Recently, several people with personal experience of anxiety have indicated that Charles Linden has sought to prevent his method being discussed on forums and bulletin boards they operate or moderate. This included threats of legal action and more. Now the people concerned are, in my view, dedicated to helping people suffering from anxiety problems, providing a valuable resource to those people and their loved ones. I understand that Charles Linden referred to OCDUK as a “sufferer’s club”! Time, I thought, to review personally the situation vis a vis the Linden Method.

It was easy to get a snapshot of what was going on. A quick search turned up the posting below, which appeared on Amazon reviews

This is part of a sequence, which at my most recent viewing shows a number of posts “removed by user”; as I understand it, this may have been because of the threat of the threat of legal action. However, it seems to sum up Charles Linden’s position so I have focussed on this rather than previous attempts to refute my review. From Amazon, I have pasted Charles Linden’s comments in Italics, then added my thoughts in bold below them.

“Forst of all. Please wait around a month and we will be publishing our 2014 data… this will be more representative of the 2012-2014 client outcomes data recently gathered. “

Great! Some data at last! However, see my comment below. It is indeed data Charles, but not data as we know it….. see section 6 below.

“You provide a quote from Paul Salkovoskis’ review of the Linden Method… let me assure you entirely that:
1. Paul Salkovskis did not have access to The Linden Method material”

I most definitely did.

2. Paul Salkovskis never spoke to a member of my staff

True. Not sure what this is meant to signify? I review scientific and clinical papers along with most of my clinical and clinical academic colleagues. We do not routinely speak to the centres involved, that’s one of the reasons that such reviews are called “independent”. As part of the NICE guidelines group for anxiety, we did not contact the authors of the papers we reviewed; their published material, in the public domain, is what is required. In any case, support for a programme of this kind would be to help the person experiencing the anxiety problem to better implement the programme as set out in the materials I had. My review was of the core, and would be entirely unaffected by any additional support which may or may not be accessed by those trying to make sense of the Linden Method. I will, however, comment on the qualifications (or otherwise) of TLM support staff in the next section of this blog.

3. Paul Salkovskis never requested data from us

This is not true. When I spoke with Charles Linden when the review first appeared, I asked about data and he said that the testimonials of people using the method was all he needed. I pointed out that this was not data of the kind usually required for clinically focussed programmes. As someone once rather cleverly, said, “the plural of anecdote is not data”. Given that I had heard testimonials from people for who it had not worked and who had been refused a refund, this was pretty much the end of this. Glad to see that Charles now claims “science” and “data” supports his position (although this is questionable…see below) but what is crystal clear that he does not have data of the type required by clinicians and scientists who adhere to an evidence based and empirically grounded approach; again see sections below.

4. Paul Salkovskis never spoke to a single TLM client.

No, that’s correct, it was multiple TLM “clients”! I think what Charles means is people he wanted me to speak to. I spoke instead to people I wanted to speak to and who wanted to speak to me.

As far as I can tell from his ‘review’… he hasn’t got a clue about any aspect of what it is we provide or do.

Completely untrue. I had the materials provided. These are the materials TLM provided to their clients at that time and I had read them carefully and, I think, understood them well. More recently, I have seen the narratives on the TLM websites (which are everywhere) and those independent comments which are still up on the web. I have seen various figures on the proportion of people accessing additional support; TLM websites claim 40%, which means that 60% rely on the materials alone at this point. It was, I suspect, a lot less in 2005.

His comment about NICE is 100% incorrect, TLM does indeed fall within CG113 for Guided Self Help… confrmed by NICE, NICE’s regional agent and by use the person who wrote the CG113 guidance.

At the time I wrote the review, I had been a member of the NICE guideline group for anxiety and it was true at the time. I have since been a member of the second guidelines group, and I am able to say that TLM peer review publications were not considered, for the simple reason that there were none in existence. There are still none in existence. A weird point. NICE does not have “regional agents”. He says he spoke to the person who wrote the guidance. The guideline group wrote the guidance….I was a member of that group and was involved in its writing. Again, I need to say: TLM didn’t appear on the horizon, because there were no published or in process peer reviewed articles on it. It is therefore by definition excluded from NICE recommendation; there are no data of the type required by NICE. Remember, NICE is an NHS organisation, and where a guideline exists for a particular problem, the NHS quite appropriately requires NICE approval. Until subjected to appropriate and properly conducted research, TLM is not going to be adopted by the NHS. CG113 refers to guided self-help based on the principles of CBT; the systematic review for the relevant section found guided self help based on the principles of CBT effective; no other approaches were found to be effective. The Linden Method was not included, as there are no data meeting the rather low criteria for inclusion in the review for the method.

His comments around TLM not being evidence based is inaccurate… he never asked for the data required and has made an assumption based on something other than the available data.

Not at all. Back in 2006 I did ask for it. More importantly, in terms of the data required by NICE and Health organisations, there are no peer review publications. None. Perhaps there are some data which might convince me not in the public domain with appropriate quality control, in which case Charles is welcome to send it to me.


His comments around our science being flawed is incorrect… far more informed people than him have confirmed that our science is, in fact, spot on

This is a tough one. I don’t want to make false claims about how well informed I am about anxiety and its problems. How well informed about anxiety and its treatment am I? Should I brag about this? Not sure that’s going to help, and I will simply have to allow people to judge how well informed or otherwise I am on the science. One way of doing that would be to google me on “Google Scholar”.
http://scholar.google.co.uk/
just put “Salkovskis” in the search field and it will show my research publications.
Now try “Teeney”, one of the leading experts used by Linden. You will find not very much from him (there are a few other Teeneys) but as far as I can tell his most cited paper is this one in the journal “Sociology”
http://soc.sagepub.com/content/44/6/1019.short
Its not about anxiety, although it is mildly interesting. But not relevant to people trying to get help for their anxiety.
I looked up the clinical psychologist on the website, Romulo Valdez in terms of peer review publications on anxiety. Not been able to find him so far, but I’m still looking. Relatively speaking, I am happy to claim being well informed about the science surrounding anxiety and its problems. I have even done some of the research and published it in peer review journals.
So back to Linden’s point. I maintain that what I saw in the materials and what I have seen on the websites more recently is seriously flawed science. Experts? From the Linden website I find Romulo Valdez, Jr., Ph.D. I had never heard of him before today. Publication record in anxiety? He has none that I can find. However, he has endorsed the Linden Method and is at least a clinical psychologist. Anxiety researchers in the USA I contacted had not heard of him. Then there is another expert; Dr Francis Teeney Honorary Lecturer in Psychology at Queens University Belfast. He is a Senior Research Fellow, Institute of Conflict Transformation and Social Justice, Queen’s University Belfast andResearch Fellow, University of Aberdeen, Leverhulme Trust funded project in Compromise after Conflict (2009). What he is not is a clinical psychologist. Publications in anxiety? None.

and that the science around CBT is in fact flawed.. in fact that the practice of CBT in the treatment of anxiety disorders is damaging to the sufferer. Even the RCPsych states that CBT isn’t a solution…

What a fantastic out of context quote! Royal College of Psychiatrists says CBT is not the solution for all people with all problems, which is of course fine. However, they do in fact strongly recommend CBT for anxiety as the leading evidence based psychological approach. This can be found in lots of places, but most accessibly here:
http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/anxiety,panic,phobias.aspx
CBT is damaging to sufferers? This claim flies in the face a very large mountain of evidence, real evidence. It is self-evidently absurd.

I have never met a person that has been cured by CBT, not one in 16 years and 160,000 ex clients… I have met many cured sufferers… they are our ex clients.

Wow! But other people have. Many other people. And then, there is the massive outcome literature. Maybe Charles should look at the NICE anxiety guideline in its full version, which summarises the data that were synthesised in meta-analyses to produce the guideline. Or perhaps read some of the actual outcome literature. I think he would find it a useful education.

His price comment is ludicrous when you consider that one of his own paperbacks costs almost as much on amazon

Here it looks like Charles is struggling to understand how Amazon works so I am happy to help him out here. I have seen Charles refer to this before, and I fear that he maybe doesn’t understand the internet, amazon and so on, He has mentioned something like this before. I think he is referring to things like:

Let me help you, Charles. These are second hand sales of an out of print book. Probably you don’t know, but this money does not go to the book’s editor (me) but to the seller. This was originally an academic book I edited, intended mainly for libraries, and very good it was too. However, if you want to see a book for which I am responsible and which is aimed at people suffering from anxiety, try

I should alert readers of this view to a potential financial conflict of interest on my part. I and my co-authors get a percentage of this; I think 12%, divided three ways. We intend to have a good night out on the proceeds in the not too distant future.
So; Charles may think my price comment ridiculous, but I maintain, as I did in the original review, that in my opinion the price of the Linden Method is way too high.

….and that for our very low fee we provide The Method materials, CDs, DVDs, a members area containing dozens of high quality resources and unlimited support by BACP and BPS registered psychotherapists

Tricky that one. Can’t see any of them registered on
http://www.bps.org.uk/bpssearchablelists/ropsip
Again, I will come back to this issue later

by email and phone for up to 12 months – That sounds like a bargain to me…

It indeed should sound like a Great Bargain to you because it is! Assuming that it is true (and the website says it is), that 200,000 people bought the Linden Basic Package (forget the more expensive versions) and, as appears to be suggested in one of the many websites, 160,000 recovered (therefore didn’t get a refund). At an average, say, of £100 per person, then that is at least £16,000,000 paid to the company. Really, it SHOULD sound like a bargain to you Charles. Maybe not so much for those that pay the money though.

We even include the postage all for £137…. (it’s £97 for I ownload version) his final comment about ‘extraordinary claims’ is laughable… the evidence was right there but he never asked for it… in fact, the guy that was originally tasked with writing the review was blown away by what we did when he visited us AT the Linden Centre… he was so impressed that he wrote a wonderful review, which was immediately ditched after he had spent a day with us and my team at the centre gathering REAL facts…. the review was too positive,

Entirely incorrect. The opposite was true. The original reviewer liked your hospitality but still was not prepared to write a positive review, which is why you protested and indicated that you did not consider him qualified to write it. That was precisely the point where I was asked to review it. Extraordinary claims do indeed demand extraordinary evidence.

So they wheeled out Salkovskis to give ita touch of his ‘magic’… a review based on absolutely nothing he had ever seen, touched, researched or been party to.

I firmly maintain that I had all I needed at the time, and was (and am) well qualified to review the Linden Method, whether or not I have wheels.

Is what we offer unfair? Materials plus unlimited qualified support and a ‘money back guarantee’ for up to one year… that sounds pretty fair to me… does Salkovskis offer a gurantee on his ‘psychological care’? Doubtful!

No, what is offered by TLM is, as I said in the review, expensive. Do I offer a money back guarantee? No. However, on the other hand, I don’t charge people with anxiety for my treatment. Like the rest of the NHS its free at the point of delivery, as in my view it should be.

If you visited the centre and spoke to our team, saw the results for yourself and listened to the team working, you wouldn’t attempt to back up the uninformed remarks of the nay sayers… you WOULD indeed support what we do.
I love what we do… why? because I KNOW that we prevent people from having to endure the 27 years of crap that I endured… the testimonials people leave about us are REAL… they are not, despite what some might believe, written by US. We all at the centre defend what we do because what we do changes lives… many lives… if Salkovskis, charities and the like have issues with us changing lives… then they have issues with people recovering and only one conclusion can be drawn from that.

We should all be careful of “Trust me, I’m a doctor and I only have your best interests at heart”. We should similarly be careful of “Trust me, I’m selling my programme and I only have your best interests at heart”. As should be clear, the issues are rather different to the ones Charles Linden is drawing attention to.
Anyway Charles, I’m happy, if you want, to update my review to your present version of the programme. Interested?