Categories
BABCP Response - NICE Consultation January 2022

A Psychological Wellbeing Practitioner Breaks The Wall of Silence

 

I will never forget how, when I started working at the IAPT call-centre, I was stressed and rested my head for a few moments. I was interrupted by a “clinical psychologist” who in accusatory tone proclaimed that, “it does not seem that you are working”. The die it seems was cast. Not once in my 3 years as a Psychological Wellbeing Practitioner (PWP) have I felt that anyone at work cared for one another.

 

 

‘When I Want Your Opinion I’ll Give It To You’

 

Naively I thought that “psychological services” would be a haven of openness, not a venue as “hellish” as any other sales related job. Contentious issues were not allowed to be placed on the agenda at meetings. If I dared to bring up issues that mattered, the Managers would “have a word with me in private”. It felt like “The Twilight Zone” and “Twin Peaks”; you could feel something was not right, but everyone pretended that things were fine and that it was me who was the problem. If there was any issue with what I said, no one gently told me, instead they went straight to my manager. So, I always felt paranoid that whatever I say or do, may be reported.

I will never forget the moments where I would try to bring up a new approach or new knowledge only to be told “it is not in line with NICE and IAPT” and “do not read extra information because you will not need it”. A re-enactment of George Orwell’s 1984, rather than the delivery of a 21st Century psychological service. Worryingly this seems to be the norm in the NHS, with the frontline troops powerless. 

 

What It Is Really Like At The Coal Face

 

The short end of it all is that being a PWP is very similar to run of the mill call-centre, telemarking and sales job. No matter what the average worker says “but we do a great service”, I feel they are a tad bit delusional. I do not blame them. To survive this job you either need to resort to trickery or delude yourself that you are doing something worthwhile. The latter group probably have a mortgage to pay. We are told what to say, how to say it, when to say it and constantly told “it’s all about the numbers/targets”. We also have a script, which is very similar to those phone contract customer service people. The hellish brilliance of IAPT is that if the targets are not reached, the organisation uses an attributional bias to blame the “practitioners”/miners and not the “system”/pit owners and fellow travellers.

 

The Re-Branding of What Doesn’t Work, Doesn’t Work

 

Pre-IAPT there were “mental health workers (MHWs)”, and the public had some idea of the discharge of this particular, professional role. But from 2008 MHWs became Psychological Wellbeing Practitioners, leaving the public and professionals scratching their head as to what the designation might mean. Where PWPs to be regarded as professionals or not? Despite the inherent confusion, I followed my work’s advice to the letter: did the questionnaires, kept the original scores and ploughed onwards. However, what I noticed is that many clients (I dislike using the term patients because it doesn’t feel like we are official clinicians either) were finishing treatment or dropping out with “high scores”. It was not too long until I was interrogated for a below 50% recovery rate.

 

Jumping Through The Hoops of ‘Recovery’

 

The recovery rate of 50% is impossible unless one manipulates the numbers or manipulates the clients to be compliant. I guess, good old fashioned “sales tactics” (convincing people they need a product or that they are better than when they started). Of course, the Managers did not care. Safe to say, I found a crack in the system: since the powers all care about numbers, if you deliver the numbers, they will not question you. However, dare you dip below what is expected of their Key Performance Indicators (KPIs), then they are like bloodhounds searching for you. But there has never been a real world KPI that a client would recognise, such as being back to their old selves for at least 8 weeks after treatment. Instead clients are expected at each session to doodle on questionnaires in the prescence of the PWP and bizarrely, these are used as the metrics of recovery.

 

At the coal face, I can conceal, to a limited extent what I am doing from the powers that be and deliver something of benefit. I do not hound them for the questionnaires every single time because let us face it, that creates a major barrier in treatment. Also, we are not MDs or Clinical Psychologists that can diagnose. It is a joke when we have to collect the data because it is meaningless.

 

Helplessness

 

The issue then becomes that I did not feel like I was learning anything. All I was learning was how to manage office politics and be a better liar. One could apply for High Intensity Training but they still focus on targets, so, no thanks. Any person of good conscience will not last long in IAPT. If you have any issues as a worker with IAPT, they will say it is a “you” problem. I once mistakenly vented my frustrations with how they were doing things at a meeting. This resulted in evident displeasure and near the end the next meeting was told to “this is not a space to vent grievances”. If the clients and workers had a platform to vent their frustrations, I do not think IAPT would still be operational. 

 

PWPs Ambassadors For A ‘Failed State’?

 

Working in IAPT is robotic: clicking tabs, ticking boxes and collecting numbers – a                                de-humanising experience.  There is little to encourage anyone to become a PWP. In fairness I suppose, at least a personal level, I have survived lockdown financially. But the service has in effect been “cooking the books” and making the company look good. I fear for the mental health not only of the ambassadors but for that of clients past and to come.

 

I am off to other pastures, can you wonder at the turnover?

 

Bernice ( a pseudonym)

 

 

43 replies on “A Psychological Wellbeing Practitioner Breaks The Wall of Silence”

Great reflection, as usual.

I was a PWP first for a few years, even with an MSc in Psychology, then a CBT therapist for more than a decade. IAPT is a sausage factory with no feelings nor caring for the well-being of either patients nor staff. It is a high deception game which to me is the greatest NHS scam in history.
I can only explain my lengthy service by a severe case of Stockholm Syndrome, but your post outlines the reality of the service, with a very glaring deficit of the values of the profession.
I have a legal case pending against my old Trust for neglect of duty of care (due to severe stress at work, and they failed to even do a stress risk assessment), bullying and harassment.

I keep wondering, as you do, how much longer this can go on before this service is independently audited.

Hi
Teresa, would love u to consider writing a blog on your experience but this would probably have to be after your Court Case is settled.
Take good care of you
Mike

I can absolutely resonate with so much of this – IAPT is a bizarre hall of mirrors. It seems as long as self interest is tied to something like a target, even if its clearly meaningless people will just unquestioningly go along with it. Even on fundamental ideas such as recovery – surely everyone in IAPT knows the manipulative box ticking ‘below clinical’ bollox is just that? But no!, they celebrate this garbage meeting after meeting, email after email, its like some weird alternative universe.

Hi! I know this is somewhat off topic but I was wondering which blog platform are you using for this website? I’m getting tired of WordPress because I’ve had issues with hackers and I’m looking at alternatives for another platform. I would be fantastic if you could point me in the direction of a good platform.

I precisely desired to appreciate you again. I do not know what I could possibly have taken care of without the type of tips shown by you directly on such a problem. It absolutely was the frightening case in my circumstances, nevertheless being able to view this expert way you resolved that forced me to jump over contentment. Now i am happy for the information and even trust you find out what a powerful job that you are doing educating the others all through your website. More than likely you’ve never come across any of us.

Youre so cool! I dont suppose Ive read anything like this before. So good to search out any individual with some unique thoughts on this subject. realy thanks for beginning this up. this web site is one thing that is needed on the net, someone with slightly originality. helpful job for bringing one thing new to the web!

Does your website have a contact page? I’m having a tough time locating it but, I’d like to shoot you an email. I’ve got some recommendations for your blog you might be interested in hearing. Either way, great website and I look forward to seeing it grow over time.

One thing I would really like to touch upon is that weightloss routine fast can be performed by the right diet and exercise. Your size not merely affects appearance, but also the general quality of life. Self-esteem, depressive disorders, health risks, plus physical ability are afflicted in extra weight. It is possible to make everything right whilst still having a gain. In such a circumstance, a problem may be the culprit. While an excessive amount of food rather than enough exercise are usually responsible, common health conditions and key prescriptions could greatly help to increase size. Thanks a bunch for your post right here.

I’m truly enjoying the design and layout of your website. It’s a very easy on the eyes which makes it much more enjoyable for me to come here and visit more often. Did you hire out a developer to create your theme? Excellent work!

Thanks for revealing your ideas. I might also like to mention that video games have been ever before evolving. Today’s technology and innovative developments have aided create practical and enjoyable games. All these entertainment video games were not that sensible when the actual concept was being used. Just like other designs of technological innovation, video games also have had to evolve by many many years. This itself is testimony on the fast growth of video games.

Somebody essentially help to make seriously articles I would state. This is the very first time I frequented your web page and thus far? I amazed with the research you made to create this particular publish extraordinary. Fantastic job!

Thank you for each of your hard work on this blog. My niece really loves managing investigation and it’s really simple to grasp why. We all know all of the powerful mode you render invaluable items via the website and even strongly encourage contribution from website visitors about this concept and our simple princess has been studying a lot of things. Have fun with the rest of the year. Your performing a pretty cool job.

excellent post, very informative. I wonder why the other experts of this sector do not notice this. You should continue your writing. I am confident, you’ve a huge readers’ base already!

I simply desired to thank you so much again. I’m not certain the things that I would have achieved in the absence of those advice revealed by you about this question. It became a real difficult dilemma for me, but considering a new specialized fashion you treated that made me to cry over contentment. I am happier for your work as well as trust you comprehend what a powerful job you’re doing training many people using your webblog. Most probably you’ve never got to know all of us.

Thank you for sharing excellent informations. Your web site is very cool. I’m impressed by the details that you抳e on this blog. It reveals how nicely you understand this subject. Bookmarked this web page, will come back for more articles. You, my friend, ROCK! I found just the information I already searched all over the place and simply could not come across. What a perfect website.

I have witnessed that intelligent real estate agents all over the place are starting to warm up to FSBO Promotion. They are acknowledging that it’s more than just placing a sign post in the front yard. It’s really concerning building human relationships with these dealers who one of these days will become purchasers. So, if you give your time and effort to assisting these sellers go it alone — the “Law connected with Reciprocity” kicks in. Great blog post.

Leave a Reply

Your email address will not be published. Required fields are marked *