Clinical Commissioning Groups (CCG’s) fund IAPT (Improving Access to Psychological Therapy Services), but have failed to ensure that mental health sufferers are not given the cheapest option, guided self-help (GSH), without being informed of its poor performance compared to regular therapy. GSH is the most commonly proferred service by IAPT and its’ usage has breached informed consent. As Pim Cuijpers https://doi.org/10.1111/cpsp.12238 has observed ‘A self-help intervention cannot replace more usual forms of psychological treatment and this should be made clear from the beginning’. CCG’s are risking legal action from patients given the cheapest treatment option without explanation of alternative treatments, risks and benefits. There is a pressing need for CCG’s to seriously appraise IAPT and not blindly fund it because ‘it is the only show in Town’.
The response of CCG’s to any criticism of IAPT is typified by the letter below that I received from the
Liverpool CCG, published as an appendix in ‘Transforming IAPT’
https://www.dropbox.com/s/ie4yg6hgmt5fybw/EDITED%20Transforming%20IAPT.docx?dl=0https://doi.org/10.1177/1359105318781873
in the August issue of the Journal of Health Psychology
Footnote: In earlier work Cuijpers
https://www.dropbox.com/s/3zgy50ub5s5q1yx/Lewinsohn%27s%20Coping%20with%20Dep%20Meta-Analyses.pdf?dl=0
has noted that the effect size for GSH for depression is small 0.28 compared to 0.6 or more (large to moderate) for the regular face to face therapy.
Dr Mike Scott