Is it possible to stop fake psychological therapy by telling the truth? The client is at a railway station to board a train to where he/she knows not, but seeking a better life. They may have arrived at the station under their own steam and/or at the promptings of family/friends/GP. But the ‘trip advisors’ have rarely visited/evaluated the destinations. In social psychology terms the advisors have not engaged in effortful central processing of outcome data. Bypassing the latter with a heuristic (peripheral processing) that the IAPT service’ must be good because it is NHS/Government funded and in any case the mental health burden will be shared out’.
The client believes that they will encounter mental health professionals who can reliably diagnose and treat whatever disorder they have. But nobody told them the service does not make diagnoses [IAPT Manual (2019). At the 30 minute telephone assessment the Psychological Wellbeing Practitioner does not tell them that: a) they are not trained to diagnose b) nor trained to provide psychological therapy and c) in the first instance they will likely undergo low intensity CBT of undetermined potency in treating depression and the anxiety disorders. The deception makes for easy boarding of the IAPT train. The PWPs cram the clients onto the train by using low intensity interventions but unsurprisingly 69% of PWPs suffer burnout, whilst the rate of burnout amongst high intensity therapists is 50% [ Westwood et al (2018)] . To help mitigate their stressors the PWPs have regular supervision, but this to is a deception, as they often have less than 3 minutes to discuss a case. Over a third (38%) [Psychological Therapies Annual Report (2020-2021)] of clients get off the train before their 2nd treatment session, but that is not at places where they want to be. Nobody told them at the start of this level of dissatisfaction. Likewise nobody told them only the tip of the iceberg reach a destination where they have lost their diagnostic status Scott (2018), 9 out of 10 remain at square one. But IAPT keeps up the pretence advising the ‘trip advisors’ and Clinical Commissioning Groups of a 50% recovery rate. A million a year now enter the IAPT gates. It is difficult to escape the parallel as to how people were conned into Auschwitz.
Dr Mike Scott