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Improving Access to Psychological Therapies (IAPT) in the United Kingdom: A systematic review and meta‐analysis of 10‐years of practice‐based evidence

Discussion in 'Other psychosomatic news and research' started by Sly Saint, Jul 23, 2020.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Improving Access to Psychological Therapies (IAPT) in the United Kingdom: A systematic review and meta‐analysis of 10‐years of practice‐based evidence

    Sarah Wakefield
    Melanie Simmonds‐Buckley
    Daniel Stockton
    Abigail Bradbury
    Jaime Delgadillo

    23 June 2020
    Published in the British Journal of Clinical Psychology

    https://onlinelibrary.wiley.com/doi/full/10.1111/bjc.12259
     
    sebaaa, Hutan, Esther12 and 6 others like this.
  2. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Dr Mike Scott CBT watch (14th July)

    full letter http://www.cbtwatch.com/british-jou...ology-responds-to-iapts-conflict-of-interest/
     
    inox, sebaaa, Hutan and 15 others like this.
  3. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    Mike Scott's words quoted by @Sly Saint above
    Anyone else similarly not surprised to find that some of these so called mental health professionals seem completely unable to read or hear other people's opinions without misinterpreting them? Even when both parties are native speakers of the same language.

    I can only conclude that either their language skills are so poor as to make them unfit to work as mental healthcare professionals, they are so blind to human nature & their own biases they are unfit to work as mental healthcare professionals, or they're self interested & ruthless to the extent they wilfully risk the mental health of others in the pursuit of their own agendas. Either way they prove themselves to be wholly unsuited to careers in mental health.

    It's a shame they taint all mental healthcare professionals and allowed to prey on one of the most vulnerable and stigmatized patient groups.

    Why aren't more mental healthcare professionals speaking out? If they don't they'll soon find their own jobs replaced by a barely trained therapist given free rein to harm some very ill and vulnerable people.
     
    sebaaa, Sean, Peter Trewhitt and 10 others like this.
  4. chrisb

    chrisb Senior Member (Voting Rights)

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    We have seen this so often, in people who should be expected to know better, that it almost seems as though there is a selection bias in favour of people who lack basic reading comprehension skills. Perhaps more worrying is that the errors are not picked up by peer reviewers, editors, or those reading the articles and for whom they are intended.
     
    Last edited: Jul 23, 2020
  5. Trish

    Trish Moderator Staff Member

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    Since so few studies did follow up assessments they ignored these altogether.

    So, no long term follow up data, no control group. So no conclusions possible. End of story.
     
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  6. chrisb

    chrisb Senior Member (Voting Rights)

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    This is what the "corresponding author" has to say of himself

    Clinically, my real interest lays in helping people with long-standing interpersonal problems with the CAT model.

    I suspect many have long standing problems with the CAT model. This, apparently, is it

    It is a cognitive therapy which promotes new awareness of thoughts and behaviour patterns. In addition, it also aims to ‘reach the parts cognitive behaviour therapy doesn’t reach’, by understanding the unconscious aspects of our thinking, our emotions and our actions. In particular, it uses the therapeutic relationship as a vehicle for change and understands people in the context of their interpersonal relationships and their social context.https://sheffield.catalyse.uk.com/about-cat/

    God help us.
     
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  7. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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  8. rvallee

    rvallee Senior Member (Voting Rights)

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    I'm not really sure how any analysis can be made here, there are no reliable data to evaluate. The thinking is that if someone went through the treatment then they were "helped". Only 4/47 had follow-up "data", some as low as 4 weeks, all of which are arbitrary psychometric questionnaires of no utility here and wildly heterogeneous.

    The conclusion of "access" is bonkers, of course if you provide a service you provide "access" to that service. People also have access to healing crystals and psychics, so what? And we know there is systemic cheating and perverse incentives on top of that, in addition to huge rates of attrition. This is little more than fiddling with spreadsheets until the numbers give out a desired pattern.

    There was an explicit target of 50% "recovery":
    There is no discussion of "recovery" beyond this. There are only 4 mentions of the word recovery, the primary outcome of this multi-billion dollar program. Maybe I'm not looking for the right thing but I see no discussion or evaluation of "recovery". So basically "access" and "satisfaction", in the form of "I did not explicitly dislike the experience" is well and good. Still, there is this nugget here saying the rates are increasing. Where? How?

    An average restaurant chain has more reliable data to evaluate their performance. This is all junk, a multi-billion boondoggle to inflate the BPS blimp of doom, filled with explosive gas straight out of natural tripe.
     
    MEMarge, inox, Arnie Pye and 9 others like this.
  9. NelliePledge

    NelliePledge Moderator Staff Member

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    IAPT = sausage machine. McTherapy.

    Good point by @rvallee that even a bog standard fast food chain would not have ‘performance’ data at the shoddy level demonstrated by IAPT.
     
    MEMarge, alktipping, obeat and 4 others like this.
  10. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    Indeed they do.

    Nearly 35 years ago I spent a summer working for a well known fast food place to earn some extra cash for my final year at uni - it's very hard work by the way.

    Even then, every time an order went through a till it was recorded, very strict stock control. There was a bin for wasted food/orders - if a customer ordered and then there was a problem with it - this was inspected at the end of shift.

    So they knew exactly what was ordered through the tills, what stock was used and what was wasted. They could even keep a running total hour by hour of how much business we did on the tills from the duty manager's office.

    This lack of accuracy at one of those fast food joints simply wouldn't have been tolerated back in the 80s. I'm sure that with new technology they would be even sharper today. These "scientists" are rank amateurs by comparison.
     
    MEMarge, inox, Arnie Pye and 8 others like this.
  11. dave30th

    dave30th Senior Member (Voting Rights)

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    It sounds like CBT plus a bit of Freud. Great! I'm sure it's very effective.
     
    MEMarge, inox, Arnie Pye and 5 others like this.
  12. Amw66

    Amw66 Senior Member (Voting Rights)

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    Psychology today reminds me of the Maureen Lipmann 1980s BT advert where she consoles her grandson who has failed almost all his exams with the phrase

    " you got an ology - you're re a scientist "
     
  13. NelliePledge

    NelliePledge Moderator Staff Member

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    I take some comfort that there are people in psychology like Joan Crawford and Brian Hughes getting on doing a good job. it’s just a pity there is a gang who spend all their time self promoting and pushing their BS onto everyone else
     
    Amw66, MEMarge, rvallee and 4 others like this.
  14. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Ensuring that the Improving Access to Psychological Therapies (IAPT) programme does what it says on the tin
    Michael J. Scott

    16 August 2020
    https://doi.org/10.1111/bjc.12264

    the last bit surprises me as I haven't seen much evidence of this 'highering of the methodological bar for interventions to be regarded as ESTs' in many if any psychosocial studies discussed here.

    full commentary here
    https://onlinelibrary.wiley.com/doi/10.1111/bjc.12264

    blog
    http://www.cbtwatch.com/british-journal-of-clinical-psychology-commentary-on-iapt/
     
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  15. rvallee

    rvallee Senior Member (Voting Rights)

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    "£5M isn't cool. You know what's cool? £4B."

    Don't be a sucker, people. This is what suckers do, believe in the blatant lies of con artists. Complete dereliction of duty and mismanagement of public resources by those who pushed this turd through the bowels of medicine. Billions wasted on a mediocre pipe dream that never had a chance to deliver even a fraction of what was promised.

    All because these people made manipulation their primary skill. They sure can manipulate people into believing they know what they're doing, but that was always what a snake oil salesman does. Nothing changed other than the charlatans working within the system of medicine, rather than outside.

    Once again: evidence-based medicine is a complete and total disaster that has not only failed to improve outcomes but actually managed to regress them. A truly unique level of mediocrity among all the professions. Truly the poster child for the problem with toxic positivity.
     
    Arnie Pye and Peter Trewhitt like this.
  16. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    From one of the quotes in post #14 :

    This author seems to be struggling to find the word "raising" i.e.

    These authors seems to be unaware of a raising of the methodological bar, for interventions to be regarded as ESTs.
     
  17. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Is Evidence Based Treatment Possible Without Evidence Based Assessment?

    http://www.cbtwatch.com/is-evidence-based-treatment-possible-without-evidence-based-assessment/
     
  18. MEMarge

    MEMarge Senior Member (Voting Rights)

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    Invisible Woman, chrisb and Amw66 like this.
  19. rvallee

    rvallee Senior Member (Voting Rights)

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    Those are not on the same level of scientific validity, but the idea that it's possible to fix any problem that is a complete mystery makes exactly as much sense as trying to cure AIDS without knowing about viruses, let alone that a particular virus causes it. The whole premise here is absurd.

    I don't understand how something this basic, as common sense as it gets, can be waived off entirely. It's possible to randomly stumble unto something by simply brute-forcing solutions but there is no credible reason why this process should be any different with psychobabble than it is with drugs, where if one were to simply randomly try all the things it would take millennia or more to randomly chance upon the right treatment.

    Nobody can even define the mechanism of so-called conversion disorder and anxiety has been stripped of all common meaning, it's left entirely to the imagination. But people think it's possible for someone to just randomly intuit the right answer? Setting aside the fact that conversion disorder is completely unscientific BS nonsense, it still makes no sense that it would be possible to randomly find the right answer without even a hint about where to begin, especially by doing the same things over and over again without learning anything from the experience.

    This isn't evidence-based it's fantasy-based. The only way any rigorous assessment or scientific research will provide clues here is in invalidating the ridiculous fantasy of psychosomatic illness, whether en masse or in individual cases. Especially in a process that advises against rigorous assessment, knowing this is how the concept has been invalidated many times in the past.

    There is no way to actually assess things here, the concepts are vague and impossible to validate. I still don't understand how it's common practice to "diagnose" anxiety or depression without any assessment whatsoever, let alone a reliable test. It's completely reckless and clearly invalid. Knowing what the problem is before fixing it is not optional. Science is not optional and fantasy-based evidence is definitely not the answer, no matter what the question.
     
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