IAPT claims a 50% recovery rate
I find it important to note that this was a target, is merely claimed as such because that was the target and not meeting the target would have been so bad for the continuation of the program that it's seen as preferable to lie.
So in essence IAPT has been "claiming" 50% "recovery" rates since before it even started. Just like PACE, where the numbers were fudged to align better with the initial target. There is no substance behind the claims of 50% recovery, it's merely aspirational and has pretty much been debunked.
Expansion of IAPT beyond its remit of depression and anxiety disorders should be halted, until it has been demonstrated that it adequately performs its’ core task
That would be devastating to the BPS model.
IAPT should not be allowed to expand its work, as it is doing to medically unexplained symptoms and long-term physical conditions until it has at least demonstrated that 50% of patients with depression and the anxiety disorders lose their diagnostic status for a period of at least 8 weeks
That would be extremely devastating to the BPS model.
Outcomes should be adopted that make sense to the patient such as no longer suffering from the disorder for an extended period of time. Point assessments using psychometric tests should be seen as an unreliable metric for discharge
That would be the end of the BPS model.
Though louder for those in the back:
Point assessments using psychometric tests should be seen as an unreliable metric for discharge
That would be a damning indictment of the entire BPS model and mark it down as a failure. Which it has been.
This is a very relevant observation:
But completion of a questionnaire for a therapist introduces demand characteristics - a wish to please therapist and to feel time has not been wasted, resulting in a possible artificial lowering of post-test scores. Further patients tend to present at their worst, often in crisis and are therefore likely to regress to the mean with the passage of time.
Stuff we have been saying for years but still feels good to see others realizing:
These psychological therapies are not however the mainstay of IAPT’s service provision. Indeed, in IAPT there is no attempt to gauge treatment fidelity, that is whether appropriate treatment targets have been identified and a matching treatment strategy deployed.
This would be devastating to Sharpe's career:
Serfaty [10] compared the efficacy of CBT delivered by High Intensity IAPT therapists with treatment as usual in patients with advanced cancer and found no difference. These authors concluded that IAPT-delivered CBT should not be considered as a first-line treatment for depression in advanced cancer and that the use of such services in patients with severe comorbid illness deserved careful scrutiny.
and literally dismantles his own argument about us being irrational since CBT is used to "help" cancer patients. Doing random nonsense doesn't formally count as helping, and anyway "helping" is literally the main argument for alternative medicine, without evidence it does not matter.
I hope people look at this and compare to the the US initiative called No Child Left Behind, enacted in the early 2000's with the aim of improving education by obsessively focusing on standardized testing and punitive measures for low-performing schools, which in practice lead to many of those schools outright cheating, with the teachers' and administration's oversight, to meet the arbitrary targets. People were essentially placed in situations in which they either lied or lost their jobs. Exactly what has been found in IAPT. Brilliant.
This program is widely seen as a failure and largely for the same reasons: ignorance and wishful thinking. Except IAPT is worse in every respect and was so obviously pie-in-the-sky. And as with every disaster there will be clean-up costs.
