A friend has recently got a post as a Hi-Intensity therapist in IAPT, he is restricted to providing just 6 sessions, but can go up to 10 for PTSD and OCD. He is expected to make 24 contacts a week, each session to be no more than 45 minutes. If he doesn’t reach the 50% recovery rate for 6 consecutive months he will have to attend a meeting. Perhaps I should book him in for a reliable assessment in 6 months time, conducted not by telephone but with hospitality. I wouldn’t consider stipulating the number of sessions in advance. But I would be mindful not to pathologise his likely stress reaction – ‘saving normal’.
I might advise that he consider whether his employer has breached a duty of care in that it is known that 6 sessions is not an evidence based dose of treatment for any psychological disorder and it is reasonably forseeable, that a therapist charged with delivering this is likely to be stressed. It would then be a matter for the Health and Safety Executive and Personal Injury Lawyers. But there are also issues of informed consent, in that clients are not informed that they are to receive a sub-therapeutic dose of treatment – they could become litigants. Clinical Commissioning Groups have done absolutely nothing to ensure that clients receive a therapeutic dose of treatment and are open to a charge of medical negligence.
Will IAPT reform itself before it is too late? There is a glimmer of hope, in that I did not meet with open hostility recently when I suggested that it needs reconfiguring to ensure reliable assessment. But the economic argument for IAPT will be in tatters after a new paper is likely published in the coming months, which will show what the National Audit Office has signally failed to make public – a matter for the House of Commons Public Accounts Committee.
Dr Mike Scott