IAPT couldn’t find enough cases of generalised anxiety disorder that a randomised controlled trial comparing CBT with the antidepressant sertraline collapsed, Buszewicz et al (2017) see link below. The metric IAPT uses, problem description is clearly useless as GAD cases are ubiquitous, effecting 4.7% of the population, more common than depression,
Similarly adjustment disorders are ubiquitous but IAPT doesn’t use such a label and engages in treating them then discovers its mistake, what a waste of resources. Dana was distressed by the criminal behaviour of her ex and her children’s exposure to him, she had 4 treatment sessions which she described as helpful, but the service advised that treatment should be suspended and the outcome was ‘mixed’.
| PHQ9 | GAD7 | |
| Pre | 7 | 13 |
| Post | 6 | 12 |
:
Yvonne had a long history of anxiety but no problems in the months before she tripped, injured herself and this initially precluded her use of her main coping mechanism of exercise. She was given treatment for ‘anxiety’ in IAPT, which she described as helpful, but she only had fear of falling a specific phobia this was not addressed at all in treatment. Yvonne had not been asked what would constitute her being back to her usual self i.e what would be a clinically relevant difference post treatment, instead IAPT goes blindly on with its own idiosyncratic metric and claims success on the basis of the changes in scores below:
| PHQ9 | GAD7 | ||
| Pre | 19 | 18 | |
| Post | 6 | 7 |
For speed IAPT weds itself to problem specification, but it doesn’t take clients to their destination of a clinically relevant outcome.
Dr Mike Scott
Buszewicz et al 2017 https://www.dropbox.com/s/1wxuws089tj74er/IAPT%20none%20recognition%20of%20GAD%20lead%20to%20collapse%20of%20trial%202017.pdf?dl=0