapeutic treatments.
Samuel Y S Wong, assistant professor 4/F
Department of Community and Family Medicine, Chinese University of Hong Kong, Hong Kong SAR, China yeungshanwong@cuhk.edu.hk
Competing interests: None declared.
References
Goldbeck-Wood S. The future of psychotherapy in the NHS: more evidence based services are taking shape to meet growing demand. BMJ 2004;329: 245-6. (31 July.)
Gabbard G, Kay J. The fate of integrated treatment: whatever happened to the biopsychosocial psychiatrist? Am J Psychiatr 2001;158: 1956-63.
Lieberman F. Psychotherapy and the clinical social worker. Am J Psychiatr 1987;41: 369-83.