‘what proportion of IAPT clients have maintained recovery from the primary disorder for which they first presented?’ . The Improving Access To Psychological Treatments (IAPT) Service prides itself on its’ large comprehensive database, as if this was somehow a guarantor of the effectiveness of the service. But it is not possible to interrogate this database to determine the extent of restoring clients to their normal functioning, as they don’t do diagnosis.
Not only don’t they do diagnosis, they refuse to share a platform with anyone known to be critical of them. To date IAPT has not published written rebuttals of its’ critics charges. IAPT uses the muscle of the British Association of Cognitive and Behavioural Psychotherapies (BABCP) when challenged. Later this month the BABCP has its Annual Conference. I have had no indication from the President Elect as to how they are going to address my concerns over conflicts of interest and editorial freedom, but I do know that pride of place is to be given to IAPT’s leading light. BABCP is IAPT’s apologist. It might better spend its’ time investigating why the IAPT documentation indicates that its therapists, who are invariably BABCP members, make it up as they go along, sprinkling their notes with CBT terms, without any evidence of fidelity to an evidence based protocol for anything.
Dr Mike Scott
6 replies on “IAPT and BABCP Duck Key Questions”
One of the things that strikes me in the services I have worked in is the number of repeat referrals. People coming back 4 or 5 times over the course of years for the same problem(s). In my experience this is never really acknowledged or talked about.
We are “treating “more and more people with complex presentations ,personality disorders , complex PTSD , long -term conditions, Fibromyalgia , MS , ME.You name it. CBT cures everything! Is there any evidence base for all of this I am not sure. When working in London a client was referred to me because they had eyes problems(!). The PWPs don’t pick on this they are being told to welcome everybody. The criteria for referrals into the system don’t exist anymore. Boundaries are being pushed all the time. Why ?some people do make a lot of money out of this , IAPT keep the monopoly , it keeps the GPS happy because they have difficulty referring into secondary care which have been decimated. The system is completely flawed. Everybody who works in IAPT knows that .The therapists bear the brunt of this flawed system .
Through micromanagement the system picks up on your recovery rate, your DNA rate, your cancellation rate , the number of patients on your caseload and this at any given time. Then comes the supervision when you are being made to look like a failure if you haven’t achieved what the algorithm asks you to do.
This is a system destined only to work for some not always for the benefit of the patient and generally not kind for the therapist .
Hi Kojay and Nadine
I so agree with both of you. The revolving door is an ongoing problem – we need a transparent track and trace for IAPT, with a testing that is reliable and credible. Otherwise the pandemic of mental health problems continues unabated. Nadine u have my total sympathy it is desperate all around
Could not agree more with Nadine. Very nicely put to be fair. It really does feel robotic. Why am I told my DNA and recovery rate as if I control it? I cannot exactly aggressively sell them the IAPT “dream”. I appreciate the comments and this website. I try to keep a critical eye, no matter how comfortable or dark it may be. The way BACP are acting about IAPT is fishy to say the least.
I am curious to see if I am able to last long in this role because honestly, the way the role is set up is very far from the therapist and patient relationship. It just feels like I am dealing with ones and zeros. Talking to the patients feels like I am selling them on something. Often I try to sneak in my own ways of helping them because the tools given for the role are severely limited. I feel ashamed when someone thanks me because I know that I did not do a thing.
It is a “good” role if you want to use it to pay your bills while you pursue something else. Like, studying on the side for another career. However, I personally do not find any reward of the role itself. Maybe it started with good intentions but I am not “feeling” anything towards it. I just stare at a screen, exhale while holding my forehead and begin talking as if nothing can bother me over the phone.
It saddens me that we cheapen people’s mental health this way.
Please keep doing what you are doing Dr Mike Scott.
You’re not alone Nathan and Nadine – I feel the same and nearly everyone I talk to in my service expresses similar feelings. The nonsense peddled by academics who know nothing of the reality of life in IAPT about how wonderful it all is just makes me laugh. Its a really, really dysfunctional system and all we can do is our best.
Hang in there guys, we’ll keep battling away