IAPT’s Rigidity – The Antithesis of Personalised Care

 

the mantra is ‘offer just 6 sessions, keep to the therapist’s original formulation of the client’s difficulties, don’t consider alternative hypotheses, even when circumstances change. If necessary offer another 6 sessions’. The case below exemplifies this:

A few years ago Mr X suffered an episode of depression, his GP referred him to the Improving Access to Psychological Therapies (IAPT)Programme were he underwent a telephone assessment. On the basis of the completed psychometric test, he was assigned to a 6 week Group CBT programme with about 12 people attending each session. He found the sessions helpful, in that he then gave less emphasis to work and engaged in more excercise.  However at a telephone follow up interview he relayed, that he had been involved in a terrible house fire, struggling to breathe when he escaped. Mr X was taken to Hospital and treated for smoke inhalation and minor burns. The therapist agreed that he should have a further 6 sessions but this time face to face. When I assessed him at the end of the individual CBT he was suffering a further episode of depression, had many of the symptoms of  PTSD but not the intrusions, was phobic about the possibility of fire and suffering from binge eating disorder. However the sequelae of the fire was not addressed at all in the IAPT treatment, when he tried to make these concerns a focus, they were dismissed and the therapist insisted on recapping what had been discussed in the group. He and his wife commented that this seemed totally inappropriate. (Some details changed to protect confidentiality).

 

Personalised medicine is nowhere to be seen.
 
 
The BABCP has its’ Annual Conference in September in Belfast, the place were the Titanic was built, I very much
 
doubt that they will consider the structural defects of IAPT anymore than the White Star Line were transparent
 
about the failings of their vessel.
 
 
But Mr X is the tip of the iceberg of those failed by IAPT. The Court of Inquiry into the sinking of the Titanic had
 
many vested interests. The IAPT prime movers have powerful connections and doubtless the same would happen if
 
ever there was an inquiry into IAPT, but at least it would be a start. For now IAPT steams forward at maximum speed,
 
with many employees wishing to jump ship, but no vessels nearby and having to contend with the familiar tunes
 
from Belfast.
 
Dr Mike Scott
 

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