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We don’t know enough about psychological treatments, and we need to

The development of effective and evidence-based psychological treatments is one of the major triumphs of the last decades. And based on this triumph, some folks say we don’t really need to know why they work, we just need more of them.

But that is jumping the gun on policy, and may just further embed the status quo into our management of mental health problems. All of this at a time when even better treatments are more possible than ever.
Every day, the news reports new studies about brain function – mental health advocates should be standing up to claim a fair share of emerging research.

As the authors of an article published in Nature argue – how and why psychological treatments work matters a great deal.

The evidence-base for psychological treatments is strong, but just like pharmaceuticals, they are not effective for everyone, whether in clinical trials or in practice. In the UK, our real-life experience with the Government’s Improving Access to Psychological Therapies (IAPT) project has demonstrated just that: psychological treatment was successful for about 40% of people and reduced the symptoms of an additional 20%. That’s three in five people with ongoing distress, still experiencing despair or anxiety after our best treatments.

Furthermore, the authors note that psychological treatments are not as targeted as they could be. They provide several examples of how greater integration of clinical science and neuroscience may help to make a difference for people living with hard-to-treat illnesses, like Major Depressive Disorder, or Obsessive Compulsive Disorder. With increased understanding of neural circuitry, the ‘wiring of the brain’, we are learning more about how “talking therapies” affect – and even change – wiring, behaviour and emotions.

Integration of sciences will make a difference for special populations too – which believe it or not, includes our children. Research is needed to understand the longer-term impact of psychological interventions to either treat or prevent mental illness.

So, what can we do to make psychological treatments even more effective? To begin with, we need to support this call for more integrated research. We will never know the potential impact of research efforts until we try.

And what are we doing to achieve this? The answer at the moment is: not enough. MQ’s preliminary findings, which informed the Nature article, show that less than 15% of UK mental health research is focused on psychological treatments.

Following MQ’s international conference on psychological treatments we launched our psy-impact programme, which is providing over a million pounds to stimulate innovation and advances in the field of psychological treatments. Importantly, the funding call represents a balanced approach to addressing questions of mechanisms and improving access to care.

But this is only a start. We need major resources now to improve our scientific understanding through research. We also need public support to help to find the answers to questions that could transform treatment and improve the quality of life for many, many people.

Last updated: 2 June 2016

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