For detailed listings of major projects within this programme, please click here
Needs addressed:
The main focus of this programme is to strengthen the evidence base relating to the clinical and cost-effectiveness of those psychological therapies which are widely practiced in the NHS but for which adequate empirical support is still lacking. These include the psychoanalytic and psychodynamic therapies, integrative therapies (eg. cognitive analytic therapy), creative therapies (eg. art therapy) and the systemic psychotherapies.
This is an important area of growth in mental health research (cf. NSF for Mental Health, NHSE Psychological Therapies Working in Partnership) where the Trust has already made a distinctive contribution with outcome studies across all age ranges and with substantial academic collaboration with several university partners both in the UK and internationally.
In addition, we prize our collaborative work with primary care research networks, which we intend to develop further..
Publications 2000/2001 = 14 publications in peer-reviewed journals
External funding
1999/2000 = £240,000
2000/2001 = £167,000
2001/2002 = £91,000
The programme plan has been developed in the light of recommendations from the NHSE Review of the Psychotherapies in England (1996). The primary emphasis is on the use of randomized controlled trial (RCT) methodology with appropriate adaptation for psychological treatments. The need for such RCTs in the field of mental health has been emphasized in the DoH Preliminary Findings from the Strategic Reviews for R&D for a First Class Service. Much of the Trust's work in this area is carried out with the support of the Psychotherapy Evaluation Research Unit (PERU).
Our aim is to bridge the conventional efficacy/effectiveness research distinction by conducting tightly controlled medium to large scale RCT research with high clinical representativeness and generalisability. The main elements of the programme are as follows:
1. Tavistock Adult Depression Study. This is the first large scale RCT of individual psychoanalytic psychotherapy for chronic/refractory depression in adults, a condition that has been highlighted as a priority in the NSF. It involves collaboration with the University of Essex Department of Health and Human Sciences, the UCL Department of Primary Care and Population Sciences and the North Thames Primary Care Research Network. The trial not only recruits patients from Primary Care, but also involves study of the impact of this 'hard-to-treat' group in a Primary Care setting. The trial is exceptional in recruiting patients who are typical of those presenting to the Health Services (ie they often have serious co-morbidity), and in applying a rigorous methodology to yield data pertaining to the effectiveness as well as efficacy of treatment. It also involves formal procedures such as manualization and recording and assessment of treatment.
2. The evaluation of psychoanalytic psychotherapeutic methods with children with a wide range of emotional and behavioural disturbances. The programme includes randomized controlled trials of treatment with the following groups:
3. Collaborative research on other psychological treatment methods for severe mental health problems (schizophrenia and personality disorder) in association with the South London and Maudsley Mental Health Trust. Such treatments include:
4. The Health Economic Evaluation of methods of psychological treatment (in collaboration with the Centre for the Economics of Mental Health, Institute of Psychiatry), including:
5. A series of individual Trust-based outcome and process studies focusing on systemic and psychoanalytic therapeutic approaches to a diversity of mental health problems in distinct patient groups, including
1. We aim to maximise the opportunities for mutual enhancement of our lifespan research into depression, and in particular, to co-ordinate our childhood and adult projects where this is fruitful
2. Research Council and other financial support will be sought for the consolidation of the Tavistock Adult Depression Study.
3.A programme of systematic reviews on psychological treatment approaches will be developed, extending our current work in the area. Within 2002/2003 we expect to complete systematic reviews on the psychological treatment of:
4. In collaboration with our primary care partners, we are developing applications for postgraduateTraining Fellowship programmes linked to the Tavistock Adult Depression Study, to bring on our junior research staff in this area.
5. We aim to consolidate our research links with the Department of Health and Human Sciences at the University of Essex, through the development of a programme of doctoral research bringing together our work on psychotherapeutic outcomes with their broader health services research perspective
6. We intend to pursue novel approaches to the typology of the conditions we are studying, so that they may be better fitted to different models of treatment
7. We are collaborating with the Mental Health Foundation in extending the involvement of Service Users in the design and evaluation of our projects
