Search results

The Improving Access to Psychological Therapies (IAPT) programme was established to treat people with mild to moderate depression and anxiety and bring them to recovery. Although the Positive Practice Guide for people with intellectual disabilities was published in 2009, no geographical areas are listed as having a special interest in specifically rolling out IAPT to people with intellectual disabilities. Issues related to whether current IAPT services can meet the needs of people with intellectual disabilities are considered, along with adaptations that would be needed to ensure the service is accessible and meets the needs of people with intellectual disabilities.

The purpose of this paper is to highlight possible implications of therapists’ working conditions on social inclusion of service users.

A search was carried out for recent papers on cognitive behaviour therapy (CBT) therapists.

One study highlighted that over half of their sample of 201 UK therapists in Improving Access to Psychological Therapy (IAPT) services reported burnout. In a second study, in interviews with ten IAPT workers in inner London services, therapists said they had to fight for extra time to adapt CBT for people who had learning disabilities, and the additional stress made them feel less positive about working with these clients. A third study, on therapists working with people with multiple sclerosis, highlights the importance of adapting CBT for people with physical conditions.

Taken together, these three papers highlight concerning implications of current working conditions for many therapists working in IAPT services. They highlight that sources of stress include services’ rigid focus on targets and inability to make expected adjustments. With regard to the UK, this may be due to the current national service model, but it has implications for the social inclusion of some service users.

The purpose of this paper is to explore the importance of equal access to Improving Access to Psychological Therapies (IAPT) for people with intellectual disabilities.

The paper identifies barriers to access and shows how a reference group can work to solve the barriers and increase access.

The paper evaluates the authors’ progress to date and how the authors plan to continue to take the work forward.

The paper highlights some of the factors responsible for the authors’ success and gives information that will be helpful to other areas who are interested in facilitating equal access.

The paper demonstrates how the focus of a reference group can drive improvements across services to improve access for people with intellectual disabilities to IAPT services.

The main aim of this paper is to highlight innovative partnership working between voluntary sector General Practitioner's and primary and secondary mental health services to improve access to services. Many clients are turned away from services when they disclose substance use, this paper discusses why clients are excluded and how psychological therapies can engage clients in treatment using an alternative approach to health centres. It identifies the need for agencies to have multiple skills in working with both mental health and substance use to provide access to services.

The improving access to psychological therapies (IAPT) group was developed to work with clients using psychological interventions to create, a more flexible approach to services for substance users with psychological difficulties and so the IAPT group was developed. To ensure group's stability it was thought that consistent staff from both organisations should remain in the programme for its duration. To ensure adequate staffing, two staff from the drug agency and three staff from the IAPT team were identified and had shown a firm commitment to work on the programme, and it was agreed that two staff were present at each meeting. The voluntary sector agency premises were chosen as the venue, due to their proximity to bus routes and the anonymity of the service location. The group convened for a period of six weeks and would be a closed group (start with the same group members and have no changes during the groups duration). This would allow clients to engage, work together and to gain confidence in supporting each other. It also allowed clients to work with existing group dynamics and to set boundaries. Establishing the group it was important that it met in the afternoon to allow clients to arrive. The group started at 1 p.m., and worked through until 4 p.m., starting with coffee and having a break within the afternoon. Time was also allocated at the end to talk to staff or other group members about any concerns. The programme included workbooks and hand outs to help clients continue the process at home. Information packs were given including helpline numbers and service information. The group was based using cognitive behavioural therapy techniques, mindfulness and dialectical behavioural therapy. Some motivational interviewing techniques and harm reduction messages as well as relapse prevention were included.

Half the group reported that they had reduced their drug use, two went on to join group programmes. In total, 100 per cent agreed to continue to meet and support each other in a less formal setting. The group felt strongly that it should remain only about cannabis and not to introduce other drugs into the group. All clients felt the group should be a 12-week programme the staff running the group concurred with this. All participants felt the group was helpful but could have been 12 weeks, that it reduced their symptoms and enabled them to interact with others who understood their needs. Peer support was highlighted as the most useful. Two participants entered other drug programmes after the group. All participants associated their substance use with their mood.

There are no other projects that have worked outside the IAPT model that integrate substance users and voluntary sector agencies. Provides a unique view of multi agency approach using IAPT in a non–General Practitioner setting with clients normally excluded from IAPT services due to drug use. Is about inclusion of a normally excluded group.

The purpose of this paper is to describe the development, implementation, delivery and evolution of a community-led, comprehensive, peer support service, including co-production approaches, peer support worker role development, outcomes, acceptability and lessons learnt over a five-year timeframe.

This case study presents a reflection on a charity’s peer support service development along with outcomes to highlight client progress.

Improvement in well-being as measured through the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) was evidenced along with demonstrating that the peer support service offers complementary support to Improving Access to Psychological Therapies (IAPT) services.

There was limited quantitative data, and that which existed was analysed on a service-wide basis as opposed to looking at individual components of the service.

This paper demonstrates the value of peer support provision as part of an overall primary care, community-based mental health service, including findings that suggest that for some individuals, where IAPT services did not help them as much, a peer-based service appeared to be more suitable.

The peer support service provided a complementary and alternative service to conventional primary care mental health services whilst offering individuals with lived experience to gain volunteering, employment and development opportunities.

Whilst peer support services have been well documented in the literature for clients experiencing serious mental illness, research on the use of such approaches in the management of common mental health difficulties including anxiety and depression is not as well established. The aim of this paper is to detail the experiences of a user-led charity in developing and delivering peer support services, including challenges encountered. Furthermore, this paper describes a peer support service that has been integrated with a co-existing low intensity IAPT service, reporting recovery rates for clients that have accessed both peer support and IAPT services.

This study aims to explore whether the cultural competency training in Improving Access to Psychological Therapies (IAPT) services is sufficient to equip Psychological Wellbeing Practitioners (PWP) to support Black, Asian and Minority Ethnic (BAME) service users.

A qualitative design was adopted using semi-structured interviews with six PWP participants. Reflexive thematic analysis using Braun and Clarke’s (2006) six-step process was used in data analysis.

Three themes revealed evaluations of PWP training, factors supporting PWPs’ cultural competency and points of improvement for PWP training. The training briefly and superficially covered cultural competency content; however, it encouraged PWPs to explore potential personal and cultural biases in therapy. PWP training can also be improved by providing more culturally relevant resources and involving BAME service users.

A small sample size (N = 6) was used, impacting the findings’ generalizability.

PWP training does not sufficiently equip PWPs to support BAME service users. PWPs’ reflection of their own ethnic identity and personal experiences, when combined with training, can improve cultural competency. IAPT training should focus on cultural awareness, knowledge and skills to enhance therapeutic experience. Moreover, PWPs should reflect on their identity, personal biases and experiences when working with diverse communities.

This is one of the few qualitative studies evaluating the cultural competencies of PWPs in IAPT.

A number of initiatives have been developed to ensure easy access to mental health services for Black and Asian Minority Ethnic (BAME) communities. Improving Access to Psychological Therapies (IAPT) is a service that delivers first line interventions for South Asian women; however, little is known about what makes IAPT accessible for this population. This paper aims to explore South Asian women’s experiences of accessing psychological therapy and whether therapy within IAPT helps individuals to re-frame their experiences within their own cultural context.

A qualitative approach was used. Semi-structured interviews were carried out with South Asian women who accessed an IAPT service. Ten participants took part in the study and interviews were analysed using thematic analysis.

Six themes were identified; access, experience, cultural framework, therapist characteristics, expectations and “sticking with it”. Having a good therapeutic relationship with the therapist was key. While cognitive behavioural therapy (CBT) enabled clients to manage their symptoms, manualised CBT led to a sense of dissatisfaction for some. Clients spoke of having to make a forced choice to either deny their culture or leave their culture at the door to access therapy. Cultural and religious exclusion had a negative impact on therapy particularly for those whose difficulties were related to their cultural or religious context.

Culture and religion continues to be excluded from psychological therapy for South Asian Women. A cultural shift is required from within IAPT services to maintain engagement for this group. Further clinical implications are discussed.

While the experiences of Black and Asian ethnic minority groups accessing secondary mental health services has been explored, this study explores and highlights the experiences of South Asian Women accessing therapy in primary care, and uniquely identifies the processes that enable women to engage in therapy.

There is a move to make primary care models of mental health care more accessible to people with intellectual disabilities (IAPT, 2009) but little evidence of their ability of services to make the necessary reasonable adjustments or their effectiveness (Dodd et al., 2011). The purpose of this paper is to describe a pilot project to evaluate an anxiety management group co-facilitated by Least Intervention First Time (LIFT) Psychology and Community Team for People with Learning Disabilities (CTPLD) services.

Five people attended a nine-week anxiety management group, adapted from a course offered by LIFT services. The Glasgow Anxiety Scale (GAS-ID) and a skills and knowledge assessment were completed pre-group, post-group and follow-up to evaluate outcome and consider the ability of LIFT to make reasonable adjustments to deliver effective services for people with intellectual disabilities.

Participants showed no significant reduction in anxiety levels but improvements in their skills and knowledge. An evaluation of the adjustments to make the group accessible for people with intellectual disabilities identified that some were feasible if offering the group on a long-term basis, and others were not. The viability of future groups is considered.

The paper looks at the viability of making reasonable adjustments to psychoeducational groups within Improving Access to Psychological Therapies services to better meet the needs of people with intellectual disabilities, an area of limited research. It raises dilemmas and considerations for the future development of such services.

The government IAPT plan reveals a welcome determination to tackle the country's mental health problems in a comprehensive manner ‐ especially by using evidence‐based psychological therapies to improve quality of life and prevent mental/emotional problems worsening. Unfortunately, despite encouraging all alternative psychological therapy bodies to submit evidence, the scales are already heavily weighted in favour of cognitive behavioural therapy (CBT) in that it is already largely considered the only evidence‐based therapy by most NHS mental health authorities. There are also signs of an ill‐informed, media‐lead, groundswell of public opinion headed in the same direction ‐ which might well ultimately influence patient choice.While acknowledging the value of CBT, there is a strong case that alternative psychological therapies, by directly addressing the root causes of problems, can achieve far better results ‐ especially in the longer term. Unfortunately, the other disciplines frequently present as poor alternatives ‐ not least because of their disparate, sometimes archaic, foundational dogmas, and the alleged potential cost of their treatment. Fortunately, much dogma can now be updated in the light of neuroscience, and the time factors can be shortened, thus rapidly paving the way for a new, more unified, approach to mental health therapy; with potentially successful treatment across all categories of patient.