Freedom of expression is a theme that recurs in different ways in this issue: in our letters pages, in an interview with a psychotherapist and dancer who works in prisons and in our report on everyday life in the West Bank which Martin Kemp and Eliana Pinto describe as ‘a gigantic open prison’. Our own media supply us with a stream of images of Palestinian people living amongst the rubble of their destroyed homes but we hear less about the short and longer term emotional impact of life under an endless occupation. The psychological consequences in children for example – a child becoming mute, another going temporarily blind, another developing panic attacks – are rarely reported. One interviewee who talked about working with ‘continuing traumatic stress disorder’ is of the view that 100 per cent of children subject to the siege of Gaza will be traumatised. This makes distressing reading especially as although there is increasing awareness and support being offered from those in the mental health field, there seems to be little hope of an improvement in the political situation.

Back home temperatures are still running high over regulation, IAPT and now NICE guidelines. Despite promises from Alan Johnson and Richard Layard in the Government’s statement of intent only a few months ago that patients must be offered a range of psychological therapies within IAPT, we now hear that NICE is currently consulting on its updated guidelines for depression 

in which counselling and short-term psychodynamic psychotherapy have been downgraded. Whereas in the existing guideline counselling is a first line intervention for mild to moderate depression in adults, the updated guideline states that counselling ‘may be considered for those who have declined a low intensity intervention or group CBT’. Counsellors, it goes on, must however ‘take care to explain the uncertainty about the effectiveness of counselling for people with depression’. The same now applies to short-term psychodynamic psychotherapy for moderate depression. To read what BACP is doing about this and what you can do go to page 46.