Do you want therapy with that? A critical account of working within IAPT

James Binnie

doi:10.1108/mhrj-11-2014-0044

Abstract

Purpose – The IAPT programme has been rolled out across England in the last ten years. Although undoubtedly many people have benefited from having greater access to psychological therapy there are several issues with the practicalities of Improving Access to Psychological Therapies (IAPT) and also with its ideology. The paper aims to discuss these issues. Design/methodology/approach – This is a personal reflection of working within the IAPT system for several years. Significant statements heard or interpretations of what has been said are presented alongside an analysis of the implications. Findings – A number of important concerns are presented. The overarching concept of the “McDonaldization” process is discussed as a way of encapsulating the IAPT experience; with its theoretical reliance on the medical model and the real world impact of tendering for services in the modern NHS. The impact of IAPT on cognitive behavioural psychotherapy is also highlighted. Originality/value – A lot has been written in the press and online about IAPT. Many of the criticisms seem to derive from people outside of the IAPT system, many of whom have their own personal or professional agenda for attacking IAPT and Cognitive Behavioural Therapy (CBT); often the criticisms are uninformed. This paper is a reflection of working within the IAPT system and not just an uninformed critique of CBT. Several concerns are raised that without remedy may seriously hold back the progress that psychological therapy has made in recent years.

Highlights

Improving Access to Psychological Therapies (IAPT) is a programme that was conceived in as the ideological vision of one of the UK’s most eminent clinical psychologists, DavidClark and the economist, Lord Layard
The overarching function was economic, in order to get people with anxiety and depression back into work, the IAPT programme dramatically re-shaped the provision of psychological therapies in the UK
Prior to IAPT, psychological therapy services were hindered by long waiting lists in secondary care services and brief counselling services in r

Summary

Introduction

Improving Access to Psychological Therapies (IAPT) is a programme that was conceived in as the ideological vision of one of the UK’s most eminent clinical psychologists, DavidClark and the economist, Lord Layard. IAPT services are supposed to see clients with mild to moderate anxiety and depression, the reality is that often inexperienced members of staff without sufficient training or psychological knowledge are left trying to assess complex clients. When IAPT therapists are not trained in behavioural therapy they struggle to work with people with anything other than standard presentations of depression and anxiety amenable to Beckian cognitive therapy.

Results

Conclusion