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Cited by 492Psychotherapy Techniques and ApplicationsMental Health Treatment and AccessPsychiatric care and mental health services

Realizing the Mass Public Benefit of Evidence-Based Psychological Therapies: The IAPT Program

Open access
Clark, David M.·2018·Annual Review of Clinical Psychology
DOI 10.1146/annurev-clinpsy-050817-084833PMC PMC5942544
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Abstract

Empirically supported psychological therapies have been developed for many mental health conditions. However, in most countries only a small proportion of the public benefit from these advances. The English Improving Access to Psychological Therapies (IAPT) program aims to bridge the gap between research and practice by training over 10,500 new psychological therapists in empirically supported treatments and deploying them in new services for the treatment of depression and anxiety disorders. Currently IAPT treats over 560,000 patients per year, obtains clinical outcome data on 98.5% of these individuals, and places this information in the public domain. Around 50% of patients treated in IAPT services recover, and two-thirds show worthwhile benefits. The clinical and economic arguments on which IAPT is based are presented, along with details of the service model, how the program was implemented, and recent findings about service organization. Limitations and future directions are outlined.

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41 of 41 references verified0 citation errors · 0 not checkable

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  • The UK's wide-scale roll-out of low-intensity CBT through the IAPT scheme demonstrated effectiveness and significant cost savings to the health system.

    “The successful wide-scale roll-out of low-intensity CBT in the UK through the Increasing Access to Psychological Therapies (IAPT) scheme has demonstrated effectiveness, as well as significant cost savings to the health system (Clark, 2018).”

    From Unguided low intensity cognitive behaviour therapy for anxiety and depression during the COVID-19 pandemic: A randomised trial (2021) · cites this paper as Clark, 2018

  • The observed rates of reliable deterioration are comparable to those observed in IAPT services for anxiety and depression as a whole.

    “Similarly, the observed rates of reliable deterioration are comparable to those observed in IAPT services for anxiety and depression as a whole (e.g. Clark 2018).”

    From The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services (2020) · cites this paper as Clark 2018

  • England is among the countries that have progressed furthest in formally implementing MBCT within an integrated NHS, and its providers routinely monitor clinical outcomes before and after treatment.

    “We used England as an exemplar, as it is currently one of the countries which has progressed furthest in terms of the formal implementation of MBCT in an integrated National Health Service (NHS), and providers routinely monitor the clinical outcomes of patients before and after treatment (Clark 2018).”

    From The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services (2020) · cites this paper as Clark 2018

  • In the present study, the effect on PHQ-9 symptoms was smaller compared to interventions offered in IAPT services overall for depression cases (1.4; Clark 2018).

    “In the present study, the effect on PHQ-9 symptoms was smaller compared to interventions offered in IAPT services overall for depression cases (1.4; Clark 2018).”

    From The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services (2020) · cites this paper as Clark 2018

  • 53% of our sample entered MBCT with acute depressive symptoms, and the effect size for outcomes (d = 0.86), whilst large, is smaller than for IAPT depression services as a whole.

    “However, 53% of our sample entered MBCT with acute depressive symptoms, and whilst acceptability and effectiveness were again encouraging, the effect size for outcomes, d = 0.86, whilst large, is smaller than for IAPT depression services as a whole (Clark 2018).”

    From The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services (2020) · cites this paper as Clark 2018

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1 of the 42 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. Griffiths S Steen S Improving Access to Psychological Therapies (IAPT) programme: setting key performance indicators in a more robust context: a new perspective Journal of Psychological Therapies in Primary Care 2013 2 133 41
  2. Layard R Clark DM Thrive: how better mental health care transforms lives and saves money Princeton, New Jersey Princeton University Press 2014b US version of Thrive: The power of psychological therapy. Outline clinical & economic arguments for IAPT
  3. NICE Anxiety: management of anxiety (panic disorder, with and without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care Clinical Guideline 22 National Institute for Clinical Excellence London,UK 2004a 20945576
  4. NICE Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder Clinical Guideline 31 National Institute of Clinical Excellence London, UK 2005a 31886982
  5. NICE Social anxiety disorder: Recognition, assessment and treatment Clinical Guideline 159 National Institute for Health and Care Excellence London, UK 2013 31869048
  6. Roth A Fonagy P What Works for Whom? A Critical Review of Psychotherapy Research New York Guilford Press 2005

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Authors
Clark, D. M.
Affiliations
University of Oxford (GB)
Corresponding author
Clark, David M.
ORCID
Clark, David M.
Venue
Annual Review of Clinical Psychology
Publisher
Annual Reviews
Published
2018-05-07
Volume
14
Issue
1
Pages
159-183
ISSN
  • 1548-5943 (ISSN-L)
  • 1548-5951
DOI
10.1146/annurev-clinpsy-050817-084833
PMC
PMC5942544
OpenAlex
W2784464703
Cited by
492
References
42
Citations by year
2026: 52 · 2025: 65 · 2024: 63 · 2023: 68 · 2022: 74 · 2021: 71 · 2020: 48 · 2019: 41 · 2018: 10
FWCI
7.20
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Annual Review of Clinical Psychology (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Wellcome Trust (200796/Z/16/Z, 069777)
  • National Institute for Health and Care Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
Improving Access to Psychological Therapies, depression treatment, anxiety disorders, access to mental health care, therapist training, research-practice gap, service organizations, public mental health services
MeSH terms
Anxiety Disorders, Depressive Disorder, England, Health Services Accessibility, Humans, Mental Health Services, Psychotherapy, Program Development, Outcome Assessment, Health Care, Evidence-Based Practice

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