The Silencing of Dissent and IAPT

 

This month’s Behavior Research and Therapy features a paper by Ali et al in which IAPT data on relapse after low intensity (Li) interventions is reviewed, and it is concluded that further attention to relapse prevention may be needed. I submitted a rejoinder essentially saying that Li-interventions have been a false economy and complaining that it had not been declared that Ali headed the Northern IAPT Research network, but it was rejected.

The editor began her letter of explanation with ‘Each of the reviewers is a highly experienced researcher in the area of low-intensity treatments for depression anxiety’.  But that is precisely the problem, researchers in low intensity see no pressing need for independent assessment using a ‘gold standard’ diagnostic interview (unlike their forbearers who conducted the bench-marking studies that gave CBT its’ credibility), although they pay lip service to it.

In practice, low intensity researchers find it ‘reasonable’ to conduct research on outcome solely on the basis of changes in a psychometric test. This strategy enables research to be done on the cheap, produce lots of papers and get brownie points in academia. There is a mutually beneficial groupthink amongst low intensity researchers and the IAPT hierarchy. Low intensity interventions fail an evidence based assessment test with a shameful lowering of the bar of methodological rigour. I will return in future blogs to editors/reviewers scant regard for criterion related validity and the misuse of Jacobsen’s Reliable and Clinically Significant Change Index, an abuse that is rampant in IAPT.

Dr Mike Scott

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