Market saturation is when the producers of a product or service are producing just enough to satisfy demand, but no more. It’s much easier if businesses can control demand to match their production capacity, and this is what sophisticated marketing aims to do. Sophisticated marketing of this kind dominates CBT in the UK, but you probably don’t notice it.
To learn how to see this marketing in action, there are three steps. First, follow the money.
CBT in the UK is overwhelmingly paid for by the NHS. You might not think that if you have been fighting your GP for five years to get on to a two-year waiting list for treatment, but it is nevertheless true.
The gradual roll-out of IAPT (“Improving Access to Psychological Therapies”) by the government had led to extra funding for CBT in the NHS, increasing the already large market share that the NHS accounts for. The NHS is where the money is.
Second, think about what marketing does. An easy question — it influences purchasing decisions. So this invisible marketing must be influencing the NHS’s purchasing decisions.
CBT is not like nurses’ uniforms or floor polish, though. The NHS’s purchasing decisions for CBT are not made by bureaucrats in procurement departments. CBT is a treatment. The NHS’s purchasing decisions for treatments are made by bureaucrats in NICE (the National Institute for Clinical Excellence).
Third, think about how NICE works. It works by considering scientific evidence. The only way to influence NICE is to submit scientific evidence to it.
Scientific evidence comes from research. The scientists who do research are not marketing agencies, they don’t work for business, do they?
Well, yes they do. They work for the same organizations that provide CBT training — universities. The training industry and the scientists are the same folks.
The invisible marketing that drives CBT in the UK is the training industry’s output of research. The research influences NICE. NICE influences the NHS. The NHS buys the end product of the training. Woot!
Gordon Brown’s official website had to remove the word ‘depression’ at the weekend, replacing it with ‘downturn’, according to a news report, presumably because the original headline might have reminded people about the rumour the Prime Minister is taking antidepressants to help him cope. Whether you call the government’s economic disaster a depression or a downturn, it’s bad for businesses, and very very bad for businesses that rely on government money. That means it’s bad for the CBT training industry.
There are already reports that IAPT funding is being stealthily diverted for other things. The market for CBT training will shrink. Marketing, in the form of research evidence, will not prevent the shrinkage. A different business strategy is called for.
When production capacity exceeds demand, one way for the business to adapt is to divert production into other products whose markets are not yet saturated. Applying this logic to the CBT training industry, you would expect to see its marketing machine promoting related products.
But what products are related? How can the NHS be persuaded to buy the product of some other kind of training related to CBT? What other training is there?
What there is, and what you will increasingly see being marketed to the NHS, is additional training in relation to IAPT. This will not just be the training that’s needed so that IAPT workers can do their jobs. It will be additional, unnecessary training to help absorb excess capacity in the training industry as primary sources of funding go into decline.
The initial reasons given to persuade the NHS that this training has to be purchased will be a pick’n’mix of the usual blather that everyone is used to from politicians — to protect the public, to save the planet, for the sake of children everywhere, to help those least able to help themselves etc. etc. — known in the US as “motherhood and apple pie” reasons. The blather will soon be followed up by “research evidence”.
Kicking off this marketing drive, the NHS employees formerly known as ‘low intensity’ workers, who provide minimal support and self-help materials to patients with the very mildest of anxiety and depression, have been rebranded ‘psychological wellbeing practitioners’ (PWPs).
The BABCP has put in place what it calls an ‘accreditation process’ for them:
PWPs are essential to the success of the IAPT programme and we are proud of the way new training courses following a National Curriculum have been established. It is essential that the unique PWP role is properly recognised and protected with an accreditation process.
You can read more on the front page of the BABCP’s in-house magazine CBT Today (if it ever appears online, that is — at the time of writing the current issue has not been made public).
The article begins:
As Psychological Wellbeing Practitioners (PWPs) make a significant impact upon the nation’s mental health…
This despite the fact that PWPs don’t actually treat anyone.
As you read this self-congratulatory drivel, you can count off the training industry folk it names — academics from the universities of (in order of appearance): Exeter, Nottingham, Sheffield, York, King’s College London and Sheffield (again). Only one other person is named in the article — a bureaucrat employed by central government via a quango.
At least, in five years’ time, if you are still fighting your GP to get on to a two-year waiting list for genuine psychotherapy, you will know where all the money went.