IAPT’s Hall of Mirrors Feedback

negates improved practice. The Organisation’s usage of the Patient Experience Questionnaire (PEQ) violates all the key requirements for eliciting feedback, which has to involve:

a) a response to questions that have an unambiguous real world meaning e.g ‘are you back to your old self  since treatment? i.e questions have to have validity

b) drawing upon a consecutive series of clients

c) completion anonymously and not in the presence of the therapist

d) a representative sample.

IAPT makes a token gesture of soliciting feedback using the Patients Experience questionnaire,  but its’ modus operandi is such that it cannot furnish a body of evidence that would demonstrate that it is not a ‘world beater’. In effect it has operated with a confirmatory bias only seeking information that would confirm its’ prior belief.

In 2016-2017, of 219 Clinical Commissioning Groups in England, 55 (25%) produced no PEQ data at all, i.e that a quarter of CCGs were funding a service in the absence of any evidence that the IAPT Service was eliciting feedback. In 2017-2018 of the 554,709 clients who completed a course of treatment  only 22% Moller et al (2019) https://doi.org/10.1186/s12888-019-2235-z completed the treatment questions on the PEQ.

There is no evidence that IAPT took active steps to ensure completion by consecutive cases or that therapists were blind to the results of the PEQ. The questions on the PEQ are themselves of doubtful validity e.g ‘how satisfied are you with your assessment’, this  question presupposes that the client has the knowledge base as to what constitutes a good assessment, imagine  if asked this question as a possible COVID patient most of us would believe ‘it is outside my expertise to judge the matter’. The question on the PEQ ‘on reflection, did you get the help that mattered to you’ is ambiguous, is it asking about the emotional significance of the encounter with the therapist, for example did they really listen/seem to care or about whether as a result of treatment you had returned to normal functioning.

Government and Clinical Commissioning Groups have turned a blind eye to IAPT’s failure to systematically elicit feedback from clients. At a cost of £4billion over the last decade and an incalcu cost to mental health. sufferers.

Dr Mike Scott



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