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When is a therapy not a therapy?

With the rise of pop psychology in the media, therapy has never been so fashionable and we all want a piece of the pie. Not real psychotherapy, you understand, as that would involve a bit of effort on our part and a level of soul-searching most of us either aren’t ready for or don’t really need. No, this therapy supposedly offers us therapeutic benefits without actually doing anything we wouldn’t be doing anyway. Thus, everything from de-cluttering your home to shopping for non-essentials to getting your legs waxed is deemed to be therapeutic. So it’s not surprising members of the medical profession get a little twitchy when discussing which therapies are to be funded by the NHS.

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Therapies in NHS healthcare

As one of the most misused words in the English language, it’s worth returning to the dictionary definition of ‘therapeutic’ when considering the place of therapies in NHS healthcare. Its meaning is given as ‘relating to the curing of disease, curative; contributing towards or performed to improve health or general wellbeing‘ (my italics). If it just said ‘to improve health’ we’d be on solid ground; there could be little argument that a person with a fractured arm might not benefit from physiotherapy to strengthen their arm muscles after six weeks of wearing a cast and not using them at all. But ‘general wellbeing’ is a much woolier concept, which is why stirring risotto is thought by some to be as therapeutic as a 5k run.

Whilst I’m not going to deny there is real pleasure in shopping for new shoes or cooking for friends I think it’s stretching things a bit far to say either is truly good for our health, particularly when such pleasures are entirely subjective. Relaxation is undoubtedly an important part of supporting good health, even more so in a world where so many people feel stressed out, but by confusing downtime with formalised programmes of therapeutic activity we’re in danger of forfeiting genuinely health-promoting therapies in the NHS. When faced with decisions about funding, it is easy for managers to dismiss the therapeutic benefits of massage, art or dance when the world at large considers splurge-shopping to be retail therapy.

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