The IAPT Pathway for People with Long-term Physical Health Conditions and MUS. Full implementation guidance.

[Arnie Pye]

From your quote, @Trish

Many clinical presentations are poorly explained by existing anxiety-based treatment models.

Does it not occur to any of these people that not every patient is anxious and they are barking up the wrong tree? And in the situation that a patient with physical symptoms is anxious it is much more likely that the physical symptoms came first. I get the impression that cause and effect have been perverted to such an extent that some "researchers" think which came first is totally irrelevant.

 

[Hutan]

I thought the following quote from the blog SlySaint posted about was worth highlighting. It mentions a recent paper suggesting even the 'supportive' CBT for depression as a consequence of conditions such as advanced cancer is not cost-effective.

Expansion Into Long Term Conditions By IAPT Is Quackery
29th October 2019

"It is worrying that Everitt et al (2019) opine:

‘Offering both web-CBT and telephone-CBT in NHS services such as Improving Access to Psychological Therapy could allow many patients to gain substantial benefits with web-CBT with minimal therapist input while allowing a step-up approach to telephone-CBT for those needing additional
support’

IAPT will surely jump on this to justify empire building and likely ignore the caution of Serfaty et al (2019)

‘our results suggest that resources for a relatively costly therapy such as IAPT-delivered CBT should not be considered as a first-line treatment for depression in advanced cancer. Indeed, these findings raise important questions about the need to further evaluate the use of IAPT for people with comorbid severe illness’

If as seems likely Clinical Commisioning Groups fund IAPT’s expansion into LTCs they should be asked to justify this expenditure in the abscence of any empirical base."​

 

[rvallee]

Expansion Into Long Term Conditions By IAPT Is Quackery
29th October 2019

View attachment 8924


http://www.cbtwatch.com/expansion-into-long-term-conditions-by-iapt-is-quackery/#comments

Well, there goes the "cBT Is ALso uSed fOR cAncER" line.

Studies of CBT for long term conditions (LTCs) show either no effect, see Serfaty et al study (2019) on cancer https://www.cambridge.org/core/jour...rolled-trial/E9264C516634EC7BC3FF9E80B551A8C5

 

[rvallee]

I notice one of the responses to the blog linked above highlights this training day on LTC's and MUS by the Royal College of Psychiatry:
Working with Long Term Physical Illness & Medically Unexplained Symptoms

This description of it gives me the horrors:

Those are all aspirational and do not describe real things, just things they wish they were able to do. It reads like a comedy sketch on pseudoscience-based medicine.

 

[Arnie Pye]

Well, there goes the "cBT Is ALso uSed fOR cAncER" line.

Off Topic : I've seen this mixing up of lower and upper case letters on phrases being used a lot in the last year or so in all sorts of circumstances. Can anyone tell me why and what it is supposed to signify?

 

[Trish]

Off Topic : I've seen this mixing up of lower and upper case letters on phrases being used a lot in the last year or so in all sorts of circumstances. Can anyone tell me why and what it is supposed to signify?

And preferably stop doing it. It's hard to read and exhausting!

 

[Arnie Pye]

And preferably stop doing it. It's hard to read and exhausting!

I agree!

 

[rvallee]

Off Topic : I've seen this mixing up of lower and upper case letters on phrases being used a lot in the last year or so in all sorts of circumstances. Can anyone tell me why and what it is supposed to signify?

I don't know exactly how it started but it's from a Spongebob Squarepants meme where you mock what someone said, in general terms, because it's stupid. Can repeat exactly or loosely paraphrase the thing.

 

[Arnie Pye]

Thanks for the explanation, @rvallee

 

[chrisb]

… and there was I, thinking it was a new mnemonic from King's.

 

[rvallee]

41% of respondents say they were asked to manipulate "performance data".

 

[Arnie Pye]

Those answers to the survey ...

are absolutely shocking. And tax payers are paying for this utterly useless service.

 

[rvallee]

Those answers to the survey ...

are absolutely shocking. And tax payers are paying for this utterly useless service.

Oh, but it's just for the low, low price of over £3B. Almost a bargain for no benefits at all.

The beauty is that the system will now feed itself, if we're to believe the 2/3 of employees who are experiencing distress as a result of their work. They will need IAPT services themselves, creating a self-perpetuating loop of therapists becoming users themselves, then back to therapist role and on and on. By the end the only users of the service will be IAPT therapists themselves taking turns doing both roles, like someone playing chess against themselves.

Some of those responses could have been written specifically about PACE. Total surprise that the thing that failed every small test is also failing every one of its much bigger tests. Nobody could have predicted that. Other than those who did...