Exploring new developments within, and the evidence base for, the Improving Access to Psychological Therapies programme in the United Kingdom

The Improving Access to Psychological Therapies (IAPT) initiative was launched in 2008 in the United Kingdom (UK) to offer evidence-based psychotherapies to patients with anxiety and depression in a stepped care service delivery model. The programme reports evaluation data in the form of monthly and annual reports of recovery rates by service and care commissioning group. In recent years the plurality of intervention in this programme has also been expanded. A systematic review and meta-analysis was conducted to review the published practice-based studies arising from the first 10-years of the English IAPT programme, focussing on the effectiveness of IAPT interventions delivered in routine practice. A total of 60 studies were included overall, with n=29 of those making up the meta-analysis. Results found large pre-post treatment effect sizes for depression and anxiety, and a medium pre-post treatment effect size for functional impairments. Implications for future work include exploring how IAPT can become more effective for people with comorbid long-term conditions and medically unexplained symptoms and improving the designs of practice-based studies. The research report investigated the effectiveness of cognitive analytic therapy (CAT) within the IAPT programme at step 3 (high intensity). Outcome comparisons with the ‘treatment as usual’ intervention offered at step 3 (i.e. cognitive behavioural therapy; CBT) were completed. Longitudinal multilevel modelling (MLM) was used to investigate symptomatic changes over time and between groups. Results suggest equivalence between CAT and CBT in an IAPT setting. CAT and CBT trajectories of symptom change do not appear to differ over time during the therapies. Implications for CAT being offered as a first-line treatment within the IAPT programme are discussed.