UK REGULATION OF PSYCHOTHERAPY

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Permalink Reply by Doreen Cohanim C.Ht on August 22, 2009 at 6:09am

Hello Gil,
Thanks for sharing this Information.

Doreen Cohanim C.Ht

• ▶ Reply

Permalink Reply by GIL BOYNE on August 22, 2009 at 6:23am

The PLG report can be found at http://www.hpc-uk.org/aboutus/consultations/


Response to PLG report July 2009 from AIP, AGIP, Arbours, CFAR, The College of Psychoanalysts-UK, Guild of Psychotherapists, The Site for Contemporary Psychoanalysis, Philadelphia Association

Before detailing specific comments on the report by the HPC Professional Liaison Group on the proposed statutory regulation of psychotherapists and counsellors, it is helpful to make some general points about the report and the draft standards of proficiency which are attached to it. All of these general points have been made repeatedly in meetings with the HPC as well as in written correspondence over the last three years:

1) The Government White Paper on Trust, Assurance and Safety had given the Health Professions Council the task of assessing the ‘regulatory needs’ of the field and ‘ensuring that its system is capable of accommodating them’. These two briefs have simply not been met by the HPC consultation or by the work of the PLG. There has been both an absence of sustained rational debate on the central issues and an exclusion of critical voices, a fact which has been brought to the attention of HPC and of MPs repeatedly.

2) Many practitioners of talking therapies do not see their work as constituting in any way a health profession, and their traditions have been critical of the received notions of health, illness and wellbeing that the HPC consultation and the PLG report take as given. Despite the fact that this point has been made innumerable times, it is not reflected in either the content of the report or the standards of proficiency.

3) The view of therapy presupposed in many parts of the report and in the standards of proficiency is at odds with many traditions of therapy over the last century. Therapy is not conceived as an intervention to be applied to a patient, but rather as an activity which the patient him or herself engages in, facilitated by the therapist. It is thus not a question of the transmission of knowledge or skills from one party to another, just as it is not in any way comparable with a medical style intervention such as the administration of a drug or any other form of predetermined procedure.

4) The report and the standards of proficiency presuppose a concept of self that is radically rejected by many schools of psychotherapy. This is the modern idea that the self is reducible to a set of skills and competencies which must be forever improved. On this model, the human being is seen as a business which has to better itself, making it an ever more viable competitor in the marketplace. Although there may be some therapists who subscribe to this view, it is totally opposed to many therapeutic traditions which base the very work of therapy on a critique of socially accepted notions of selfhood.
5)
For these therapies, the self is not there to be ‘improved’ or ‘bettered’, but rather to allow its history to be explored, and its fractures, frustrations and disappointments to be recognised. The growth and change that may follow do not constitute an 'improvement' or 'bettering', as this would suggest a normative view of what people should be. The standards of proficiency thus presuppose the very idea of self that thousands of therapists work every day to undermine in their practice. There is thus both a contradiction and an absurdity in trying to force therapists to frame their work within standards of proficiency that uphold the very values that the therapeutic process aims to put in question.


Comments on HPC Draft Document on the Statutory Regulation of Psychotherapists and Counsellors.

Page 6

The constitution of the PLG is described here as including “individuals representing professional bodies, education and training providers, a qualification awarding body and organisations representing the interests of service users”. It is not pointed out that the choice of the 17 members rigorously excluded all those who had critical views of HPC regulation who had been nominated by their organisations or who had nominated themselves for the PLG. It was thus a highly biased collection of individuals, which also excluded the service user group the Association of Psychoanalysis Users. Instead HPC chose the advocacy group Witness, which is funded partly by the Department of Health and which has worked closely with HPC. It is also incorrect to state that the PLG included “organisations” representing service users, as there was only one, if Witness can be so described.

Page 7

The report states that ‘the responses to the [HPC’s] Call for Ideas informed the discussion and recommendations of the PLG’. In fact there has been a remarkable failure to respond to any of the critical responses to the Call for Ideas aside from noting which groups had made which points in a previous HPC document. After this cosmetic registering of some criticisms, HPC has failed to respond in any detailed or serious way to the points made in response to the Call for Ideas. It was pointed out several times to the HPC that the PLG meetings had failed to include adequate discussion of the majority of the points that had been made.

Paragraph 19 and 20 refer to the stakeholder events held in Manchester in March 2009. There is no mention of the criticisms made of the HPC project there or of the HPC’s refusal to hold a further meeting in response to the request from stakeholders and members of the public who attended and saw an absence of any engagement with the points that were made. The Manchester event was simply there as an airbrushing exercise to create the false impression that HPC had ‘listened’.

Page 8

Paragraph 26 It is stated that ‘the role of the PLG was to discuss and make recommendations about how psychotherapists and counsellors might be regulated in light of the conclusions in the White Paper’. Yet the White Paper had required the HPC to assess the ‘regulatory needs’ of the field and whether it was suited to ‘accommodate’ this field. Neither of these crucial questions was in fact taken up in any sustained or serious way by the PLG meetings, the minutes of which are publicly available.

Page 29

Voluntary registers to be considered for transfer to HPC require that members demonstrate a commitment to CPD. Although many therapists would accept this idea, there are also important traditions in psychoanalysis and psychotherapy which do not accept the idea of CPD. Becoming an analyst or therapist, according to these traditions, involves profound psychological change which is not the result of knowledge or anything that can be taught in a course or learning environment. Such change can be more accurately compared to losing a limb than to memorising a handbook of information. For these traditions, that is what allows the person to then be open to working with the unconscious of other people. Given this view, it makes little sense to argue that the practitioners need to update their knowledge and skills on an annual basis. This would be like making the person prove on an annual basis that their limb hadn’t miraculously re-grown. These traditions also hold that the result of any serious analysis or therapy is a questioning of the vanity of human knowledge. This is completely at odds with the modern mentality of CPD in which an ‘expert’ is brought in to dispense the latest knowledge to those who wish to better or improve themselves. Psychoanalysis and many forms of psychotherapy do not have a cumulative model of knowledge, but rather sees the loss of knowledge as decisive. Freud, for example, said that the analyst must forget everything they know each time they see a patient. Taking this seriously, CPD would involve ensuring that the practitioner is able to not know anything. The paradoxes of this form of assessment are also well known, with clinicians feeling that they have to prove themselves to some external authority: This, indeed, is exactly the kind of dynamic that many forms of therapy aim to collapse.




Page 32

Point 9 Here, and at several other places in the document, there is a reference to clinicians only being able to practice ‘in those fields in which they have appropriate education, training and experience’. On the surface this may seem a very reasonable obligation, but it introduces important political factors which have an impact on how the fields are defined for which such education, training and experience are relevant. There is a very real danger here that models of diagnosis and categorisation of human distress – such as that provided by DSM – will be used here as benchmarks, despite the fact that many traditions in psychoanalysis and psychotherapy have their own classificatory systems which disagree with those of DSM, or indeed, which object to the very notion of the classification of human beings into groups through the process of dividing them via external symptoms. The danger is that notions prevalent in modern healthcare, such as ‘best practice’, ‘evidence based research’ and ‘mental illness’ will be used uncritically in order to tell therapists who they can and cannot work with.

Page 35

The document states that if a registrant’s competence is called into question, the ‘standards of proficiency set by HPC are taken into account in deciding whether any action is necessary’. Since the standards of proficiency proposed are so dramatically incompatible with many long established traditions in psychotherapy, it puts registrants at great risk of having their practices adversely affected by the application of frameworks which are unsuited to assess or evaluate them.

Page 36

There are several paragraphs here which state the requirements of certain standards of proficiency in English language to enable a therapist or counsellor to be able to practice. This is a rather absurd requirement as there is no intrinsic reason why a therapist should have to speak a certain level of English: this may be for the obvious reason that the patients they receive would wish to speak in their own mother tongue, shared with the therapist which is not English but also, and more fundamentally, because language is itself a psychological variable which will form part of the transference. If someone has been brought up by a parent who couldn’t speak the language of the country they happen to be in they may well seek out later in life a therapist who clearly has difficulty speaking a language. As long as the therapist does not claim to have standards of proficiency which they do not in fact possess it is surely the choice of the patient who they wish to speak to. Insisting on a certain proficiency in English language removes that freedom of choice from members of the public.

--

• ▶ Reply

Permalink Reply by GIL BOYNE on December 5, 2009 at 6:50am

Kevin Carey tells a tale:

While Congress has become pretty thoroughly professionalized in recent decades, state legislatures are still home to some genuinely eccentric people. Back when I was working for the Indiana General Assembly, one member (and not the member who was, no lie, a radio psychic) became convinced that it was crucially important for the state to address, via statute, the problem of rogue hypnotists travelling the land, preying upon unsuspecting Hoosiers. He wasn't anti-hypnotist, mind you--he thought the government needed to protect people from unqualified hypnotists. If you ask me, real hypnotists are the ones we should be worried about (You want...to give me...your credit card...information...) but then I'm not a duly-elected public servant.

So the state passed a hypnotist licensing law, complete with the requisite boards, professional standards, forms to fill out, fees to pay, and so on. The law is still on the books; see here for more information on the Indiana Hypnotist Committee and its approved study guides (e.g. Hypnosis, Is it For You?, Lewis R. Wolberg, M.D., Dembner Books 1982.) If you're interested, the next exam is scheduled for Friday, December 11th at 9:00 AM. Bring a pencil!

Then, after the law was enacted, a funny thing started happening: The state began receiving license applications from people who didn't live in Indiana. People who lived in states (i.e. most states) that didn't require hypnotist licensing of any kind. Some were from as far away as California. It turns out they were doing it so they could advertise in the yellow pages and on bus-stop billboards as "state-licensed." They would just neglect to mention which state.
Carey's point is that (a) there's a lot of stupid occupational licensing laws out there, but (b) there's also a need for some way to signal that you're competent. I would add two more lessons: (c) people aren't always honest about the signals they're sending, and (d) sometimes licensing can facilitate that dishonesty rather than restrain it.



GIL BOYNE said:

The PLG report can be found at http://www.hpc-uk.org/aboutus/consultations/


Response to PLG report July 2009 from AIP, AGIP, Arbours, CFAR, The College of Psychoanalysts-UK, Guild of Psychotherapists, The Site for Contemporary Psychoanalysis, Philadelphia Association

Before detailing specific comments on the report by the HPC Professional Liaison Group on the proposed statutory regulation of psychotherapists and counsellors, it is helpful to make some general points about the report and the draft standards of proficiency which are attached to it. All of these general points have been made repeatedly in meetings with the HPC as well as in written correspondence over the last three years:

1) The Government White Paper on Trust, Assurance and Safety had given the Health Professions Council the task of assessing the ‘regulatory needs’ of the field and ‘ensuring that its system is capable of accommodating them’. These two briefs have simply not been met by the HPC consultation or by the work of the PLG. There has been both an absence of sustained rational debate on the central issues and an exclusion of critical voices, a fact which has been brought to the attention of HPC and of MPs repeatedly.

2) Many practitioners of talking therapies do not see their work as constituting in any way a health profession, and their traditions have been critical of the received notions of health, illness and wellbeing that the HPC consultation and the PLG report take as given. Despite the fact that this point has been made innumerable times, it is not reflected in either the content of the report or the standards of proficiency.

3) The view of therapy presupposed in many parts of the report and in the standards of proficiency is at odds with many traditions of therapy over the last century. Therapy is not conceived as an intervention to be applied to a patient, but rather as an activity which the patient him or herself engages in, facilitated by the therapist. It is thus not a question of the transmission of knowledge or skills from one party to another, just as it is not in any way comparable with a medical style intervention such as the administration of a drug or any other form of predetermined procedure.

4) The report and the standards of proficiency presuppose a concept of self that is radically rejected by many schools of psychotherapy. This is the modern idea that the self is reducible to a set of skills and competencies which must be forever improved. On this model, the human being is seen as a business which has to better itself, making it an ever more viable competitor in the marketplace. Although there may be some therapists who subscribe to this view, it is totally opposed to many therapeutic traditions which base the very work of therapy on a critique of socially accepted notions of selfhood.
5)
For these therapies, the self is not there to be ‘improved’ or ‘bettered’, but rather to allow its history to be explored, and its fractures, frustrations and disappointments to be recognised. The growth and change that may follow do not constitute an 'improvement' or 'bettering', as this would suggest a normative view of what people should be. The standards of proficiency thus presuppose the very idea of self that thousands of therapists work every day to undermine in their practice. There is thus both a contradiction and an absurdity in trying to force therapists to frame their work within standards of proficiency that uphold the very values that the therapeutic process aims to put in question.


Comments on HPC Draft Document on the Statutory Regulation of Psychotherapists and Counsellors.

Page 6

The constitution of the PLG is described here as including “individuals representing professional bodies, education and training providers, a qualification awarding body and organisations representing the interests of service users”. It is not pointed out that the choice of the 17 members rigorously excluded all those who had critical views of HPC regulation who had been nominated by their organisations or who had nominated themselves for the PLG. It was thus a highly biased collection of individuals, which also excluded the service user group the Association of Psychoanalysis Users. Instead HPC chose the advocacy group Witness, which is funded partly by the Department of Health and which has worked closely with HPC. It is also incorrect to state that the PLG included “organisations” representing service users, as there was only one, if Witness can be so described.

Page 7

The report states that ‘the responses to the [HPC’s] Call for Ideas informed the discussion and recommendations of the PLG’. In fact there has been a remarkable failure to respond to any of the critical responses to the Call for Ideas aside from noting which groups had made which points in a previous HPC document. After this cosmetic registering of some criticisms, HPC has failed to respond in any detailed or serious way to the points made in response to the Call for Ideas. It was pointed out several times to the HPC that the PLG meetings had failed to include adequate discussion of the majority of the points that had been made.

Paragraph 19 and 20 refer to the stakeholder events held in Manchester in March 2009. There is no mention of the criticisms made of the HPC project there or of the HPC’s refusal to hold a further meeting in response to the request from stakeholders and members of the public who attended and saw an absence of any engagement with the points that were made. The Manchester event was simply there as an airbrushing exercise to create the false impression that HPC had ‘listened’.

Page 8

Paragraph 26 It is stated that ‘the role of the PLG was to discuss and make recommendations about how psychotherapists and counsellors might be regulated in light of the conclusions in the White Paper’. Yet the White Paper had required the HPC to assess the ‘regulatory needs’ of the field and whether it was suited to ‘accommodate’ this field. Neither of these crucial questions was in fact taken up in any sustained or serious way by the PLG meetings, the minutes of which are publicly available.

Page 29

Voluntary registers to be considered for transfer to HPC require that members demonstrate a commitment to CPD. Although many therapists would accept this idea, there are also important traditions in psychoanalysis and psychotherapy which do not accept the idea of CPD. Becoming an analyst or therapist, according to these traditions, involves profound psychological change which is not the result of knowledge or anything that can be taught in a course or learning environment. Such change can be more accurately compared to losing a limb than to memorising a handbook of information. For these traditions, that is what allows the person to then be open to working with the unconscious of other people. Given this view, it makes little sense to argue that the practitioners need to update their knowledge and skills on an annual basis. This would be like making the person prove on an annual basis that their limb hadn’t miraculously re-grown. These traditions also hold that the result of any serious analysis or therapy is a questioning of the vanity of human knowledge. This is completely at odds with the modern mentality of CPD in which an ‘expert’ is brought in to dispense the latest knowledge to those who wish to better or improve themselves. Psychoanalysis and many forms of psychotherapy do not have a cumulative model of knowledge, but rather sees the loss of knowledge as decisive. Freud, for example, said that the analyst must forget everything they know each time they see a patient. Taking this seriously, CPD would involve ensuring that the practitioner is able to not know anything. The paradoxes of this form of assessment are also well known, with clinicians feeling that they have to prove themselves to some external authority: This, indeed, is exactly the kind of dynamic that many forms of therapy aim to collapse.




Page 32

Point 9 Here, and at several other places in the document, there is a reference to clinicians only being able to practice ‘in those fields in which they have appropriate education, training and experience’. On the surface this may seem a very reasonable obligation, but it introduces important political factors which have an impact on how the fields are defined for which such education, training and experience are relevant. There is a very real danger here that models of diagnosis and categorisation of human distress – such as that provided by DSM – will be used here as benchmarks, despite the fact that many traditions in psychoanalysis and psychotherapy have their own classificatory systems which disagree with those of DSM, or indeed, which object to the very notion of the classification of human beings into groups through the process of dividing them via external symptoms. The danger is that notions prevalent in modern healthcare, such as ‘best practice’, ‘evidence based research’ and ‘mental illness’ will be used uncritically in order to tell therapists who they can and cannot work with.

Page 35

The document states that if a registrant’s competence is called into question, the ‘standards of proficiency set by HPC are taken into account in deciding whether any action is necessary’. Since the standards of proficiency proposed are so dramatically incompatible with many long established traditions in psychotherapy, it puts registrants at great risk of having their practices adversely affected by the application of frameworks which are unsuited to assess or evaluate them.

Page 36

There are several paragraphs here which state the requirements of certain standards of proficiency in English language to enable a therapist or counsellor to be able to practice. This is a rather absurd requirement as there is no intrinsic reason why a therapist should have to speak a certain level of English: this may be for the obvious reason that the patients they receive would wish to speak in their own mother tongue, shared with the therapist which is not English but also, and more fundamentally, because language is itself a psychological variable which will form part of the transference. If someone has been brought up by a parent who couldn’t speak the language of the country they happen to be in they may well seek out later in life a therapist who clearly has difficulty speaking a language. As long as the therapist does not claim to have standards of proficiency which they do not in fact possess it is surely the choice of the patient who they wish to speak to. Insisting on a certain proficiency in English language removes that freedom of choice from members of the public.

--

• ▶ Reply

Permalink Reply by GIL BOYNE on December 29, 2009 at 12:58pm

Fears of hypnosis “not proven”
Article from the Sunday Mail, Adelaide
The Psychological Practice Bill 2006 would remove the requirement restricting hypnosis to registered psychologists, medical practitioners and dentists. A Health Department report, called for by Health Minister John Hill has looked into the concerns and possibility of a code of conduct.
The April 2008 report found "evidence of harm to the public does not appear sufficient to warrant a prohibition on the practice" for lay hypnotists.. In Parliament, Mr Hill recommended the issues be examined as part of the Social Development Committee's inquiry into bogus, unregistered and de-registered health practitioners.
He said there were a number of reasons for removing hypnotherapists from the act.
"The reasons for doing that were the recommendations that the fact no other state regulated hypnosis in this way, and the lack of evidence that the lack of regulation of hypnosis had caused any detriment in the community," he said.

• ▶ Reply

Permalink Reply by GIL BOYNE on December 31, 2009 at 2:38pm

Home Health Health NewsBritish surgeons should hypnotise patients for some operations, says academic
British surgeons should be taught to hypnotise patients to control pain for some operations rather than rely on general anaesthetics, according to a leading American academic.

By Daily Telegraph Reporter
Professor David Spiegel, of the Department of Psychiatry and Behavioural Sciences at Stanford University, wants the National Institute for Health and Clinical Excellence (Nice) to sanction sweeping changes.
He will tell the Royal Society of Medicine on Monday that Nice should add hypnotherapy to its list of approved therapeutic techniques for the treatment of conditions ranging from allergies and high blood pressure to the pain associated with cancer treatment and bone marrow transplantation.

"It is time for hypnosis to work its way into the mainstream of British medicine," says Professor Spiegel.
There is solid science behind what sounds like mysticism and we need to get that message across to the bodies that influence this area.

"Hypnosis has no negative side-effects. It makes operations quicker, as the patient is able to talk to the surgeon as the operation proceeds, and it is cheaper than conventional pain relief. Since it does not interfere with the workings of the body, the patient recovers faster, too.

"It is also extremely powerful as a means of pain relief. Hypnosis has been accepted and rejected because people are nervous of it. They think it's either too powerful or not powerful enough, but, although the public are sceptical, the hardest part of the procedure is getting other doctors to accept it."

Last year, the Daily Telegraph reported how a pensioner had knee surgery using just hypnosis to control the pain.

Trained hypnotist Bernadine Coady, 67, was wide awake for the one-hour operation, which is usually performed under a general anaesthetic.

A spokesman for the National Council for Hypnotherapy said of her case that the technique has been used for centuries for pain relief.

He added: "It is used often other countries, for example Belgium, as an alternative to anaesthetics and patients report that it is very successful, that they feel no pain during their operations."

The theory behind medical hypnosis is that the body's brain and nervous system cannot always distinguish an imagined situation from a real occurrence. As a result the brain can act on any image or verbal suggestion as if it were reality.

Hypnosis puts patients into a state of deep relaxation that is very susceptible to imagery; the more vivid this imagery, the greater the effect on the body.

Nice said it would welcome submissions for hypnotherapy to be considered as an approved therapeutic technique on the NHS if it could be cost-effective and consistent delivery could be guaranteed.

But Professor Steve Field, who chairs the Royal College of General Practitioners, said he was sceptical as to whether hypnotherapy could meet these standards.

"It is a useful tool used by some GPs and patients for relaxation, but I don't think it is something that we should support being rolled out to all medical students and all doctors," he said.

"We can't call on the NHS to support it without there being a firm medical and economic basis, and I'm not convinced those have been proved to exist."

• ▶ Reply

Permalink Reply by Kelley Woods on December 31, 2009 at 2:59pm

There it is...a firm economic basis being an obstacle. Why give inexpensive, side-effect free hypno-analgaesia when millions can be profited from drugs?!

GIL BOYNE wrote
"But Professor Steve Field, who chairs the Royal College of General Practitioners, said he was sceptical as to whether hypnotherapy could meet these standards.

"It is a useful tool used by some GPs and patients for relaxation, but I don't think it is something that we should support being rolled out to all medical students and all doctors," he said.

"We can't call on the NHS to support it without there being a firm medical and economic basis, and I'm not convinced those have been proved to exist."

• ▶ Reply

Permalink Reply by Attila J. Kun ACHE Cert.Instr. on January 1, 2010 at 8:53pm

Hello, My name is Attila Kun and I am a Clinical Hypnotherapist based in Ontario, Canada . Three years ago, I attended Gil Boyne’s Master Class in Los Angeles and I told him I was from Hungary and I wanted to introduce Hypnotherapy into my homeland. It has been unknown there and a few Doctors had prevented anyone from practicing or teaching it.

He told me that the first step was to make a plan and take some direct action as soon as I could. He promised that if I made a start, he would come to Budapest to assist me.

In 2008, I went to Budapest and taught a class to eleven students. One of them is an influential businessman who offered to help. He invited Mr. Boyne to come to Budapest to teach and arrangements were made for him to appear on the #1 talk show on the only national TV channel in Hungary. In addition, magazine interviews were arranged as well.

The TV show featured Mr. Boyne hypnotizing King Victor, who is the top singer, dancer and stage performer in Hungary and then hypnotizing the host of the show as well.

More than seven million people watched the show and the result has been amazing.

I will be giving a much larger class in 2010 and several students have set up their

practice.already.

I read the invitation that Mr. Pap Lambert Istvan sent to Gil Boyne which has been posted on this forum and I want everyone to know how generous Gil has been (he refused any payment for his 4-day visit)
and how effective his presentation has been.

I feel certain that hypnotherapy will grow and flourish in Hungary after this great awakening.

Attila Kun

• ▶ Reply

Permalink Reply by GIL BOYNE on January 2, 2010 at 2:06pm

Hello Kelley, This is the reason I went to Budapest---7 1/2 Million people watched the TV presentation. A flood of of emails, letters and class reservations have resulted. Ignorance and blackouts are being overcome!

Hello Mr. Boyne
My name is Pap Lambert Istvan,
I became the first certified complementary hypnotherapist in Hungary, with your training that Attila was teaching us in 2008 and 2009. All course materials was of the Hypnotism Training Institute and Attila translated to Hungarian and presented with over 300 pages information to a group of 11 people for 4 weeks, among them a dentist, psychologist, teachers, and some massage therapist, etc…
First, in 2008, I finished a teacher’s course on basic hypnosis and I teach a two days course of the hypnosis basics. This course is the foundation for Attila’s more advanced trainings.
In Hungary the law is still very old and referring to a case of a person died in a séance over a hundred years ago and currently only medical practitioners are allowed to use hypnotherapy for healing.
They already tried to shut me down and had to appear in front of a medical hearing board of an accusation of practicing medicine without proper credentials. Fortunately, I used the same legal knowledge that you wrote in your book, and Attila taught us the way to explain things and they had withdrawn for now and dropped the case.
You are now a legend among all of us, whom Attila trained and .
I would like to invite you to Hungary for a few days, if there is a possibility in October this year when Attila is teaching three courses again. I would offer a private home for your comfort with all luxuries, a car with chauffeur, and a tour in Budapest.
It would be a first time when the people would have a chance to meet, talk and learn from such master as you. In Hungary, We really need things to be different in the field of hypnosis and I would pull all my resources to get a TV or a newspaper interview for you, After all this would be the first time that, the Hypnotist of the Century would visit my country.
We are in a need for that here, so the non-medical practice of hypnotherapy could be accepted.

With all respect,
Pap Lambert Istvan
www.hipnotizor.hu
► Reply to This


Kelley Woods said:

There it is...a firm economic basis being an obstacle. Why give inexpensive, side-effect free hypno-analgaesia when millions can be profited from drugs?!

GIL BOYNE wrote
"But Professor Steve Field, who chairs the Royal College of General Practitioners, said he was sceptical as to whether hypnotherapy could meet these standards.

"It is a useful tool used by some GPs and patients for relaxation, but I don't think it is something that we should support being rolled out to all medical students and all doctors," he said.

"We can't call on the NHS to support it without there being a firm medical and economic basis, and I'm not convinced those have been proved to exist."

• ▶ Reply

Permalink Reply by Henxy on January 4, 2010 at 11:27pm

Hi Kelley,

NICE recommends treatments based on effectiveness and cost-effectiveness. HT IS expensive per person. If the same or similar benefit can be gained from a few tablets (even Tramadol, which is probably the most expensive oral analgesic), then it is going to be chosen over HT for that very reason. All the added benefits of HT can't be taken into consideration by NICE; as the basis for accepting or denying treatment for a particular situation needs to be tightly focused. Most analgesics are out of patent here now anyway, so cheap generics are bought instead.

NICE denies thousands of drugs to be recommended, too. Its purpose is cost-effectiveness (so usually, expensive means not recommended).

Kelley Woods said:

There it is...a firm economic basis being an obstacle. Why give inexpensive, side-effect free hypno-analgaesia when millions can be profited from drugs?!

• ▶ Reply

Permalink Reply by Kelley Woods on January 5, 2010 at 7:01am

What?! Are you busting my belief bubble here, Henxy?! I had assumed the monetary costs of using drugs outweighed a hypno-approach, but you have pointed out otherwise. I suppose I was thinking of clients who have been dependent on opiates and other medications for years...like one of mine who was taking 27 pills a day.
Thanks for the information ~ Kelley

Henxy said:

Hi Kelley,

NICE recommends treatments based on effectiveness and cost-effectiveness. HT IS expensive per person. If the same or similar benefit can be gained from a few tablets (even Tramadol, which is probably the most expensive oral analgesic), then it is going to be chosen over HT for that very reason. All the added benefits of HT can't be taken into consideration by NICE; as the basis for accepting or denying treatment for a particular situation needs to be tightly focused. Most analgesics are out of patent here now anyway, so cheap generics are bought instead.

NICE denies thousands of drugs to be recommended, too. Its purpose is cost-effectiveness (so usually, expensive means not recommended).

Kelley Woods said:

There it is...a firm economic basis being an obstacle. Why give inexpensive, side-effect free hypno-analgaesia when millions can be profited from drugs?!

• ▶ Reply

Permalink Reply by Henxy on January 5, 2010 at 11:46pm

Sorry, Kelley!

I'm not sure what it's like across the pond, as I know only of UK costs etc, but opiates such as morphine are cheap (it's drug dealers who make them expensive!). Sadly, it's peoples' time which is the most expensive, particularly when the patient/client requires more than one treatment session. I would post the cost differences here, but it's privileged information, unfortunately.

Tablets with different formulations and mixtures can be expensive, but only when they're within their patent years. (Which is how the company recoups the cash from R&D and testing, and makes a profit). As soon as they're off patent, anyone can copy them into cheap generics.

And the thing about tablets? They don't need any training or qualifications to administer, and therefore the greatest expense (i.e. staff) is saved by the patient taking the meds themselves.

Personally, I like to have all the options open to me. And I don't like to restrict myself to a single, particular approach. Sadly, when rationing needs to occur, then cost-effectiveness has to play its part. Most people could benefit from HT IMHO, but most people aren't presenting with problems which can justify the expense when resources are finite.

Kelley Woods said:

What?! Are you busting my belief bubble here, Henxy?! I had assumed the monetary costs of using drugs outweighed a hypno-approach, but you have pointed out otherwise. I suppose I was thinking of clients who have been dependent on opiates and other medications for years...like one of mine who was taking 27 pills a day.
Thanks for the information ~ Kelley

Henxy said:

Hi Kelley,

NICE recommends treatments based on effectiveness and cost-effectiveness. HT IS expensive per person. If the same or similar benefit can be gained from a few tablets (even Tramadol, which is probably the most expensive oral analgesic), then it is going to be chosen over HT for that very reason. All the added benefits of HT can't be taken into consideration by NICE; as the basis for accepting or denying treatment for a particular situation needs to be tightly focused. Most analgesics are out of patent here now anyway, so cheap generics are bought instead.

NICE denies thousands of drugs to be recommended, too. Its purpose is cost-effectiveness (so usually, expensive means not recommended).

Kelley Woods said:

There it is...a firm economic basis being an obstacle. Why give inexpensive, side-effect free hypno-analgaesia when millions can be profited from drugs?!

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Permalink Reply by Michael Ellner on January 6, 2010 at 4:29am

Kelley,

On our side of the pond - non-steroidal anti-inflammatory drugs, or NSAIDs generates many billions of dollars. These are the expensive pain killers that are used for arthritis and other types of chronic pain.

Henxy,

It seems to me the NHS bean counters are not counting the human costs of taking these tablets for the rest of one's life. Example, in 2003 Vioxx earned 2.5 billion dollars in worldwide sales and in 2004 Vioxx was pulled from the shelves because it was killing it's long-term users. Factor in the costs of visits and treatments for Vioxx related heart disease and stroke and Hypnosis is very cost effective!

6 to 12 HT sessions could improve the patients quality of life and reduce or elminate the need for pain killers and working with a hypnotist can give them skills that will serve them for the rest of their lives. I think that is a lot cheaper than paying for the future visits and additional treatments that become necessary for treating the adverse effects of the long term painkiller use...

Just my opinion.



Henxy said:

Sorry, Kelley!
I'm not sure what it's like across the pond, as I know only of UK costs etc, but opiates such as morphine are cheap (it's drug dealers who make them expensive!). Sadly, it's peoples' time which is the most expensive, particularly when the patient/client requires more than one treatment session. I would post the cost differences here, but it's privileged information, unfortunately. Tablets with different formulations and mixtures can be expensive, but only when they're within their patent years. (Which is how the company recoups the cash from R&D and testing, and makes a profit). As soon as they're off patent, anyone can copy them into cheap generics.

And the thing about tablets? They don't need any training or qualifications to administer, and therefore the greatest expense (i.e. staff) is saved by the patient taking the meds themselves.

Personally, I like to have all the options open to me. And I don't like to restrict myself to a single, particular approach. Sadly, when rationing needs to occur, then cost-effectiveness has to play its part. Most people could benefit from HT IMHO, but most people aren't presenting with problems which can justify the expense when resources are finite.

Kelley Woods said:

What?! Are you busting my belief bubble here, Henxy?! I had assumed the monetary costs of using drugs outweighed a hypno-approach, but you have pointed out otherwise. I suppose I was thinking of clients who have been dependent on opiates and other medications for years...like one of mine who was taking 27 pills a day.
Thanks for the information ~ Kelley

Henxy said:

Hi Kelley,

NICE recommends treatments based on effectiveness and cost-effectiveness. HT IS expensive per person. If the same or similar benefit can be gained from a few tablets (even Tramadol, which is probably the most expensive oral analgesic), then it is going to be chosen over HT for that very reason. All the added benefits of HT can't be taken into consideration by NICE; as the basis for accepting or denying treatment for a particular situation needs to be tightly focused. Most analgesics are out of patent here now anyway, so cheap generics are bought instead.

NICE denies thousands of drugs to be recommended, too. Its purpose is cost-effectiveness (so usually, expensive means not recommended).

Kelley Woods said:

There it is...a firm economic basis being an obstacle. Why give inexpensive, side-effect free hypno-analgaesia when millions can be profited from drugs?!

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