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BABCP Response - NICE Consultation January 2022

‘CBT Today’ An Apologist for IAPT Expansionism

CBT Today is the Official Magazine of the British Association of Behavioural and Cognitive Therapy, the supposed lead organisation for CBT. But today it is a vendor for cheap and easy solutions to human difficulties. This sits comfortably with its’ friends in high places, politicians and the media. The funds flow, almost £2billion a year for IAPT  adult, children and young people services. With £988.0m the projected spend on children and young people in 2022/23. But no independent valuation of whether either service is value for money. This would beggar belief at any time, but in these days of financial stringency it has to be insanity, corruption or some combination thereof.

In the December issue of CBT Today Dr Adrian Whittington the new Clinical Lead for Psychological Professions at NHS England and Health Education England, states the IAPT services ‘have lived up to the assumptions that showed they would save money overall for the public purse’ p 10. But the article fails to state that he is also the IAPT National Clinical Advisor: Education clearly vested interests are at work. The null hypothesis for any service, including IAPT, is that it costs something. A null hypothesis, is assumed to be true, unless contradictory evidence is provided. But Dr Whittington and the IAPT powerholders have provided no refutation of the null hypothesis. My own findings confirm the null hypothesis, see previous blog .

Dr Whittington (2022) continues ‘we need to  support a a psychological approach as the norm  for major health conditions. We know that these developments can support people to adjust and manage long term conditions more effectively, reducing unwarranted medical consultations’.  A further null hypothesis is that psychological therapy makes no difference to the management of these conditions. Again the burden of proof is with those who would  rebut the null hypothesis. Who is it that judges that there are ‘unwarranted medical consultations’? What is the world view of a person who sees many consultations for long term conditions as unwarranted?

Dr Whittington (2022) lauds it that the expansion of the Adult IAPT service is being mirrored in the provision of services for children and young people in the form of Mental Health Support Teams in school and colleges.. But there has been no audit of the Service for children and young people at all.The smoke and mirrors continue. 

In the same issue of CBT today Dr Claire Willis declares ‘a small to moderate effect’ for a transdiagnostic approach to persistent physical symptoms in a trial in which she was a therapist. She enjoins that the same approach should be used with Long Covid. No matter that the protocol was evaluated by those who developed the protocols. These authors engaged in a fishing expedition to find any positive findings, administer enough measures something will urn up positive by chance. The spurious claims for the study Dr Willis were rebutted in an earlier blog  of mine.

 

Dr Mike Scott

 

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