Psychotherapy

The Improving Access to Psychological Therapies programme is very much occupying centre stage these days. We put a number of questions to Richard Layard about how the programme will affect BACP members. How will accredited counsellors with years of experience be treated in the new system compared with people who have done a short training course? What can our members do to help the IAPT initiative? Will jobs in GP surgeries disappear with the advent of the IAPT?

Amidst all the anxieties and cynicism flying around about CBT, it’s easy to forget that getting the Government to put £170 million into psychological therapies is an incredible achievement that would have seemed unthinkable 10 years ago. Maybe I’ve just been ‘taken in’, but I left our interview with Richard Layard with a spring in my step, a feeling of wanting to support this challenging endeavour and my head full of optimistic thoughts about the millions of people who might benefit from it – people who wouldn’t have had any hope of accessing therapy in the past.

While the low-intensity workers who act as the first port of call for clients will be drawn from the ranks of graduate mental health workers and other counselling skills users, the new psychological therapist positions will go to experienced therapists who are already trained. IAPT want counsellors and psychotherapists on board to give the programme the best chance of success. Yes, practitioners who want to work within IAPT will get CBT training on the job so that they can fulfill the requirements of the NICE Guidelines.

For some this will be too great a compromise but others will be prepared to add this string to their bow. CBT cannot help every problem but as Angela Greatley said at the Psychological Therapies Conference last year ‘Let’s not forget the million people who will be helped by CBT’. If it’s clear that someone will not benefit from CBT, the therapist will presumably work with them in a different way or refer them on. The programme, like any hugely ambitious project, will learn and evolve. Feedback we are getting from the Doncaster and Newham pilots shows that the IAPT teams are working with other services in the areas, and local counselling and psychotherapy services are finding their referrals going up.

Therapy serves many different client groups and emotional problems. IAPT can only tackle some of these. The NHS probably isn’t the right context to offer some types of long-term therapy anyway. But after even just a short course of CBT, clients may become interested in the different types of therapy and self-help that are out there. What is positive is that we are experiencing a cultural change which is actually about what people want – talking treatment instead of medication.

Sarah Browne