Last month I gave a days workshop ‘Better Together’ at the Maudsley Hospital for an IAPT Service, I did think it was going into the lion’s den but the hospitality was superb. The link to my presentation is below:
I presented for the first time the DAGger for groups, a questionnaire containing the dysfuntional attitudes that will often have to be circumnavigated to successfully engage someone in a group. I also spelt out how to engage in a debate about the ‘DAG’s using the vectors of validity, utility and authority. But such dialogues are not easily possible with IAPT’s standard triage, there is a need for reform to make groups properly viable. One of the problems with groups is that those most likely to benefit from groups are those least likely to agree to attend!
Groups are not the same as classes and I was struck at the Workshop by the lack of understanding that there is a strong evidence base for the former for depression and most anxiety disorders but the evidence base for the latter is extremely weak by comparison. There was also near universal acceptance that a stepped care model was intrinsically better and that not having an extended face to face conversation with a client initially was in any way problematic. Near the end I did mention my findings of a 10% recovery rate in IAPT see link below:
but by then attendees were either too tired/polite/fearful to say anything. But I must thank Marion Cuddy the organiser for a great day.
Dr Mike Scott
3 replies on “Groups An Attractive Option…. But?”
Are you talking single or mixed sex/gender groups here Mike, because I’m sure that many women would feel extremely threatened/vulnerable in a mixed sex/gender group situation?
You have raised exactly the point I was trying to make – unless you spend time really listening to the story of the potential group member, you can’t know say that they were abused by a male and that therefore allocating them to a mixed group could be very problematic. In fact it is not a matter of allocating at all, but simply asking them to pause and consider whether a particular group might make a real world difference to their life. In this connection any proferred group has to be relevant i.e it is for those with more or less the same story (the same diagnosis confers some commonality). Thus thorough preparation for a group is essential, it can’t be done in the ‘triage’ manner of IAPT. The way in which people are allocated classes in IAPT is also very problematic, nobody thinks to ask potential attendees ‘what was your experience of classes at school’ . The PWPs running the classes likely had positive school experiences, thereby becoming educated but dont stop to think that that is not the experience of most people so they either dont turn up for a class or soon dropout. Nobody has really assessed whether the class would be judged as relevant to their life. The classes become mini-versions of PWP training!
I think we can assume that a lot of women have been harassed, assaulted or abused in the past so would likely feel vulnerable in a mixed sex/gender group with strangers. Single sex groups should at least be an option for all women, (NB there are cultural/religious considerations here too), otherwise I fear that a large number of women would be excluded from this type of therapy.