“IAPT The Myth and the Reality” Vanquished By BABCP Presidents

 

here is the CBT Today article rejected not by the Editor, but by the power holders, I wrote:

The Improving Access to Psychological Therapies (IAPT) Programme has only ever marked its’ own homework, making claims for its’ effectiveness suspect. IAPT and its’ devotees (see February issue of CBT Today) are it seems undeterred by the absence of a publicly funded independent evaluation.  The CBT Today articles cite no contrary evidence to IAPT’s claim of a 50% recovery rate, despite a whole issue of the Journal of Health Psychology for August 2018 being devoted to the matter and in which my work suggested a likely 10% recovery rate.  In my paper ‘IAPT – The Need for Radical Reform’ I also detailed the stories of the recipients of IAPT’s services. None of the powerholders have actually spent time systematically listening to the experiences of IAPT clients.

IAPT Is Highly Persuasive and Misleading

Unfortunately, the NHS, Clinical Commissioning Groups, BABCP, BPS and the Media hierarchies have bought into IAPT’s outstanding marketing, with dissenters not allowed a voice.  When the crowd is behind you, you are probably facing the wrong direction. It is disturbing when only the powerholders and progenitors express support for the IAPT programme.

The ‘gold standard’ of independent assessment using a standardised diagnostic interview has been jettisoned with regards to IAPT, yet it was the hallmark of the randomised controlled trials that it professes to base its’s treatment on. Espousal of compliance with NICE guidelines has become a key marketing ploy by IAPT, richly rewarded – £4billion since its’ inception over 10 years ago. Yet there is no evidence that IAPT reliably establishes a base of diagnosis on which is built disorder specific treatment targets and strategies.

The Way to Hell Is Paved With Good Intentions

Nobody doubts the importance of improving access to psychological therapies, but by 2015 from conversations I was having with former IAPT clients, it was becoming increasingly obvious that they thought the system was radically failing them. Analysis of 90 clients assessed using a standardised diagnostic interview revealed a 10% recovery rate i.e only the tip of the iceberg lost their diagnostic status whether or not they were treated pre or post their personal injury [Scott (2018)].  The National Audit Office began an investigation into IAPT, its’ stated mission was to assure healthcare bodies such as Clinical Commissioning groups of the integrity of the IAPT data but it never got around to doing this.  In June 2018 the NAO stopped its’ investigation because of other pressing concerns including Brexit and the collapse of Carillion.

IAPT’s Ministry of Propaganda

On November 13th 2019 BBC Radio 4 and Radio 5 Live voiced the concerns of some IAPT therapists that they were pressured to falsify test results, but their voices were drowned out by that of the President of the BABCP and Lead Clinicians for IAPT, the media went with the powerholders – none of the 3 hours of my recordings were aired, nor that of the hour long interviews with an IAPT worker and a client who had been through IAPT twice.  A former IAPT client treated by them after the Manchester bombing was unfortunately too upset on the day to give a live interview and only a minute of hours long pre-recorded interviews was broadcast.  The media approach amounted to ‘let’s show we are on the side of mental health, it takes too much effort to think the issues through, so let’s go with the powerholders and present a positive message’, an approach that mirrors journals propensities to only publish positive results.

In the same month I sent a letter to my local Clinical Commissioning Group protesting that Talk Liverpool’s just published claim of an 89% recovery rate was suspect as the IAPT’s national claim was a mere 50% recovery rate. I expressed a view that these exaggerated claims may have fuelled the 25% increase in Talk Liverpool’s funding, rising to £10 million in the coming financial year.  The Liverpool CCG have not even bothered with the courtesy of a reply. If Talk Liverpool had truly discovered some clinical secret they would be top of the agenda at IAPT’s Best Practice meetings, this is not the case.

The BABCP Has Become An Ambassador for IAPT

It has done nothing to look after the two thirds of IAPT workers suffering burn out. It has squashed debate on IAPT in the pages of CBT Today, pays lip service to evidence-based treatment and fosters alleged CBT. The very credibility of BABCP is at issue, my hope is that the new President addresses these issues.    

Scott, M.J (2018) IAPT – The Need for Radical Reform, Journal of Health Psychology, 23, 1136-1147.

Scott, M.J (2017) Towards a Mental Health System That Works London: Routledge.

To disagree with my article is fine but not to engage in open debate is totalitarian. I am not holding my breadth as Andrew Beck takes the matter to the BABCP Board.

 

Dr Mike Scott

2 thoughts to ““IAPT The Myth and the Reality” Vanquished By BABCP Presidents”

  1. It is a double bind that repels me: I need to continue membership of the BABCP to maintain accreditation as I prepare to leave the NHS for good and set up private practice. But the BABCP has never had my interests at heart. Working for IAPT for 11 years, being bullied as routine and ordered to “cook the books” has broken me beyond repair and I have been in long term sick leave with burnout. The future looks very uncertain and I would like to sever ties with the BABCP, but I feel like a kidnap victim: I would lose accreditation if I do.
    IAPT is the absolute worst that could have happened to the profession.

  2. Oh Teresa, I hear this so often. If there is anything I can possibly do don’t hesitate to contact me, feel free to use just my personal e-mail michaeljscott1@virginmedia.com. I am dismayed at BABCPs stranglehold on accreditation. I do not believe BABCP’s determination of competence has anything to do with how therapist’s actually fare with clients. In the short term competence should be assumed on the basis of successful completion of CBT courses, while we distil a better way of assessing competence. I think consideration should be given to an alternative to BABCP for cbt therapists.

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