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Why has our recovery rate dropped? An audit examining waiting times, starting scores and length of treatment in relation to recovery within an IAPT service

Published online by Cambridge University Press:  15 April 2015

Kyla Vaillancourt ,
John Manley  and
Nicholas McNulty
Kyla Vaillancourt*
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK The South London and Maudsley NHS Foundation Trust, London, UK
John Manley
Affiliation:
The South London and Maudsley NHS Foundation Trust, London, UK
Nicholas McNulty
Affiliation:
The South London and Maudsley NHS Foundation Trust, London, UK
*
*Author for correspondence: Miss K. Vaillancourt, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Addiction Sciences Building, 4 Windsor Walk, London, SE5 8AF, UK ([email protected]).
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Abstract

The Improving Access to Psychological Therapies (IAPT) initiative was created to provide mental health services for those experiencing mild to moderate depression and anxiety. IAPT is commissioned on the basis that it achieves adequate performance on a number of ‘key performance indicators’, one of which is the proportion of clients who ‘move towards recovery’ following treatment. The impetus for the current evaluation was a significant reduction in the proportion of clients recovering within an IAPT service. Data for this clinical audit was obtained from IAPT electronic records (IAPTus). Three factors (waiting times, clinical contact and starting scores on the PHQ-9 and GAD-7) were examined and explored separately for each level of care (i.e. steps 2 and 3). These factors were analysed in relation to recovery and compared between periods of low and high recovery within the service. Results reveal that there was little change in the severity of clients’ starting scores between the periods of low and high recovery. Increased waiting time in the period of low recovery was not associated with recovery status. The amount of clinical contact was related to recovery at both time periods. Limitations and implications of the findings are discussed.

Keywords

IAPToutcomesprimary careservice evaluation
Type
Service models and forms of delivery
Information
the Cognitive Behaviour Therapist , Volume 8 , 2015 , e7
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

Blackburn, IM, James, IA, Milne, DL, Baker, C, Standart, S, Garland, A, Reichelt, FK (2001). The revised cognitive therapy scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy 29, 431–446.CrossRefGoogle Scholar
Department of Health (2011). Technical guidance for the 2012/13 operating framework (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216413/dh_132045.pdf). Ac- cessed 15 March 2013.Google Scholar
Department of Health (2012). Mental health clustering booklet 2012–2013, v2.01. (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216217/dh_132656.pdf). Accessed 15 March 2013.Google Scholar
Gyani, A, Shafran, R, Layard, R, Clark, D (2011). Enhancing recovery rates in IAPT services: lessons from analysis of the year one data. Improving Access to Psychological Therapies, London, UK.Google Scholar
Hagby, MM, Donnelley, M, Corry, J, Vos, T (2006). Cognitive behavioural therapy for depression, panic disorder and generalised anxiety disorder: a meta-regression of factors that may predict outcome. Australian and New Zealand Journal of Psychiatry 40, 9–19.Google Scholar
Health & Social Care Information Centre (HSCIC) (2014). Psychological Therapies, England: Annual Report on the use of Improving Access to Psychological Therapies services – 2012/13. V1.0 (http://www.hscic.gov.uk/catalogue/PUB13339/psyc-ther-ann-rep-2012-13.pdf). Accessed 22 September 2014.Google Scholar
Kroenke, K, Spitzer, RL, Williams, JB (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medication 16, 606–613.CrossRefGoogle ScholarPubMed
Lambeth First (2011). State of the borough (http://www.lambethvac.org.uk/data/Strategies__Reports/State_of_the_Borough_20111.pdf). Accessed 1 March 2014.Google Scholar
Lucock, M, Kirby, R, Wainwright, N (2011). A pragmatic randomized controlled trial of a guided self-help intervention versus a waiting list control in a routine primary care mental health service. British Journal of Clinical Psychology 50, 298–309.CrossRefGoogle Scholar
Mander, H (2014). The impact of additional initial face-to-face sessions on engagement within an Improving Access to Psychological Therapies service. The Cognitive Behaviour Therapist 7, e1, 1–8.CrossRefGoogle Scholar
NHS England (2014). Measuring improvement and recovery in adult services. Version 2 (http://www.iapt.nhs.uk/silo/files/measuring-recovery-2014.pdf). Accessed 15 September 2014.Google Scholar
NICE (2004). Management of anxiety (panic disorder, with or without agoraphobia and generalized anxiety disorder) in adults in primary, secondary and community care. London, National Collaborating Centre for Primary Care (UK) (http://www.nice.org.uk/nicemedia/pdf/cg022fullguideline.pdf). Accessed 1 March 2014.Google Scholar
NICE (2009). Depression in adults: the treatment and management of depression in adults London (http://www.nice.org.uk/guidance/CG90). Accessed 1 March 2014.Google Scholar
Richards, DA, Suckling, R (2008). Improving access to psychological therapy: the Doncaster demonstration site organisational model. Clinical Psychology Forum 181, 9–16.CrossRefGoogle Scholar
Royal College of Psychiatrists (2011). National Audit of Psychological Therapies for Anxiety and Depression, National Report 2011 (https://www.rcpsych.ac.uk/pdf/NAPT%20Report%20amended%20March%202012%20FINAL.pdf).Google Scholar
Shafran, R, Clark, DM, Fairburn, CG, Arntz, A, Barlow, DH, Ehlers, A, Freeston, M, Garety, PA, Hollon, SD, Ost, LG, Salkovskis, PM, Williams, JMG, Wilson, GT (2009). Mind the gap: improving the dissemination of CBT. Behaviour Research and Therapy 47, 902–909.CrossRefGoogle Scholar
Spitzer, RL, Kroenke, K, Williams, JBW, Löwe, B (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine 166, 1092–1097.CrossRefGoogle ScholarPubMed
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