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BABCP Response - NICE Consultation January 2022

IAPT’s Capitalisation on Time Is A Great Healer

The natural recovery rate for depression is 50% within 6 months. The Improving Access to Psychological Therapies (IAPT) claim a 50% recovery  rate for its clients. It is therefore not at all obvious that psychological treatment has conferred any benefit. The rate of natural recovery from depression is about 2% per week. Looking at natural recovery in generalised anxiety disorder (GAD), of those who had ever suffered GAD, 72% had not had it in the past year. Whilst recovery rate from depression and anxiety disorders at 2 year follow up was 41.7%. These high rates of natural recovery offer Service providers, such as IAPT, a golden opportunity to claim that they have played a pivotal role in client’s recovery. 

Many, many years ago I had a Summer job working part of the time in a Mortuary, the day I began was a glorious Summer’s day and the most Senior pathologist remarked that  ‘you’ve brought the good weather with you’. Much as I had a tendency to take credit when things went well, and to blame others when it didn’t, I did feel that even I couldn’t take credit for the good weather. But Service provider’s it seems have no such inhibitions. They operate with a self-serving heuristic in which the exact mechanisms by which they bring about change are left unattended and they invite others to believe their eminent representatives. In this way effortful processing of data is by-passed, by an appeal to ‘credible sources of persuasion’ as it is termed in the Elaboration Likelihood Model of Persuasion.

Within this ‘Capitalisation’ it easy to smuggle in other purported benefits of psychological therapy such as getting people back to work, improving their physical health without actually demonstrating either, see Layard and Clark (2015) by simply saying ‘it is likely’. All to the glee of politicians, Clinical Commissioning Groups and media. Thus the band wagon continues in a race to the bottom.

 

Dr Mike Scott

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