UK: Improving Access to Psychological Therapies (IAPT) articles, blogs and discussion

What Is The Added Value of IAPT?

http://www.cbtwatch.com/what-is-the-added-value-of-iapt/

 

40% of the time, it works 50%. If you define work as simply going through the process.

That's a very poor business proposition. Honestly by this standard, Theranos was very mild fraud.

 

What are their criteria for recovery rate?

40% simply not believable on its face. Most of the people I know with mental health problems have them for years or decades despite significant treatment.

 

It means filling in a questionnaire differently

 

Has anyone even bothered to study mental healthcare with the same rigor as physical healthcare?

Some autism research is just as bad as the PACE trial. They use the wrong outcome measures, like reduction in signs and symptoms, which is useless, because autism is not a disease. So young children with autism are given rigid obedience-based therapy that can cause PTSD or other problems functioning that don't surface until adolescence or adulthood. (This is vaguely similar to GET making pwME worse) But that's "okay", because it reduces the signs, most of which are benign (like hand-flapping, having different facial expressions), easily compensated for (sensitivity to noise or certain clothes), or beneficial (intense interests leading to rewarding career)

My journey with autism is vaguely similar to me journey with ME. I learned I was autistic after having it for years, but everything I learned about finding out was from a neurodiversity standpoint. This allowed me to better adapt to my brain differences and resist the shame that who I am is a disease. It parallels how I got ME, didn't know for years, but when I dived in, everything I read was from a biomedical perspective. That allowed me to avoid dangerous treatments and resist the same that ME is my fault.

 

Mis-Guided Self Help In IAPT

http://www.cbtwatch.com/mis-guided-self-help-in-iapt/

 

It's free. People rarely refuse free stuff. It has to be extremely bad for people to be offered free stuff and think it's not even worth their time. You can see this everywhere, offer free stuff to people and even if it's useless they'll take it anyway. Likely to throw it away soon enough but they'll still take it in case it's not as useless as it first seems.

And yet their reaction is simply to figure out how to change the useless junk they're giving away just enough, or maybe how to hand it to passersby, so that fewer people throw it away immediately, completely indifferent to whether they simply end up throwing it away later. As long as it appears to have been accepted, that's all they care about. Results in real life play no role in any of this.

This is possibly one of the most corrupt publicly-funded fraud in the modern world because it has no private industry counterpart, this giant scam is almost entirely out of either public funding or insurance pools, which is ultimately paid by the insured. It's basically an academic scam when you drill down the origins and perpetuation. Possibly the worst academic/scientific scandal in human history... and it's popular, which fully explains how it became so massively disastrous.

 

So with the current oversight set-up, measuring of outcomes being left to the departments themselves to choose their own measures and methods etc and no requirement of data being made publicly available we basically have a set-up where IAPT will only give the data to those who will be favourable and not criticise them. Ergo there is nothing at all in any constitutions or oversight that means someone independent or not can look at that data in an open-minded critical manner?

Taking 'only positive results get published' to a whole new level isn't it?

 

from Oct
Number using IAPT services rises by one-fifth
More people are accessing NHS psychological therapies, but only half move into recovery, according to new figures

https://futurecarecapital.org.uk/latest/number-using-iapt-services-rises-by-one-fifth/

 

I don't believe a word of it!

http://www.cbtwatch.com/what-is-the-added-value-of-iapt/

 

That rise is from a major fall off the previous year because of COVID - comparable numbers are 2019/20 = 1.17m accessed IAPT services (increase of 5.6% 2021/22) and 1.69m total referrals (increase of 5.5% 2021/22) . The gap between total referrals and both 'entered treatment' and 'ended treatment' grew, although that is hardly surprising given the impact of COVID.

https://app.powerbi.com/view?r=eyJr...iZmUtNDAxYS04ODAzLTY3Mzc0OGU2MjllMiIsImMiOjh9

 

The gender split is significant:

 

IAPT’s Capitalisation on Time Is A Great Healer

http://www.cbtwatch.com/iapts-capitalisation-on-time-is-a-great-healer/

 

Wow, what a surprise that this is the same pattern everywhere in BPSland, where they simply attribute themselves credit for natural outcomes along with generic constructs and arbitrary definitions. As if the entire ideology is built on it.

So much coincidence.

 

‘CBT Today’ An Apologist for IAPT Expansionism

http://www.cbtwatch.com/cbt-today-an-apologist-for-iapt-expansionism/

 

My bolding in the quote.

This really suggests to me that Dr Whittington (whoever he is) wants to throw in the towel when it comes to curing disease and just wants to train people to put up with their ailments until they die.

 

Whittington says "need", when it means "want". There is absolutely no need for this, it's strictly a supply-side wish model based on a clearly false "what if". And actually we know the opposite of that, "can support" is simply not a valid standard for a program of any size, let alone a giant multi-billion boondoggle that basically acts as a jobs program.

Billions wasted in direct spending, and the very best they can boast about is still and ever was that it "can be of help to some" and some generic hand-waving that has exactly the same validity as astrology: stars and planets definitely can influence life on Earth, in fact without Jupiter our current models indicate that life on Earth would not have been possible without Jupiter acting as a tug on asteroids coming in the inner system. Still doesn't make horoscopes and zodiac signs anything more than narratives and myths, just like the BPS model.

 

I asked an IAPT psychologist what 'recovered' meant when reported to NHS commissioners, they said when the person no longer reaches 'caseness'.

As google will tell you, caseness is the term used to describe a referral that scores highly enough on measures of depression and anxiety to be classed as a clinical case.

So *I THINK* that if (totally random numbers here) 6/10 was 'caseness' and the person went from 6/10 before therapy to 5/10 immediately after therapy then they count them as recovered.

If I had the time and the inclination I'd want to dig into the reporting and see whether they balance that against the average number of people who would go from caseness to not caseness over six weeks without any intervention, and also whether they do longer term follow ups (pretty sure both are a no).

Reliable improvement "requires that any improvement in scores on the appropriate outcome measures between pre and post treatment exceeds the measurement error of the scales".