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Horses for courses: choosing an evidence-based psychological therapy for your patient

  • David McCormack (a1) and Trudie Chalder (a2)
Summary

Choosing an intervention for a patient experiencing distressing symptoms and/or suffering with a mental disorder is part of routine practice for clinicians. While there are now many effective pharmacological and psychological therapies for mental health problems, syndromes and persistent physical symptoms (e.g. chronic pain), choosing the ‘right’ therapy can sometimes be a challenge. This can certainly be the case when it comes to psychological therapies. There are many different approaches to choose from and many have not been subjected to rigorous study.

In this article, we aim to help inform and guide the busy clinician in choosing a psychological therapy for their patient. We give a brief overview of the major psychotherapy modalities and consider which guidelines to refer to and which psychological therapies have been found to be most effective for the presenting problem(s) seen in clinic. Lastly, we discuss the limitations of the current guidelines in relation to comorbid presentations and consider how this can be best addressed.

LEARNING OBJECTIVES

  • Develop knowledge regarding the major psychotherapy approaches
  • Be aware that there is no psychotherapy equivalence
  • Learn that there is good evidence that some approaches are more effective than others for specific problems and be better able to choose a psychological therapy

DECLARATION OF INTEREST

D. McC. works on research trials funded by the Guy's and St Thomas’ Charity. T. C. receives salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, and receives several grants for evaluating the efficacy of different cognitive–behavioural approaches. This article received no specific grant from any funding agency, or from the commercial or not-for-profit sectors. The views expressed in this article are those of the authors and not necessarily those of the NIHR or the NHS.

Copyright
Corresponding author
Correspondence Professor Trudie Chalder, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK. Email: trudie.chalder@kcl.ac.uk
References
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Adam, D (2013) On the spectrum. Nature, 496: 416–8.
Ali, S, Findlay, C (2016) A review of NICE guidelines on the management of borderline personality disorder. British Journal of Medical Practitioners, 9(1): a909.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (5th edn) (DSM-5). American Psychiatric Publishing.
Barlow, DH, Farchione, TJ, Fairholme, CP, et al. (2010) Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Oxford University Press.
Bateman, A, Holmes, J (1995) Introduction to Psychoanalysis: Contemporary Theory and Practice. Routledge.
Beck, AT (1976) Cognitive Therapy and the Emotional Disorders. Meridian.
Beck, AT (1993) Cognitive therapy: nature and relation to behavior therapy. Journal of Psychotherapy Practice and Research, 2: 342–56.
Bion, WR (1962) Learning from Experience. Heinemann.
Blenkiron, P (1999) Who is suitable for cognitive behavioural therapy? Journal of the Royal Society of Medicine, 92: 222–9.
Breuer, J, Freud, S (1895) Studies on hysteria. Reprinted (1953–1974) in the Standard Edition of the Complete Psychological Works of Sigmund Freud (trans & ed Strachey, J), vol. 2. Hogarth Press.
Butler, G (1998) Clinical formulation. In Comprehensive Clinical Psychology. Volume 6 Adults: Clinical Formulation & Treatment (eds Bellack, AS, Hersen, M): 124. Pergamon.
Butler, AC, Chapman, JE, Forman, EM, et al. (2006) The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clincal Psychology Review, 26: 1731.
Carr, A (2008) What Works with Children, Adolescents, and Adults?A Review of Research on the Effectiveness of Psychotherapy. Routledge.
Cristea, IA, Gentili, C, Cotet, C (2017a) Efficacy of psychotherapies for borderline personality disorder: a systematic review and meta-analysis. JAMA Psychiatry, 74: 319–28.
Cristea, IA, Stefan, S, Karyotaki, K, et al. (2017b) The effects of cognitive behavioral therapy are not systematically falling. Psychological Bulletin, 143(3): 326–40.
Dummett, N (2005) Processes for systemic cognitive-behavioural therapy with children, young people and families. Behavioural and Cognitive Psychotherapy, 34: 179–89.
Elliott, R, Watson, J, Greenberg, LS, et al. (2013) Research on humanistic-experiential psychotherapies. In Bergin & Garfield's Handbook of Psychotherapy and Behavior Change (ed Lambert, MJ): 495538. Wiley.
Ellis, A (1962) Reason and Emotion in Psychotherapy. Citadel Press.
Flaskas, C (2005) Psychoanalytic ideas and systemic family therapy: revisiting the question ‘why bother?’. Australian and New Zealand Journal of Family Therapy, 26: 125–34.
Freud, S (1910) The origin and development of psychoanalysis. American Journal of Psychology, 21: 181–96.
Gabbard, GO (2007) Major modalities: psychoanalytic/psychodynamic. In Oxford Textbook of Psychotherapy (eds Gabbard, GO, Beck, JS, Holmes, J): 313. Oxford University Press.
Goldberg, SB, Tucker, RP, Greene, PA, et al. (2018) Mindfulness-based interventions for psychiatric disorders: a systematic review and meta-analysis. Clinical Psychology Review, 59: 5260.
Hacker, T, Stone, P, MacBeth, A (2016) Acceptance and commitment therapy – Do we know enough? Cumulative and sequential meta-analyses of randomized controlled trials. Journal of Affective Disorders, 190: 551–65.
Horney, K (1999) Neurosis and Human Growth. Routledge.
Janet, P (1901) The Mental State of Hystericals. Putnam's Sons.
Jenkins, H, Asen, K (1992) Family therapy without the family: a framework for systemic practice. Journal of Family Therapy, 14: 114.
Johnsen, TJ, Friborg, O (2015) The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: a meta-analysis. Psychological Bulletin, 141: 747–68.
Johnstone, L, Dallos, R (2006a) Formulation in Psychology and Psychotherapy: Making Sense of People’s Problems. Routledge.
Johnstone, L (2006b) Controversies and debates about formulation. In Formulation in Psychology and Psychotherapy: Making Sense of People's Problems (eds Johnstone, L, Dallos, R): 208–31. Routledge.
Klein, M (1984) Envy and Gratitude and Other Works 1946–1963. Hogarth Press.
Lampropoulos, GK (2001) Bridging technical eclecticism and theoretical integration: assimilative integration. Journal of Psychotherapy Integration, 11: 519.
Leichsenring, F, Rabung, S, Leibing, E (2004) The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders: a meta-analysis. Archives of General Psychiatry, 61: 1208–16.
Ma, K (2006) Attachment theory in adult psychiatry. Part 1: conceptualisations, measurement and clinical research findings. Advances in Psychiatric Treatment, 12: 440–9.
Mace, C, Binyon, S (2005) Teaching psychodynamic formulation to psychiatric trainees. Part 1: basics of formulation. Advances in Psychiatric Treatment, 11: 416–23.
Minuchin, S, Rosman, BL, Baker, L (1978) Psychosomatic Families. Harvard University Press.
Mowrer, OH (1947) On the dual nature of learning – a re-interpretation of ‘conditioning’ and ‘problem-solving’. Harvard Educational Review, 17: 102–48.
NICE (2005a) Post-traumatic Stress Disorder (PTSD): Management (NICE Clinical Guideline CG26).
NICE (2005b) Obsessive-Compulsive Disorder: Treatment (NICE Clinical Guideline CG31).
NICE (2007) Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy): Diagnosis and Management (NICE Clinical Guideline CG53).
NICE (2009a) Depression in Adults: Recognition and Management (NICE Clinical Guideline CG90).
NICE (2009b) Borderline Personality Disorder: Recognition and Management (NICE Clinical Guideline CG78).
NICE (2013) Social Anxiety Disorder: Recognition, Assessment and Treatment (NICE Clinical Guideline CG159).
NICE (2014) Psychosis and Schizophrenia in Adults: Prevention and Management (NICE Clinical Guideline CG178).
Norcross, JC, Goldfried, MR (2005) Handbook of Psychotherapy Integration. Oxford University Press.
Oei, TPS, Dingle, G (2008) The effectiveness of group cognitive behaviour therapy for unipolar depressive disorders. Journal of Affective Disorders, 107: 521.
Patton, MJ, Meara, NM, Robbins, SB (1992) Psychoanalytic Counseling. John Wiley & Sons.
Pavlov, IP (1927) Conditioned Reflexes. Oxford University Press.
Pearce, S, Scott, L, Attwood, G, et al. (2017) Democratic therapeutic community treatment for personality disorder: randomised controlled trial. British Journal of Psychiatry, 210: 149–56.
Power, M, Brewin, CR (1991) From Freud to cognitive science: a contemporary account of the unconscious. British Journal of Clinical Psychology, 30: 289310.
Rogers, C (1951) Client-Centered Therapy. Constable.
Roth, A, Fonaghy, P (2005) What Works for Whom? A Critical Review of Psychotherapy Research. Guilford Press.
Shadish, WR, Baldwin, SA (2003) Meta-analysis of MFT interventions. Journal of Marital and Family Therapy, 29: 547–70.
Spinelli, E (2014) Practising Existential Therapy. Sage.
Stratton, P (2011) The Evidence Base of Systemic Family and Couples Therapies. Association for Family Therapy.
Taylor, CDJ, Bee, P, Haddock, G (2017) Does schema therapy change schemas and symptoms? A systematic review across mental health disorders. Psychology and Psychotherapy: Theory, Research and Practice, 90: 456–79.
Tarrier, N, Johnson, J (2015) Case Formulation in Cognitive Behaviour Therapy: The Treatment of Challenging and Complex Cases (2nd edn). Routledge.
Vos, J, Craig, M, Cooper, M (2015) Existential therapies: a meta-analysis of their effects on psychological outcomes. Journal of Consulting and Clinical Psychology, 83: 115–28.
Watson, JB, Rayner, R (1920) Conditioned emotional reactions. Journal of Experimental Psychology, 3: 114.
Wolpe, J (1968) Psychotherapy by reciprocal inhibition. Conditional Reflex, 3: 234–40.
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BJPsych Advances
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Horses for courses: choosing an evidence-based psychological therapy for your patient

  • David McCormack (a1) and Trudie Chalder (a2)
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