Recovery and reliable change rates for patients scoring severe on depression, anxiety or impaired functioning in a psychological therapies service: IAPT
| Pages | 28-35 |
| DOI | https://doi.org/10.1108/MHRJ-06-2014-0022 |
| Date | 09 March 2015 |
| Published date | 09 March 2015 |
| Author | Christopher Alan Griffiths,Laura Jayne Griffiths |
| Subject Matter | Health & social care,Mental health |
Recovery and reliable change rates for
patients scoring severe on depression,
anxiety or impaired functioning in a
psychological therapies service: IAPT
Christopher Alan Griffiths and Laura Jayne Griffiths
Dr Christopher Alan Griffiths is
the Head of Evaluation based
at, Rethink Mental Illness,
London, UK.
Laura Jayne Griffiths is a
Psychologist based at,
Coventry and Warwickshire
Partnership Trust, Rugby, UK.
Abstract
Purpose – The NHS Improving Access to Psychological Therapies (IAPT) programme provides access to
psychotherapy in England through a stepped care approach for adults with depression and anxiety
disorders. This evaluation sought to investigate IAPTrecovery and reliable change rates of those who scored
severe on depression (PHQ-9), anxiety (GAD-7) or impaired functioning (WASA). The paper aims to discuss
this issue.
Design/methodology/approach – This evaluation employed a within groups design: a single case
evaluation follow-up. Routine service data (from services set-up in 2008-2009 to February 2012) from
25,034 patients treated at four IAPT services was analysed.
Findings – The analysis revealed that 29 per cent (n ¼7,059) of patients were assessed as being in
the WASA severe range, 41 per cent (n¼10,208) in the PHQ severe range, and 57 per cent (n¼14,612)
in the GAD-7 severe range; with 14 per cent (n ¼3,548) in the severe range on all three measures
combined. There were significant falls on all three measures and a large effect size. The percentage of
patients who recovered to a point below the recovery threshold was 30 per cent for depression, 34 per cent
for anxiety, 18 per cent for impaired functioning, and for those presenting severe on all measures: recovery
rates were 21 per cent for anxiety, 26 per cent for depression, and 15 per cent for impaired functioning.
Reliable change for anxiety was found to be greater than IAPT patients overall.
Originality/value – The results show that IAPT enables approximately a third of people scoring severe to
recover,lower than IAPT recovery rates overall. Reliable change may be a more effective measure of patient
progress.
Keywords Psychotherapy, Anxiety, Recovery, Depression, IAPT, Psychoeducation
Paper type Research paper
Introduction
The NHS Improving Access to Psychological Therapies (IAPT) is a primary care mental health
programme for adults in England seeking treatment for anxiety and depression, which provides
access to National Institute of Health and Care Excellence (NICE) approved psychotherapy,
most commonly Cognitive Behavioural Therapy (CBT). IAPT aims to relieve distress and
transform the lives of people experiencing anxiety and depression (Department of Health,
2010). In the first three years of the IAPT programme over 150 services have been established
(Department of Health, 2012).
People access IAPT through their GP or another professional’s referral, or directly into the
service through self-referral. People are initially assessed and then IAPT uses a stepped
care approach with the least intrusive “low intensity” treatment offered in the first instance
Received 23 June 2014
Revised 18 September 2014
13 November 2014
Accepted 24 November 2014
PAGE 28
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MENTAL HEALTH REVIEW JOURNAL
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VOL. 20 NO. 1 2015, pp. 28-35, CEmerald Group Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-06-2014-0022
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