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Treatment protocols validated for Improving Access to Psychological Therapies initiative

28 August 2009

New research, led by Professor David Clark, Common Mental Disorders Theme Lead,  National Institute for Health Research (NIHR) Biomedical Research Centre (BRC )  for Mental Health, at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry  at King's, has been published in the journal Behaviour Research and Therapy, validating the treatment protocols for the UK Government’s Improving Access to Psychologies Therapies (IAPT) initiative for depression and anxiety disorders.

The Department of Health established two pilot projects in Doncaster and Newham to collect information to inform the national roll-out of IAPT.  Doncaster and Newham received funds to rapidly increase the availability of CBT-related interventions and to deploy them in new clinical services, operating on stepped-care principles (ensuring that patients receive the minimum intensity intervention that is needed for recovery). The evaluation showed that both demonstration sites had substantial achievements in numbers treated, clinical and employment outcomes, outcome monitoring, referral routes and meeting the needs of a diverse population.

An impressive number of people were assessed and treated by both sites and both achieved good recovery rates. Clinical outcomes were broadly in line with expectation and treatment gains were largely maintained at 10 month follow-up.  The effects of the IAPT services on employment were also encouraging.  Newham, which had the most ethnically diverse community, succeeded in engaging these communities with equal recovery rates and the research indicated that being able to self-refer facilitated access by these groups.

Professor Clark said: 'The study gives us valuable information about how to translate the findings of clinical trials into effective clinical services.'

The findings from both sites show that treatment protocols developed in research studies can be applied with reasonable success in varied clinical settings with a large number of people from diverse backgrounds.  However, further issues to consider for the future development of IAPT services include identifying relevant NICE guidance through efficient early provisional diagnosis and ensuring service users achieve enduring psychological gains through routine follow-up.

Dr Saliha Afzal, Centre Manager, NIHR BRCentre for Mental Health said: 'The NIHR BRC for Mental Health is committed to delivering research supported improvements in care for people suffering from common mental illnesses.  Studies such as these have important implications for developing appropriately tailored NHS services'.

Professor Clark's colleagues in this evaluation were Richard Layard and Rachel Smithies from London School of Economics, David A Richards from University of Exeter, Rupert Suckling from Doncaster Primary Care Trust and Benjamin Wright from East London NHS Foundation Trust.  The evaluation was funded by the Department of Health and supported by the NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London.

Full copy of the evaluation:



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