The Entire IAPT Process Is Based on Deception

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

6 thoughts to “The Entire IAPT Process Is Based on Deception”

  1. Mike, thank you as always for your work on this blog.

    It gives people like myself confidence to leave IAPT for good and never go back. When I talk to some people about what I do, some honest and sincere people reply “oh so you lie to them and read from a script?” and I agree with them. Being a PWP is just about double-speak and deception of sorts. It is basically being the telemarketer who annoys it’s customers saying “if you upgrade with us, you will get a 20% discount”. Also, hearing “it’s all about the numbers” and “we are human, not robots” enough times makes at work me start to lose respect for myself. So, I am glad that I will be leaving the field for good soon enough. It’s just not worth losing one’s sense of self over such a shoddy job.

    I have been following your blog since I was a trainee. Every criticism I had about IAPT was always backed up by your blog. I tried to be critical of their ways to their faces but nope, they weren’t having any of that. Good luck trying to challenge management on the flaws of IAPT, they will just put HR on you for being “disruptive”. They wouldn’t want their “cash cows” to be put on the spotlight.

    Please keep doing what you are doing because it truly is a godsend.

    1. Thank you so much Nathan for your encouragement. If you would like to write about your experiences as a blog on cbtwatch I would be delighted to put it up, anonymously if that is less problematic. The distressing thing is that IAPT like its fellow traveller BABCP totally refuse all open debate, they are totalitarian. There are it seems too many vested interests in the middle and higher ranks. This exactly parallels Rudolf Vrb’s difficulties in being believed after he escaped from Auschwitz.
      Very best wishes
      Mike

      1. I highly agree with that.

        Also, I would not mind sharing my experiences here, anonymously to be safe. Please let me know what would be the best way to do it. A lot of my experiences are very similar to the experiences shared in books such as “CBT The Cognitive Behavioural Tsunami Managerialism, Politics and the Corruptions of Science by Farhad Dalal” and “Sedated How Modern Capitalism Created our Mental Health Crisis by James Davies”. Amusingly, they are difficult to find books.

        Thank you as always
        Nathan

  2. Sorry Mike, but I don’t think this analogy, and particularly the picture, are appropriate, and they are not going to help your case. I’m usually right behind you, and grateful for your campaigning on this, but it calls for measured and thoughtful comment that opponents are not going to be able to throw back at you as exaggeration.

    Best wishes,

    Steve.

  3. In the 5 years of cbtwatch my ‘measured and thoughtful comments’ have been totally ignored by ‘opponents’. There is always a problem with analogies, and I certainly wasn’t saying that the consequences of IAPT are in any way comparable to the Holocaust, but deception has played a key role in both. You are right though Steve, it is important to focus on the central issues and it is certainly arguable that I’ve given others an opportunity, to engage in peripheral processing of the data. Never was a politician! Thanks for keeping me on my toes Steve
    Best wishes

    Mike

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