Merits of Simple Intervention

Abstract

This chapter concerns the growth of an idea about the merits of simple intervention. At the outset, I should own up to the bias of my own vantage point, that of a psychiatrist working within the United Kingdom National Health Service. It is important to acknowledge this particular perspective because it has determined the clinical influences that I feel have been important. Shedding firmly held beliefs about treatment is a disconcerting and unnerving process, particularly when new beliefs come to be held with equal tenacity. Are the new beliefs about simple intervention based on convincing evidence or are they simply the latest fashion waiting to be discarded for the next season’s model? In 1977, The Lancet commented on current approaches to services for alcoholics thus:

This treatment approach owes its existence more to historical process than to science. It is possible to discern the deposits, akin to geological layers, of a sequence of therapeutic fashions—the residue of almost forgotten enthusiasms for in-patient psychotherapy units, for group processes and the therapeutic community, for family therapy and later for community psychiatry. To say that treatment for alcoholism is only an accretion of fads and fashions would be too harsh, for it is also built on much clinical experience; but it must be admitted that we have not done enough to assess scientifically the effectiveness of treatment methods. (Lancet, 1977, p. 489)