Leichsenring, Falk; Abbass, Allan; Fonagy, Peter; Levy, Kenneth; Lilliengren, Peter; Luyten, Patrick; Midgley, Nick; ... Sterinert, Christiane; + view all Leichsenring, Falk; Abbass, Allan; Fonagy, Peter; Levy, Kenneth; Lilliengren, Peter; Luyten, Patrick; Midgley, Nick; Milrod, Barbara; Sterinert, Christiane; - view fewer (2024) The WHO treatment guideline for mental disorders. The Lancet Psychiatry (In press).

Text Luyten_aLancet_Psychiatry_Comment - The WHO guideline for mental disorders.pdf Access restricted to UCL open access staff until 23 November 2024. Download (213kB)

Abstract

The World Health Organization (WHO) recently issued updated guidelines for treating mental health conditions, emphasizing evidence-based manual-guided psychotherapeutic treatments.1 We applaud the WHO's effort to broaden access to evidence-based psychotherapy. Yet, we are concerned that the recommendations predominantly endorse behavior therapy (BT) and cognitive-behavior therapy (CBT) methods, for both adults and young people. This selection overlooks the significant evidence supporting other therapeutic approaches, including but not limited to psychodynamic therapy, except for a brief acknowledgment of its use in treating adult depression. Recent high-quality research reviews, which have been published in high-ranking and leading scientific journals2, have demonstrated that manual-guided psychodynamic therapy meets the updated American Psychological Association's (APA) criteria for empirically supported treatments 3, based on several comprehensive meta-analyses.2 This endorsement covers the psychodynamic treatment of depressive, anxiety, somatoform, and personality disorders, with clinically meaningful effects over controls and no meaningful differences in efficacy compared to other evidence-based treatments and confidence intervals comparable to, for example, CBT.2 The quality (certainty) of evidence was comparable to that of the evidence on which the WHO based their recommendations, for example, for depressive disorders, anxiety disorders, or self-harm and suicide.4, p. XVIII-XXX In line with APA’s criteria for evidence-based treatments, this substantial body of evidence for psychodynamic therapy was shown to warrant a “strong recommendation” of psychodynamic therapy in the conditions listed above.2

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