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BABCP Response - NICE Consultation January 2022

The Re-Branding of IAPT, ‘Never Mind The Quality Feel The Width’

It is inevitable that when a product fails, it is renamed, so to with The Improving Access to Psychological Therapies (IAPT) service, it is now NHS Talking Therapies, for anxiety and depression.  In 2021 I published a paper ‘Ensuring IAPT Does What It Says On the Tin’ , over the last 2 years it has signally failed to put its’ house in order. On June 28th 2022 the Lets Talk IAPT website identified ‘a series of seven core problems and failings of the IAPT, including an unproven treatment rationale, a weak and contested evidence-base, biases in treatment promotion, exaggeration of recovery claims, under-reporting of drop-out rates, and a significant risk of misdiagnosis and inappropriate treatment’. None of these problems have been addressed and so it has been given an air of respectability as NHS Talking Therapies.

The avowed focus is depression and the anxiety disorders, but it has extended its scope to include the psychological  sequelae of long term physical conditions. Given that almost half the adult population have at least one LTC, this offers massive opportunities for expansion. But the evidence on effectiveness with this population is weak to non-existent.  However given that IAPT has usurped the NHS this is likely to matter little.

Professor Clark and Dr Whittington announcing the name change note ‘”Many of those who do find their way to services are looking for help with other difficulties that the services are not set up to treat, such as psychosis or complex emotional needs associated with a diagnosis of “personality disorder”. Clark and Whittington claim ‘You don’t need a “diagnosis” to come for therapy, a skilled practitioner will help work out with you whether and how the service can help’ and add that they offer treatment not only for depression and the anxiety disorders  but also OCD, PTSD, body dysmorphic disorder, health anxiety and mixed anxiety and depression. But given that its practitioners are not trained to diagnose according to the latest IAPT Manual, by what magic do they decide who to treat with what?   No matter, Clark and Whittington proclaim that 50% of treated people recover, this strains credibility.

 

Clark and Whittington state ‘Within NHS Talking Therapies services most of the psychological therapy will be quite practical. It may involve working through self-help materials with guidance from a clinician, possibly via a dedicated online platform (which we call ‘digitally enabled therapies’). It may involve help with problem solving skills or practical exercises to examine and overcome your fears. It may involve facing and working through traumatic memories in a safe way’. Can trauma focussed CBT be really regarded as quite practical, in routine practice most clients find it quite toxic Scott and Stradling (1997).

 

Dr Mike Scott

14 replies on “The Re-Branding of IAPT, ‘Never Mind The Quality Feel The Width’”

I tried out IAPT with the online treatment thing .I already had some training in CBT ( retired dentist who specialised in treating dental anxiety and phobia with a psychology degree )
I share your reservations which you set out I’m not sure that working through online exercises counts as ‘talking ‘

We have always had talking therapies up north. I forced their big boss to own up to underdiagnosing female autists. Like they do all the time it was verbal on the phone so no evidence, they all say stuff verbally. If you ask for a written letter they either don’t or the social services completely did the opposite as to what they said in the phone. They conveniently record us but when the ring is the conveniently don’t record their calls. Then when they send us a letter they do the opposite of what they said on the call then they wonder why autistics they misdiagnosed life long then peddled CBT, IAPT and the same BS relabelled talking therapies.

I really would love Dr Scott to see what they did to me in my DRs notes. And are still doing. I purely don’t suicide to pee them off. They are liars and invalidators gaslighters and dark triads imho they probably hire nazi attitudes re disability and MH. This is cultural and it’s throughout the system. “Don’t help them they will have learned helplessness”.
I am a woman trapped on her own 0 people also with degenerative prolapsed discs. They are doing this too, that’s in an upstairs flat in a village with a none functioning bus service. All I want Is a 1 bed bungalow with room to move. A decent kitchen a walk in shower very few steps. And help once a week with phone calls when I can’t take bad customer
Service what causes me to have a meltdown. And help setting all my passwords up properly in all my systems.
Some social support to meet with other like minded female autistics who have been through the same rubbish.
Not much to ask given I served and represented my country in sports and worked 21 years unsupported re autism needs. Looked after a woman with cancer 12 years free to society and other stuff and volunteered 15 years all in 53 years. I don’t need bullied and labelled lazy I need access to the training I want to do and opportunity to do that job of advocacy for others. Frankly would like to set up the autism support group myself and to have space in it for none intellectually disabled autistics.
The services particularly hate us because we see the truth and what needs done.
But they prefer to lord their professional corruption over us and drive us to suicide and have the public think we are all lazy scroungers who should go die quietly or glue a smile on our faces as all our rights are removed by this fascistic puppet government.

To me the name change infers a change in service to one that now focuses solely on Anxiety and Depression and an end to LTCs etc. I’m assuming though they’ll carry on expanding, so much for clarity. Adding NHS to the name change reminds me of NHS Test and Trace. I haven’t noticed much chance to freely talk in the old IAPT service, bet that doesn’t change either.

I totally agree with the 3 of you, all we are asking is that NHS Talking Therapy starts with a decent conversation, not one were the professional facing you, is essentially looking over your shoulder, ticking boxes. Therapy is intrinsically a relationship without it all the rest founders. Relationships involve giving the time of day.

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