Cognitive Behavioural Therapies in Britain: Welfare, Society and the Individual since 1948

英国的认知行为疗法：1948 年以来的福利、社会和个人

• 批准号: MR/S016120/1
• 负责人: Sarah Marks
• 金额: $ 44.31万
• 依托单位: Birkbeck, University of London
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FS016120%2F1
• 关键词: Cognitive; Behavioural; Therapies; Britain; Welfare

Cognitive Behavioural Therapy is the most widely-used talking treatment in the contemporary world, with significant political and economic backing within the UK health service. Its techniques are also widely influential in private psychotherapeutic practice, self-help, social work, educational, occupational and criminal justice contexts. It is also one of the most controversial treatments, widely discussed in the public sphere, with some clinicians and service users arguing it is a "quick fix" that fails to address individuals' complex emotional, social and economic needs. Others, by contrast, campaign vehemently for its expansion. These contemporary debates lack a historical background - and professional politics often obscure the experiences of patients themselves. This research project addresses this gap. The adoption and development of behaviour therapies since the 1950s, and CBT in recent years, has been closely bound up with the history of the NHS, the rise of evidence-based medicine, and changing understandings of the individual and the welfare state. This research will result in a book, along with peer-reviewed research papers, based on archival sources from key research hospitals, the Wellcome Archives, universities' special collections, professional societies and mental health charities, and advocacy and service-user organisations. In addition, it will draw from a substantial printed literature including psychological research publications, specialised journals, clinical trials, professional memoirs, and policy and campaign literature from government, political parties, the third sector and patient groups. It will also use oral history interviews with clinicians, service-users, and policy-makers. Placing cognitive and behavioural approaches centre-stage challenges the continued over-representation of psychoanalysis in the historical writing on 20th century psychotherapeutics. Given the prominence of cognitive and behavioural approaches in contemporary society, a critical eye needs to be cast upon the history of its emergence and justifications for its use. Crucially, the experiences of service users needs to be written into the story, which I will do through extensive oral history interviews. This project will uncover the intertwined relationship between innovations in therapeutics and the rise of evidence-based research and governance, within an economically rationed National Health Service. It explores the development of new forms of service delivery, from specially-trained nurses and clinical psychologists, through to self-help books, 1970s innovations in computer programmes and later internet- and telephone-based services, examining the implications of these for patient experience. It also interrogates the clinical and cultural controversies surrounding its use in non-western and lower-income settings, in light of the increasingly influential Global Mental Health movement. Finally, I trace how CBT has become a cypher in wider cultural discussions about the relationship between the individual and the welfare state, the governance of labour and employment, and controversies around the psychological professions and coercion. Cognitive and behavioural therapies have long been the focus of vociferous debates about the nature of mind, rationality and personal responsibility, offering a prism through which we can better understand contested visions of human nature and agency since the Second World War. I also explore the cultural and political reasons why these approaches came to be so dominant in Britain in particular, by comparison with other European countries where it has not been so widely influential in policy.The finding of this research will offer new insights for contemporary debates about the use of cognitive and behavioural interventions in health, and in broader governance. In turn, it will be used to inform clinical training, and will have implications for clinical practice and policy.

认知行为疗法是当今世界最广泛使用的谈话治疗，在英国卫生服务中具有重要的政治和经济支持。它的技术在私人心理治疗实践、自助、社会工作、教育、职业和刑事司法方面也具有广泛的影响力。它也是最具争议的治疗方法之一，在公共领域被广泛讨论，一些临床医生和服务用户认为这是一种“快速解决方案”，无法解决个人复杂的情感，社会和经济需求。而另一些人则相反，他们激烈地为扩张而斗争。这些当代辩论缺乏历史背景，而职业政治往往掩盖了患者本身的经历。这个研究项目解决了这个问题。自20世纪50年代以来，行为疗法的采用和发展，以及近年来的CBT，与NHS的历史，循证医学的兴起以及对个人和福利国家不断变化的理解密切相关。这项研究将导致一本书，沿着同行评审的研究论文，基于来自主要研究医院的档案来源，威康档案馆，大学的特殊收藏，专业协会和心理健康慈善机构，以及宣传和服务用户组织。此外，它将从大量印刷文献中汲取，包括心理学研究出版物，专业期刊，临床试验，专业回忆录以及来自政府，政党，第三部门和患者团体的政策和运动文献。它还将使用对临床医生、服务使用者和政策制定者的口述历史采访。将认知和行为方法置于中心地位，挑战了精神分析在世纪心理治疗学历史著作中的持续过度表现。鉴于认知和行为方法在当代社会的突出地位，需要对其出现的历史和使用的理由进行批判性的审视。至关重要的是，服务用户的经历需要写入故事，我将通过广泛的口述历史采访来完成。该项目将揭示治疗创新与循证研究和治理的兴起之间的相互交织的关系，在经济配给的国家卫生服务中。它探讨了新形式的服务提供的发展，从受过专门训练的护士和临床心理学家，通过自助书籍，20世纪70年代在计算机程序和后来的互联网和电话为基础的服务的创新，研究这些对患者体验的影响。鉴于全球心理健康运动的影响力日益增强，它还探讨了围绕其在非西方和低收入环境中使用的临床和文化争议。最后，我追溯了CBT如何在更广泛的文化讨论中成为一个密码，这些讨论涉及个人与福利国家之间的关系，劳动和就业的治理，以及围绕心理职业和胁迫的争议。长期以来，认知和行为疗法一直是关于心灵本质、理性和个人责任的激烈辩论的焦点，它提供了一个棱镜，通过它我们可以更好地理解自第二次世界大战以来关于人性和能动性的有争议的观点。我还探讨了文化和政治原因，为什么这些方法来是如此占主导地位，特别是在英国，与其他欧洲国家相比，它还没有那么广泛的影响力在policy.The发现的研究将提供新的见解，当代辩论的认知和行为干预的健康，并在更广泛的治理。反过来，它将用于通知临床培训，并将对临床实践和政策产生影响。

项目成果

Hidden persuaders on film: Exploring young people's lived experience through visual essays

电影中隐藏的说服者：通过视觉文章探索年轻人的生活经历

• DOI: 10.14324/rfa.05.2.13
• 发表时间: 2021
• 期刊: Research for All
• 作者: Pick D

An Introduction to Mental Health and Illness: Critical Perspectives

心理健康和疾病简介：批判性观点

• 发表时间: 2020
• 作者: Marks, S.

Freud in Cambridge Review Symposium

剑桥弗洛伊德评论研讨会

• DOI: 10.1177/09526951221084503
• 发表时间: 2022
• 期刊: History of the Human Sciences
• 影响因子: 0.9
• 作者: Callard F

Understanding Mental Health and Counselling

了解心理健康和咨询

• 发表时间: 2020
• 作者: Marks, S.