Evaluating the IAPT Initiative

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What is IAPT?
NHS program offering NICE approved treatments for depression and anxiety. Promotes taking therapy and uses the stepped care model.
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What is the IAPT workforce?
Trains LI and HI CBT workers. Establishes a clear curriculum for training both HI and LI, high quality training courses and clear ways of monitoring standards.
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What therapies were mainly delivered before IAPT?
Primarily medication for depression and anxiety. Little provision of psychological therapies, and often not evidence based.
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Who delivered therapy and who was most likely to receive it?
Delivered by expensive clinical psychologists, often to only the severe end of the spectrum.
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What was the result of growing waiting lists?
Increased referrals.
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How is IAPT cost effective?
Cost of treatment delivery will be saved by reductions in working days lost and reduced benefit utilisation over the long term.
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How did service users help to build the case for IAPT?
They wanted access to psychological therapies instead of/ alongside medication.
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What were the piloting studies of IAPT?
Demonstration sites set up in 2006. The results showed 55-65% recovery rates, but there was no control group, so results were compared to wait-list results from other studies.
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What is the cost of IAPT per recovered patient?
LI= £1043. HI= £2895.
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How does the cost per session compare to the cost-benefit ration?
It exceeded previous estimation, but it still suports IAPT's cost-benefit ratio.
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Is IAPT cost effective?
Only just. Cost per QALY is £29,500; the limit being £30,000.
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What was the focus of the 2010 Glover et al. report?
Equality of access: both genders well represented; older adults, ethnic minorities and persistent anxiety disorders under represented; depression over represented.
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What were the outcomes of the 2010 Glover et al. report (1)?
On average, 45% recovery rate.
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What were the outcomes of the 2011 Glover et al. report (4)?
Better response if there was higher step up rates and higher number of sessions in LI and HI, no difference between CBT and counselling for depression, CBT superior to counselling for anxiety disorders, guided self-help better than pure self-help.
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What were some problems with IAPT implementation (8)?
Implementation occurred too early, limited service user involvement in IAPT design, service too CBT centric, high case load and work pressure, increased referral, creation of waiting lists, lack of patient choice, completion rates lower than desired.
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What were some benefits established with IAPT implementation (2)?
Recovery rates in excess of 45%, 45,000 people moved off sick pay and benefits.
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What are some achievements of IAPT (5)?
Improved access to evidence based talking therapies, promising outcomes, an example of influencing government investment, shows how to establish a new workforce successfully, improved chances of those with depression or ADs receiving treatment.
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What are some criticisms of IAPT (5)?
Doesn't help people back into work as well as hoped, assumes existence of only discrete diseases that can be cured, neglects chronic course/ comorbidity/ environment, CBT effectiveness still up for debate, promotes CBT over all other therapies.
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What are the future steps for IAPT (7)?
Complete rollout of adult IAPT, broadening range of treatments offered, making service more accessible to older adults, better training of workforce, expand IAPT to more people, broadening employment support, export to other countries.
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Card 2

Front

What is the IAPT workforce?

Back

Trains LI and HI CBT workers. Establishes a clear curriculum for training both HI and LI, high quality training courses and clear ways of monitoring standards.

Card 3

Front

What therapies were mainly delivered before IAPT?

Back

Preview of the front of card 3

Card 4

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Who delivered therapy and who was most likely to receive it?

Back

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Card 5

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What was the result of growing waiting lists?

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