Sign the open letter: End mask “requirement” in healthcare settings
Given the lack of good scientific evidence to support the wearing of ‘face coverings’ to reduce viral transmission, together with the wide range of harms associated with them, there is no justification for healthcare services to persist with the ‘requirement’ for all staff, patients and visitors to wear a mask.
Health professionals, scientists and patients/members of the public are invited to co-sign our open letter to the NHS Chief Executives below. We will also be posting hard copies of this letter to the addressees.
Please note, we will not list individual names of members of the public but provide a total count instead.
Open Letter From Health Professionals, Scientists & Patients to the NHS Chief Executives:
- Amanda Pritchard, Chief Executive, NHS England
- Caroline Lamb, Chief Executive, NHS Scotland
- Judith Paget, Chief Executive, NHS Wales
- Robin Swann, Minister of Health, Northern Ireland
cc UK Secretary of State for Health and Social Care, UK Prime Minister & First Ministers Of The Four Nations.
We the undersigned British health professionals, scientists and patients, agree it is time to put the patient first again by ditching the mask in healthcare settings.
Given the sparsity of robust scientific evidence to support the effectiveness of ‘face coverings’ in reducing viral transmission, together with the wide range of harms associated with them as comprehensively detailed in this letter, there can be no justification for healthcare services to persist with the ‘requirement’ for all staff, patients and visitors to wear a face covering.
Indeed, several of the negative consequences are even more problematic in healthcare settings.
We call for the guidance for doctors, nurses and other health professionals be revised with immediate effect, leaving the individual (professional or service user) to decide and thereby bringing healthcare into line with other community settings.
(Full letter continues below…)
Sign This Open Letter Here
Now Over 8,850 Signatures
The United Kingdom has witnessed the lifting of almost all mask mandates, thereby allowing people to choose whether or not to cover their faces in community settings. Largely as a result of this welcome removal of coercive legislation, there has been a marked visible reduction in the prevalence of face coverings in retail settings, hospitality venues and on public transport. The prominent exceptions to this return to a mask-free society are NHS facilities and venues allied to health, with widespread masking of both staff and patrons persisting in all hospitals, health centres and GP practices, and most dentists, opticians and pharmacies. When asked to justify their ongoing ‘requirement’ for face coverings, a common response is that they are following NHS protocols to keep people safe.
We believe that healthcare’s insistence that staff and visitors continue to wear masks is both irrational and to the detriment of the people who use these services. The evidence and reasoning to support this assertion will be structured under four headings:
- The ineffectiveness of masking healthy people as a means of reducing viral transmission.
- The multiple harms associated with masking healthy people, with particular emphasis on those of most detriment in healthcare settings.
- The sparsity of evidence that high-quality medical masks – including those worn by surgeons when operating – are an effective means of infection control.
- The negative consequences of masks becoming culturally embedded in our healthcare venues.
1. The ineffectiveness of masking healthy people as a means of reducing viral transmission
A wealth of empirical evidence has accumulated in support of the premise that masking healthy people in community settings achieves no substantial reduction in levels of respiratory-virus transmission.
With regards to randomised controlled trials (RCTs) – the most robust type of evidence – a review of 14 such studies into the spread of influenza found that masks led to no significant reduction in risk of infection for neither the wearer nor others. As for the SARS-CoV-2 virus, a large RCT (often referred to as the ‘Danish mask study’), using appropriately-fitted and high-quality surgical masks, failed to realise any significant benefit for the wearer. Another RCT, conducted in rural Bangladesh, reported a very small reduction in general levels of COVID-19 infections among the mask-wearing group. But, importantly, the Bangladesh trial was essentially an exploration of the impact of a wider public health campaign that incorporated mask promotion as one of several elements and, therefore, the marginal reduction in the intervention group could plausibly have been the result of changes in other aspects of the participants’ behaviour, such as a greater inclination to stay at home when ill.
Real-world comparisons of masked and unmasked geographical regions, have also not delivered consistent support for the claimed benefits of face coverings. While some studies – such as this Canadian report – have proposed that COVID-19 infection and/or death rates have been significantly lower in places with mask mandates compared to those without, they have attracted wide-ranging criticism. In particular, the accusation of cherry-picking seems justified in light of there being many regions where infection rates were higher in mandated areas, such as shown in this comparison of Scottish and English schools during the autumn 2021 term. Furthermore, a Spanish study evaluating the impact of mask requirements on primary schools concluded they had no significant effect on rates of viral transmission, and a another investigation found that American states with compulsory-mask regulations did not realise significantly lower rates of viral transmission than states that did without such mandates. Also, a recent Spanish study that examined over 300 people with COVID-19 observed no association between risk of transmission and reported mask usage by their contacts.
Comprehensive reviews of all mask literature – incorporating those studies that suggest masks might achieve some benefits – have drawn the same overarching conclusion: masking the healthy is of no appreciable value. Thus, one detailed analysis formed the view that there is ‘little to no evidence’ that cloth masks in the general population are effective in reducing the transmission of respiratory viruses, while another review, conducted by the Cato Institute, concluded that a large volume of low-to-medium quality evidence had ‘largely failed to demonstrate their value in most settings’.
There are three plausible reasons why masking healthy people in the community is ineffective in reducing the transmission of respiratory viruses. First, the concern that those without symptoms will spread the SARS-CoV-2 virus – an argument commonly given to justify the blanket wearing of face coverings – has been inflated, based primarily on small-scale reports from China in the early stages of the pandemic. More robust research suggests that asymptomatic transmission contributes very little – maybe less than 7% – to the propagation of a pandemic.
Second, the virus is mainly spread by microscopic aerosols – not larger droplets – the former being far too small for masks to act as a barrier. Expert scientists have argued – despite some recent concerted efforts to censor their views – that cloth face coverings contain perforations that are far too big to act as a viral blockade and therefore ‘offer zero protection’. Furthermore, one study concluded that cloth face coverings can amplify the spread of infectious particles by acting as a ‘microniser’ transforming large droplets, which would ordinarily fall to the ground close to the person, into smaller, truly airborne ones.
Third, it is inevitable that the majority of non-specialist people, including reception and auxiliary staff in healthcare settings, often wear ill-fitting face coverings that have been improperly stored, frequently touched and rarely washed (cloth) or appropriately disposed of (plastic). As such, the insistence on universal masking will constitute a contamination hazard, thereby exacerbating the longstanding and seemingly intractable problem of hospital-acquired infections.
In summary, this lack of robust evidence to support the assertion that masking healthy people significantly reduces the transmission of respiratory viruses is, on its own, sufficient to raise serious doubts about the rationality of requiring the general public (and non-specialist workers) to wear face coverings in healthcare venues. After all, a piece of ill-fitting cloth or plastic does not transform into an impermeable viral barrier by virtue of crossing the threshold of a hospital or health centre.
2. The multiple harms associated with masking healthy people, with particular emphasis on those of most detriment in healthcare settings.
Mask wearing is not a benign intervention. The donning of face coverings by healthy people is associated with a wide range of potential harms, including impacts on our physical health (for example, headaches, skin irritation, fatigue and dehydration and eye dryness), our social and psychological wellbeing (dehumanising, impedes children’s emotional development, perpetuates fear and promotes mindless compliance) and on the environment (the mass dumping of non-recyclable plastic masks in landfill sites and the subsequent seepage of toxic chemicals into our waterways).
There are, however, other harms of wearing face coverings that are likely to be additionally problematic for the users of healthcare settings:
a) Impaired communication
Clear communication is a central requirement for effective healthcare. By muffling speech and hiding non-verbal signals, masks significantly impede the efficiency of information sharing, potentially impairing the professional’s understanding of the clinical problem and the patient’s understanding of the recommended therapeutic intervention. Those with hearing impairment (estimated to be about one-in-six of the UK population), who often rely on lip-reading, will suffer the most. Given that the elderly population are frequent users of health services, the number of people impacted by this mask-induced communication problem will be even higher in these settings. And the consequences of muffled speech when discussing, for example, medication can sometimes be catastrophic.
b) Increased risks of falls in the elderly
By blocking parts of the lower peripheral visual field, and causing spectacles to steam up, masks will increase the risk of falls in older people with ongoing mobility difficulties. Injuries, such as fractured femurs, are more prevalent in the elderly; expecting this demographic, the most regular visitors to healthcare facilities, to don a face covering can only exacerbate this risk.
c) Aggravation of respiratory problems
For patients with existing breathing problems, the requirement to cover their airways with cloth or plastic will often inflict additional respiratory distress. Wearing masks – particularly for long waiting periods, such as those routinely associated with hospital Accident and Emergency departments – might be especially challenging given the breathing difficulties associated with extended wear. Furthermore, face coverings can inflate the risk of acquiring pneumonia and other respiratory infections, one study, for example, finding that as little as four hours of wearing a cloth or plastic mask increased vulnerability to bacterial infection. And there are the largely unknown dangers to health of inhaling micro-plastics.
d) Re-traumatising those with histories of abuse
Another group of people who will be over-represented in healthcare settings are those who have suffered historical sexual and physical abuse. Many of these victims will be re-traumatised by the requirement to wear face masks, the somatic sensation of material covering the nose and mouth, or simply the sight of masked people, triggering disturbing memories – ‘flashbacks’ – of assault and degradation. To make matters worse, exercising one’s legal right to go without a face covering is likely to attract harassment and victimisation, particularly when in hospitals and other health-related venues.
e) Exacerbation of existing mental health problems
A disproportionately high number of attendees at hospitals and GP practices will display existing mental health problems. Many people already tormented by recurrent panic attacks, involving catastrophic thoughts of imminent death and feelings of breathlessness, will find masks very difficult to tolerate. Similarly, those suffering obsessive-compulsive fears about the prospect of contamination, or severe health anxieties, will have their emotional difficulties intensified by regular mask wearing. It is a common misconception that a face covering will provide reassurance; on the contrary, habitual wearing will prolong their fears. Also, many people on the autistic spectrum will be distressed by the expectation and (overt and covert) pressure to wear a mask.
To summarise, there are a wide range of negative consequences associated with pervasive mask wearing, and several of these are additionally problematic within healthcare systems. In light of these harms, and especially when considered together with their lack of efficacy in reducing viral transmission, there is no rational justification for recommending (let alone mandating) the wearing of face coverings in our hospitals, health centres and GP practices.
Many commentators who believe that face coverings provide some protection argue that their benefits would be apparent if people adopted the higher-quality medical masks and everyone wore them (and stored them) appropriately. Although plausible in a theoretical sense, in the real world such a scenario is impractical and highly unlikely. But even if we did all wear high quality, properly fitting masks – ‘like surgeons do’ – would it achieve any significant benefits in regards to infection control?
3. The sparsity of evidence that even high-quality medical masks – including those worn by surgeons when operating – are an effective means of infection control
Surgeons have worn masks in operating theatres since the beginning of the 20th century and it has become a tradition for them to continue to do so. However, the effectiveness of this routine practice is an under-researched area, and it remains unclear as to whether their deployment adds any additional value to modern-day infection-control measures.
In an early naturalistic study, involving the ditching of masks in an operating theatre for a period of six months, there was no increase in the rate of infections – in fact the researchers recorded a statistically significant reduction. The authors concluded that masks in routine general surgery is ‘a standard practice that could be abandoned’. In the same year, German researchers discovered that around 25% of surgical masks were already contaminated prior to being worn by the surgeon. A subsequent laboratory investigation in 1993 that tested a range of masks for aerosol penetration found that surgical masks provided ‘insufficient’ protection against sub-micron particles such as respiratory viruses.
A laboratory-based experiment commissioned, in 2008, by the Health and Safety Executive, did find that surgical masks achieved a six-fold reduction in exposure to the influenza virus (albeit much less impressive than the 100-fold reduction associated with the use of respirators). These researchers, however, went on to acknowledge that many NHS surgical masks offer less protection than that reported in their in-vitro investigation, and that these type of face coverings were ‘not intended to provide protection against infectious aerosols’.
More recently, two comprehensive reviews of the evidence have reached the same conclusion: the wearing of masks by surgical teams achieves no significant benefits for infection control. A literature review by researchers in Oxford, published in 2015, did not suggest that surgical face masks conferred any tangible benefits, concluding that ‘Overall there is a lack of substantial evidence to support claims that facemasks protect either patient or surgeon from infectious contamination’. An updated Cochrane review in 2016 formed a similar view. After a thorough search of databases to identify all robust experimental studies that compared surgical masks with no masks – incorporating data from over 2000 patients – the Cochrane team found ‘no statistically significant association between mask usage and the incidence of surgical site infection’.
Based on the above evidence it is reasonable to conclude that the wearing of surgical masks by medical staff in hospital settings, while providing a degree of protection from wound splashback and lowering the likelihood of facial debris from the surgeon (for example spittle, hair) falling into open wounds, has not been demonstrated to significantly lower infection risk from microscopic particles such as the SARS-CoV-2 virus. Clearly, the frequent pro-mask mantra, ‘Well, why do surgeons wear them?’ could be answered with, ‘Not sure, but it is not to prevent the transmission of respiratory viruses’.
4. The negative consequences of masks becoming culturally embedded in our healthcare venues
While face coverings are disappearing from many spheres of daily life, they stubbornly remain evident in healthcare settings, where they are rapidly evolving into part of the uniform. Doctors, nurses and allied-health professional are becoming culturally wedded to masks, where – despite the absence of robust evidence to support their infection-control benefits – they identify people as part of the team fighting against a virus, ‘working together to beat the enemy’. Service users and their relatives are coerced into joining this war by the requirement to wear a face covering, a symbol that distinguishes ally from foe.
This cultural descent into ubiquitous masks in hospitals and health centres is hugely concerning. In addition to the many specific harms associated with them (as previously described), this ideological trend ignores a fundamental tenet: a positive relationship between professional and patient is an essential ingredient of a healing environment (Norcross, 2011). And warmth, empathy, trust and openness – key elements of a therapeutic relationship – are more difficult to demonstrate when access to facial expressions is impeded.
Many psychological therapy sessions are undertaken in hospitals and GP practices, and – throughout the pandemic – these have often been conducted in environments that require both patient and practitioner to wear a mask. Although little research has been done on the impact of COVID-restrictions on the effectiveness of specialist talking therapy, the limited human connection between two faceless people is likely to be especially problematic, compromising the effectiveness of these interventions for people struggling with emotional difficulties.
But the therapeutic damage associated with masks is not limited to the realm of psychological interventions. Human connection is the bedrock of the healing process. As a consequence of the often stymied relationships resulting from masked protagonists, service users of all kinds will experience sub-optimal care: the confused, hard-of-hearing elderly person with memory loss; the apprehensive cancer patient receiving test results; the distressed teenager contemplating deliberate self-harm; and the frightened child in acute pain. Humane healthcare, delivered with demonstrable warmth and compassion, will always be more effective than the version delivered by a faceless professional hidden behind a veneer of sterility.
In the words of one enlightened GP, it’s time to ‘put the patient first again’ by ditching the mask in healthcare settings. We urge you to do so.
Now over 8,850 Co-Signatories
Including 2,000+ Doctors & Healthcare Professionals, & 180+ Scientists:
Author
Dr Gary Sidley, retired NHS consultant clinical psychologist
Co-signatories
Professor Richard Ennos
Professor Simon Conway Morris
Professor Neil Scolding MRCP, PhD
Professor John Fairclough, BM BS BMed Sci FRCS FFSEM
Professor Roger Watson, FRCP Edin
Professor David Forrest
Professor Alan Kennedy, PhD FRSE
Professor Anthony Fryer, BSc (Hons) PhD FRCPath
Professor Brent Taylor
Professor C. Jesshope
Professor Christopher Page
Professor Robert M. Sauer
Dr Michael D Bell, MBChB MRCGP
Dr T James Royle, MBChB, FRCS, MMedEd
Dr Tom Carnwath, Consultant Psychiatrist
Dr Fiona Martindale, MBChB MRCGP
Dr Ian Comaish, BM BCh FRCOphth
Dr Rohaan Seth, MBChB, BSc, MRCGP
Dr Jayne LM Donegan, MBBS DRCOG DCH DFFP MRCGP
Ian McDermott, FRCS Orthopaedic Surgeon
Dr Stuart Morgan
Dr T G Watkins, MB BCh, FRCA
Dr Victoria Black
Dr. Gordon Wolffe, M.Sc., BDS, FDS RCS
Dr. Tom Goodfellow, retired NHS consultant
Dr Branko Latinkic, Molecular Biologist
Dr Mark Nesti, PhD
Dr Leanne Nichols, BDS DPDS FNC
Dr Alasdair Lennox
Dr Anne Smith
Dr Benjamin Mathew DC
Dr Adriano Gagliardi
Dr Ali Akademir
Dr Ali Chowdhury
Dr Alvin Milner
Dr Anthony Dykes
Dr Andonis Yannakopoulos
Dr Andrew Bosanquet
Dr Chris Bateman
Dr Christine Gunn
Dr Colin Clark
Dr Colin Hindmarch
Dr Damien Bush MRCVSQ
Dr Danie Leach
Dr David Walton
Dr Ellis Judson
Dr Geoffrey Pocock
Dr Helen Davies
Dr James Conboy
Dr Johanna Barry
Dr John S Easterby
Dr Kalistheni Charalambous
Dr Kerry Nield
Dr Livia Tossici-Bolt
Dr ML Irving
Dr Martin Sewell
Dr Matthew Cockerill
Dr Matthew Owens
Dr Maxwell Roberts
Dr Melanie Bass
Dr Michael Hughes
Dr Neil Creamer
Dr Nick Collier
Dr Peter Duff
Dr Philip Davies
Dr Rachel Mann
Dr Rachel Nicoll
Dr Robin Connolly
Dr Sarah Burke
Dr Stephen Mack
Dr Steven Robinson
Dr Susie Coughlan
Dr Tim Green
Dr William Ryves
Dr Wolf D. Schwidop
Dr MJ Woods
John Collis, Retired Nurse Practitioner
Artur Bartosik, Lek. Med.
Nick Mitchel, Charge Nurse
Nick Morecroft, Counsellor
Nicola McQuaid, Retired Registered Nurse
Nicola Ransome-Lewis, Occupational Therapist
Jan Puskas, ICU Nurse
James Cook, NHS Registered Nurse, Master in Public Health
Cheryl Cockayne, Registered Nurse BSc, Specialist Practitioner Adult Nursing
Michael Cockayne, MSc, PG Dip, SCPHNOH, BA, RN, Occupational Health Practitioner
Marsha Towey, Trainee Clinical Psychologist
Paul Goss, Chartered Physiotherapist
Maureen O’Driscoll, Cardiology Specialist Nurse
Naomi Robinson, Occupational Therapist
Joanne Buck, Sign Language Interpreter
Nichola Davies, Nurse
Dr Adil Karmali, BSc MChiro
Co-signatories (Partial List)
Dr Renée Hoenderkamp, BSc MBBS MRCGP
Dr Ros Jones, retired Consultant Paediatrician
Dr Jonathan Engler, MBChB
Dr Helen Westwood, MBChB MRCGP
Dr David Critchley, BSc., PhD. Clinical Pharmacologist
Dr Julie Maxwell, Community Paediatrician
Dr Val Fraser, Education Adviser
Dr Zoe Harcombe
Dr Julia Wilkens, FRCOG MD
Dr Rachel Newton
Dr Brian Mc Kinney, MB BChr FANZCA
Dr Christian Buckland, Doctor of Psychology in Psychotherapy and Counselling
Dr Emma Varga, LDSRCS(Eng), MDS(Liverpool), Specialist Oral Surgeon
Dr Tina Peers, Menopause Specialist
Dr Gemma Kemp, MBBS FRCPath
Dr Greta Mushet, MBChB, MRCPsych
Dr A Widdrington
Dr Abby Astle
Dr Adam Phillips
Dr Adil Karmali
Dr Alan Mordue
Dr Alexander Deane
Dr Alexandra Rose-Roberts
Dr Alice Welham
Dr Andrew Kiridoshi
Dr Anna Ducharme
Dr Anne Smith
Dr Azeezah Isaacs
Dr Beatriz Mestre
Dr Belinda Roxburgh
Dr Ben Maddison
Dr Brian Mc Kinney
Dr John Bull
Dr Carlton Jarvis
Dr Carrie Ruxton
Dr Catriona Walsh
Dr Charankumal Singh Thandi
Dr Charlie Sayer
Dr Christian Buckland
Dr Christina Spyratou
Dr CJ Wilson
Dr Clare Willocks
Dr Cordelia Howitt
Dr Craig Pratt
Dr Hannah Emmett, DC
Dr Harry Delmar, BChD
Dr Helen Heaton, BM BS MRCGP
Dr Virginia Bell, Clinical Psychologist
Dr John Isaacs
Dr Jonathan Eastwood
Dr Jonathan Rogers
Dr Mary Dainton
Dr Matteo Pizzo
Dr Matthew Dennison
Dr Melanie Graeme-Barber
Dr Michael Ford
Dr Mike Daly
Dr Milan Patel
Dr Miranda Flory
Dr Najmiah Ahmad
Dr Niall McCRae
Dr Nichola Ling
Dr Nigel Smaller
Dr Noel Thomas
Dr Noreen Akhtar
Dr Pat Woker
Dr Patrick Quinn
Dr Patrycja Jakubiec
Dr Paula Robinson
Dr Selena Chester
Dr Serpil Djemal
Dr Simon Rubidge
Dr Steve James
Dr Stuart Hendry
Dr Stuart Morgan
Dr T G Watkins
Dr Tamara Roycroft
Dr Thomas Campbell
Dr Timothy Kelly
Dr Toby Greenall
Dr Tracey Grant Lee
Dr Ulrica Breitenau
Dr Valerie Pearce
Dr Veerle Van Tricht
Dr Victoria Black
Dr Virginia Bell
Dr Vivienne Hornby
Dr Yasemin Zaremba
Dr. Andi Fratila
Dr. Borbala Vaczy
Dr. Bryan Atkinson
Dr. Eleonora Capuani
Dr. J Bunni, Consultant Surgeon
Dr. Mary Walsh
Dr. Patricia De la Garza Jiménez
Dr. Prasenjit Das
Dr. Tom Goodfellow
Dr. Wendy Baird
Dr. Wendy Wright (Phc., MB. BS., MRCS, LRCP)
Nat Stephenson, Health Professional
Gareth Hart, Health Professional
Tammy Stephenson, Health Professional
Samantha Barton, Health Professional
Co-signatories
Dr Zenobiah Storah, Child and Adolescent Clinical Psychologist (DClinPsy, CPsychol)
Dr Damian Wilde, Clinical Psychologist
Dr Keith Johnson, BA D.Phil (Oxon)
Dr Anthony Hinton, MB ChB, FRCS
Dr Elizabeth Evans, MA(Cantab), MBBS, DRCOG, Director UK Medical Freedom Alliance
Dr Clare Craig, Diagnostic Pathologist, BM BCh FRCPath
Dr Rufus May, Clinical Psychologist
Dr Alan Black, MB BS MSc DipPharmMed
Dr Pedro Parreira
Dr Kate Porter
Dr Ali Haggett, PhD, History of Medicine (mental health)
Dr J Alderson, General Practitioner
Dr John Giles, FRCP FRCR
Dr John Harrison, PhD, FDSRCSEng, FRCPath Retired Consultant Pathologist
Dr Jonathan Eastwood, General Practitioner
Dr Jonathan Rogers, MB ChB (Bristol) MRCGP DRCOG
Dr M Smith
Dr Matthew Dennison, MBBS MRCGP IBLM
Dr Milan Patel, MSc MRCC
Dr Noel Thomas, retired General Practitioner
Dr Noreen Akhtar
Dr Raymond Martin, BSc DC
Dr Dalvir Singh Bajwa
Dr Daniel Caris
Dr Daniel Hurt
Dr David Cartland
Dr David Rhinds
Dr Deborah Le Roux
Dr Deborah Underwood
Dr Duncan Hancox
Dr Eleonora Capuani
Dr Emma Varga
Dr Eve Alder
Dr Felicity Wilkes
Dr Fiona Hendry
Dr Fiona Nicol
Dr Fiona Underhill
Dr Francesca Payne
Dr Gabriel Eke
Dr Gabriella Day
Dr Gemma Kemp
Dr Geoffrey Turner
Dr Glenn Healey
Dr Graeme Munro-Hall
Dr Grahame J Wells
Dr Greta Mushet
Dr Hannah Emmett
Dr Harry Delmar
Dr Harry Smith
Dr Helen Heaton
Dr Helen McArdle
Dr Helen Ross
Dr Ian Butters
Dr Ian Poulton Knights
Dr Irene Wittich
Dr J Alderson
Dr Jahanshad
Dr Jane Ritchie
Dr Jennifer Logue
Dr Jessica Engler
Dr John Barr
Dr John Giles
Dr John Harrison, PhD, FDSRCSEng, FRCPath
Dr Peter Chan
Dr Phil Caswell
Dr R Darby
Dr Raymond Martin
Dr Rebecca O’Connor
Dr Reem Abed
Dr Richard O’Shea
Dr Robert Richardson
Dr Roberta Pischedda
Dr Roger Watson
Dr Rose Thomas
Dr Russell Newlove
Dr Ruth Wilde
Dr S Ferdinando
Dr S Ting
Dr Sally Cope
Dr Sarah Myhill
Dr Josephine Baxter
Dr Josh Wymer
Dr Katarzyna Siubka-Wood
Dr Kathryn Caris
Dr Kathryn Cooper
Dr Lee Kumalo
Dr Lewis Moonie
Dr Lisl Semmend
Dr Louise Hattingh
Dr M Smith
Dr Maré Olivier
Dr Marek Kunc
Dr Margaret Stroud
Dr Mario A Calleja
Dr Mario Sammut
Dr Mark Jones
REF.
Norcross, J.C. [Ed] (2011). Psychotherapy relationships that work. 2nd edition. New York. Oxford University Press
