The July/August 2020 Issue of the Psychologist has a one page advert from the Forward Trust recruiting IAPT workers and others for positions in five prisons. The Service Development Manager of the Trust speaking to the Psychologist said ‘Many of our clients present with complex issues that would preclude then from community IAPT’. Which raises the interesting question of what body of evidence are they to call upon in dealing with these complex cases. Doubtless the Trust has done valuable work in for example giving out self-help leaflets to help prisoners manage the Covid crisis and facilitating connections with family. But such work was done hitherto by probation officers. The Trust was founded 30 years ago to support people in prison with drug problems. Where is the added value of an IAPT input?
IAPT has already published data showing clients with personality disorders do less well in community IAPT. But IAPT clinicians have no way of reliably identifying clients with personality disorders. Further there is no evidence that they can faithfully administer a treatment protocol for personality disorder. It seems that this is yet another example of IAPT’s expansionism, matching its’ foray into treating long term physical conditions that are medically unexplained. The lack of demonstrated evidence seems not to bother the service, it will likely proceed by running workshops of alleged best practice. It takes it for granted that its’ expansion is an obvious good. This is actually incredibly arrogant, demeaning of pre-existing services.
