Do you want therapy with that? A critical account of working within IAPT
| Pages | 79-83 |
| Published date | 08 June 2015 |
| DOI | https://doi.org/10.1108/MHRJ-11-2014-0044 |
| Date | 08 June 2015 |
| Author | James Binnie |
| Subject Matter | Health & social care,Mental health |
Do you want therapy with that? A critical
account of working within IAPT
James Binnie
James Binnie is Lecturer in
Counselling Psychology at the
London South Bank University,
London, UK.
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 numberof important concerns are presented.The overarchingconcept of the “McDonaldization”
processis discussed as a way of encapsulating the IAPTexperience; with its theoretical relianceon the medical
model andthe real world impact of tendering for servicesin the modern NHS. The impactof IAPT on cognitive
behaviouralpsychotherapy is also highlighted.
Originality/value –A lot has beenwritten in the press andonline about IAPT. Manyof the criticisms seemto
derive frompeople outside of the IAPT system, many of whom have theirown personal or professional agenda
for attackingIAPT and CognitiveBehavioural Therapy(CBT); often the criticismsare 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.
Keywords Psychotherapy, NHS, CBT, IAPT, Critique
Paper type Viewpoint
Introduction
Improving Access to Psychological Therapies (IAPT) is a programme that was conceived in 2004
as the ideological vision of one of the UK’s most eminent clinical psychologists, David Clark and
the economist, Lord Layard. This vision was realised in 2006 and rolled out in 2008. Although 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 primary care that lacked consistency
in terms of delivery. IAPT promised much and has delivered effective interventions to many who
would previously been unable to access psychological therapy. However, from working within an
IAPT service for nearly four years it has been difficult to maintain a belief that all is well with the
system. The specific IAPT service I have worked in is not in itself substandard and is helping
people with mental health problems. There are many committed and dedicated therapists
delivering IAPT interventions, many of whom also acknowledge the limitations of the system
but still endeavour to make real changes to people’s lives. What I am going to put forward is
a selection of fundamental misgiving with the practical implementation of the IAPT ideology and
at times a critique of the ideology itself. This paper is presented by highlighting significant
statements I have actually heard over the years or my interpretations of what has been said,
followed by an analysis of the implications.
Received 27 November 2014
Revised 29 January 2015
19 March 2015
Accepted 19 March 2015
DOI 10.1108/MHRJ-11-2014-0044 VOL. 20 NO. 2 2015, pp. 79-83, © Emerald Group Publishing Limited, ISSN 1361-9322
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MENTALHEALTH REVIEW JOURNAL
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