this could be the opening gambit in the prosecutions case against the Improving Access to Psychological Therapies Service. The indictment is that IAPT has misled GP’s and the public into believing that 50% of its clients recover. Further it is on this basis that IAPT has wrongfully acquired Government funding of £2 billion a year covering adult and children’s services.
IAPT IS ON TRIAL
IAPT is being tried in absentia, because in the 6 years of cbtwatch.com the Service has steadfastly refused to engage in any public debate. In principle, IAPT could call defence witnesses, the British Association for Behavioural and Cognitive Behaviour Therapy (BABCP), the progenitors of IAPT Professor David Clark and Lord Layard, Dr Adrian Whittington the Clinical Lead for Psychological Professions at NHS England and Health Education England, and the IAPT National Clinical Advisor. There is an open invitation to them to attend the trial but there is no Court Order mandating their attendance. Given their track record to date the likelihood is that they will treat the proceedings with contempt and a deafening silence will ensue.
The prosecuting barrister’s role is to present to a Judge and jury in ordinary language the truth of the matter. Operating on the maxim “KISS’ keep it simple stupid, he/she would utilise an everyday notion of recovery, explaining to the jury that in everyday parlance, it means being back to your old self and staying that way. In this way the Judge and jury are invited to consider the evidence that 50% of IAPTs clientele are back to their old selves with treatment and stay that way. But the Judge smells a rat when he/she learns that there has been no independent corroboration of IAPT’s claim. In the circumstances the Judge feels obliged to advise the jury of the distinction between direct evidence and circumstantial evidence and that IAPT’s case, at best, rests on circumstantial evidence. Reminding the jury that at an interview we would all say that we are the best possible person for the job. The claim might possibly be right, but it could not be relied upon, because of the likelihood of bias. The prosecuting barrister has thereby placed a seed of doubt in the mind of the Judge and jury.
The prosecuting barrister puts the latest IAPT Manual in the dock, under cross examination it is revealed that 50% of IAPT clientele drop out before they have had 2 treatment sessions. When asked ‘is it likely that they are happy bunnies?’, a deafening silence reverberates around the Courtroom. The Judge intervenes ‘please answer the question that Counsel has asked?’ but this is met with a stony silence, and the Judge muses whether this constitutes contempt of Court. The prosecuting barrister wades in ‘I put it to you, that on the balance of probability, their disengagement signifies disenchantment’ or ‘are you seriously asking us to believe that in one therapy session or after just an assessment, the lifes of half or more disengagers has been transformed and permanently so?. The Manual protests that the claim of a 50% recovery rate only applies to those who attend two or more treatment sessions. The Judge intervenes and addresses the Manual ‘let me be clear on this, looking at all who attend IAPT we have 50% who do not have treatment as you define it, and even if it were the case that 50% of the remainder recover, the overall recovery rate would be just 25%, have I got that right?’, the Manual mutters ‘I suppose so’ . The prosecuting barrister continues that the Manual states that IAPT’s therapists are not trained to make diagnoses, how then can they possibly know whether a person has recovered or indeed what the recovery rate is for the Service? To speak of recovery without diagnosis is nonsense, recovery from what?
The prosecuting barrister then calls myself to the witness stand and I explain that in the context of my role as an Expert Witness to the Court, I assessed 90 litigants who went through IAPT, whether before or after their personal injury and which ever was the case, only the tip of the iceberg recovered see previous blog. The barrister asks ‘so your primary duty was to the Court, and not to anyone instructing you?’ and I reply in the affirmative. The cross-examination continues ‘is there a possibility of your having a bias over IAPT’, I reply no and that it was not until about 2015 that it was becoming apparent that the Service simply was not working. In my book of 2009 Simply Effective CBT I was neither for or against IAPT considering it a worthwhile experiment that may or may not work.
At this point the Judge declares this would be good time to break for lunch, with the defence barrister cross-examining Dr Scott afterwards. The Judge asks the defence barrister ‘is it the case that you are not calling any Expert Witnesses for your own side?’ The defence barrister confirms this and the Judge can be overheard muttering beneath his breath ‘strange’.
Dr. Mike Scott