The Open UniversitySkip to content
 

How should we evaluate research on counselling and the treatment of depression? A case study on how NICE’s draft 2018 guideline considered what counts as best evidence

Barkham, Michael; Moller, Naomi P. and Pybis, Joanne (2017). How should we evaluate research on counselling and the treatment of depression? A case study on how NICE’s draft 2018 guideline considered what counts as best evidence. Counselling and Psychotherapy Research, 17(4) pp. 253–268.

Full text available as:
[img]
Preview
PDF (Version of Record) - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (202kB) | Preview
DOI (Digital Object Identifier) Link: https://doi.org/10.1002/capr.12141
Google Scholar: Look up in Google Scholar

Abstract

Background: Health guidelines are developed to improve patient care by ensuring the most recent and “best available evidence” is used to guide treatment recommendations (NICE Guidance, 2017). NICE’s revised guideline development methodology acknowledges that evidence needed to answer one question (treatment efficacy) may be different from evidence needed to answer another (cost effectiveness, treatment acceptability to patients; NICE, 2014/2017). This review uses counselling in the treatment of depression as a case study, and interrogates the constructs of ‘best’ evidence and ‘best’ guideline methodologies.

Method: The review comprises six sections: (1) the implications of diverse definitions of counselling in research; (2) research findings from meta-analyses and randomised controlled trials (RCTs); (3) limitations to trials-based evidence; (4) findings from large routine outcome datasets; (5) the inclusion of qualitative research that emphasises service-user voices; and (6) conclusions and recommendations.

Results: Research from meta-analyses and RCTs reviewed in the draft 2018 NICE guideline is limited but positive in relation to the effectiveness of counselling in the treatment for depression. The weight of evidence suggests little, if any, advantage to CBT over counselling once bias and researcher allegiance are taken into account. A growing body of evidence from large NHS datasets also evidences that counselling is both effective and cost-effective when delivered in NHS settings.

Conclusion: Recommendations in NICE’s own updated procedures suggest that sole reliance on RCTs and meta-analyses as best methodologies is no longer adequate. There is a need to include large standardised collected datasets from routine practice as well as the voice of patients via high-quality qualitative research.

Item Type: Journal Item
Copyright Holders: 2017 The Authors
ISSN: 1746-1405
Keywords: counselling; depression; IAPT; Health Guidelines; RCTs; large datasets; qualitative research
Academic Unit/School: Faculty of Arts and Social Sciences (FASS) > Psychology
Faculty of Arts and Social Sciences (FASS)
Item ID: 50623
Depositing User: Naomi Moller
Date Deposited: 22 Aug 2017 10:42
Last Modified: 25 Oct 2017 08:32
URI: http://oro.open.ac.uk/id/eprint/50623
Share this page:

Altmetrics

Download history for this item

These details should be considered as only a guide to the number of downloads performed manually. Algorithmic methods have been applied in an attempt to remove automated downloads from the displayed statistics but no guarantee can be made as to the accuracy of the figures.

Actions (login may be required)

Policies | Disclaimer

© The Open University   contact the OU