Saturday, February 17, 2018

Transparency about the outcomes of Improving Access to Psychological Therapies

Graham Thornicroft's Lancet editorial on Improving Access to Psychological Therapies (IAPT) glosses over the effectiveness of the programme. True, he does say there has been little evidence of greater workplace productivity, which was the argument used to gain funding for the programme. He also acknowledges that although there has been a substantial increase in treatment of common mental disorders, admittedly particularly with antidepressants rather than psychological therapy, but still the prevalence of disorders has not decreased.

But, there is no questioning of the value of mandatory routine data collection, much of which is useless because it's uncontrolled (see previous post). By being so uncritical, Thornicroft could be said to be condoning the rhetoric of unrealistic claims for the effectiveness of the programme (eg. see another previous post). How much are outcomes just expectancy effects (see previous post)? I'm not wanting to undermine the work of IAPT therapists but we do need realistic assessments of the effectiveness of the programme. The title of the paper by Clark et al (2017), on which the editorial is based, is said to be about transparency about outcomes. I wish it was.

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