Human Givens Therapy: The Evidence Base

Summary
This review of 95 documents on human givens therapy in the context of mental health finds that the evidence base is limited. It is overwhelmingly based on expert opinion backed up by brief case studies, or on therapists’ anecdotes, and little is published in the mainstream literature. Further, robust research is required.

Context
Human givens therapy developed in the early 1990s and is based on the notion that everyone has ‘given’ emotional and physical needs, and the innate resources to meet them. These are part of human nature and the means by which people achieve their full potential. Proponents claim that human givens therapy incorporates elements from other counselling and psychotherapy approaches, and can be used to identify and treat any problem, however severe, in one or two sessions. This review from the Centre for Ageing and Mental Health at Staffordshire University aims to test the evidence for what is an increasingly popular therapy.

Methods
What sources were used?

The following sources were searched from 1992 to June 2008: the Cochrane Library; Dogpile metasearch engine; Ebrary [Staffordshire University e-books]; Google Scholar; Ovid Nursing Collection; ProQuest Nursing and Allied Health Source; PsycINFO; PubMed; ScienceDirect; Scirus; Social Care Online; Web of Knowledge; and ZETOC. Three Human Givens journals were also hand searched, although with gaps for issues that were unavailable: Therapist; New Therapist; and Human Givens.

What search terms/strategies were used?

The sole search term was ‘human givens’.

What criteria were used to decide on which studies to include?

This is primarily a scoping review to identify what literature is in existence in a new field. Any reference to human givens therapy was thus potentially relevant.

Who decided on their relevance and quality?

A total of 876 items was identified, of which 582 were immediately excluded as irrelevant (e.g. web links, media articles, book reviews) or duplicates. Of the remainder, 13 were unavailable and another 144 were excluded on closer inspection as editorials, conversation pieces, personal pages or other subjective items. A total of 135 documents were acquired in full text, dealing with the human givens approach in various contexts including mental health, business, social work, education and policy. Documents selected for review were quality assessed using a referenced approach that allocates a level of evidence from Ia (based on meta-analysis of randomised controlled trials) to IV (evidence from expert committee reports or opinions, or respected clinical experience, or both). Specific responsibility for screening and quality assessment is not reported.

How many studies were included and where were they from?

The review focuses on the 95 documents dealing with the human givens approach in mental health. These are listed in Table 1 which categorises studies on the basis of context (human givens approach, mental health services, human givens therapy, miscellaneous) and descriptors (conceptual, organisational, application, techniques), and reports their evidence level.

How were the study findings combined?

The review is narrative and based on the categorisation in Table 1.

Findings of the review
Human givens approach

Of the 30 documents in this category, 22 were purely theoretical and offered no evidence of effectiveness. The remainder consisted of five ‘expert opinions’ accompanied by brief case studies, and three were anecdotal accounts by therapists. Twenty-four of the documents were from Human Givens publications (i.e. one of the three hand searched journals, or books from Human Givens publishers).

Mental health services

Seven studies examined the impact of employing human givens therapy from an organisational perspective, including the NHS and voluntary sector. All were categorised as expert opinion, five included brief case studies and two provided anecdotal evidence from a therapist. Six were from Human Givens publications.

Human givens therapy

Forty-one papers or books (40 from Human Givens publications) focused on therapies and were further sub-divided into general, addiction, anxiety, depression, psychosis, children or young people, clients’ experience, training, practice research network and miscellaneous. Virtually all were based on expert opinion plus brief case studies, or on anecdote, and all claimed positive outcomes. Only two papers provided slightly higher Level III evidence from descriptive studies and these focus specifically on the use of the rewind technique (also known as the visual-kinaesthetic dissociation technique, or fast phobia cure) to treat trauma, rather than on human givens therapy per se.

Miscellaneous

The 17 papers in this category referred to philosophy, approach or techniques but did not go into any detail. Eleven appeared in Human Givens publications and none provided evidence of effectiveness.

Authors' conclusions
The current evidence of effectiveness for human givens therapy is limited, overwhelmingly positive in respect of therapeutic outcomes, and largely based on expert opinion or anecdote. It is ‘not of sufficient quality to allow strong recommendations for its use to be made.’ Further research using rigorous designs and methods is needed, and details of some current initiatives by the Human Givens Foundation are provided. Mainstream journals are also advised to give ‘space for healthy debate to take place between counsellors, psychotherapists and all professionals in the mental health field.’