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IAPT - Improving Access to Psychological Therapies - manages CG53!!

Keela Too

Sally Burch
Messages
900
Location
N.Ireland
Mary Dimmock tweeted this yesterday. Did anyone else know this? I didn't. No wonder we are making no progress with the CG53 guideline. No wonder there is a psycho-social, behavioural bias!

Duh.. just realised.. it's IAPT - Improving Access to Psychological Therapies - not "increasing" as I first put in the title. Duh.

 
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Hutan

Senior Member
Messages
1,099
Location
New Zealand
I don't think IAPT is managing the guidance for CFS. I think it is just that CFS is one of the conditions covered by the Improving Access to Psychological Therapies project.

In which case, the list of NICE guidances given on the page is just provided as helpful information. I hope so anyway.

Improving Access to Psychological Therapies (IAPT) services provide evidence-based psychological therapies to people with anxiety disorders and depression.

We will assess digitally enabled therapies for anxiety, depression and medically unexplained symptoms which offer the potential to expand these services further.


(i.e. NICE guidances for 'conditions <that are> managed by IAPT')

Regardless, having IAPT address CFS/ME is so wrong (and a waste of money).
 
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Jonathan Edwards

"Gibberish"
Messages
5,256
I don't think IAPT is managing the guidance for CFS. I think it is just that CFS is one of the conditions covered by the Improving Access to Psychological Therapies project.

In which case, the list of NICE guidances given on the page is just provided as helpful information. I hope so anyway.

In theory that may be the case. However, the more I see of this the more it seems to me that one has to conclude that there is a commercial marketing programme for therapist-delivered treatments heavily influencing NICE policy, which is treated quite differently from 'commercial pharma'. Would an 'Increasing Access to Drug Therapies' outfit be welcomed by NICE?
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Just to highlight what we expect from their guidelines, the advice for SEVERE ME includes -

People with severe CFS/ME should be offered an individually tailored activity management programme (see recommendation 1.6.2.22) as the core therapeutic strategy, which may:
  • be delivered at home, or using telephone or email if appropriate
  • incorporate the elements of recommendation 1.6.2.22 and draw on the principles of CBT and GET (see recommendations 1.6.2.1–21).
 

Jonathan Edwards

"Gibberish"
Messages
5,256
Looking at the sites a bit more it seems that IAPT is some sort of policy unit within the NHS and IS managing NICE guidelines for ME. Effectively it is part of the NICE machinery. But I am pretty sure it also involves commercial interests, even if those are disguised as academic units making money out of training people in non-validated techniques. I think things are as bad as it looks.

The whole problem, as I see it here, is that as long as peer review and validation is kept within psychological medicine there will be nodding through of therapies without any hard evidence. The NHS has been persuaded that therapists are cheap and so they are happy to buy in services.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
"People with severe CFS/ME should be offered an individually tailored activity management programme (see recommendation 1.6.2.22) as the core therapeutic strategy, which may:
  • be delivered at home, or using telephone or email if appropriate
  • incorporate the elements of recommendation 1.6.2.22 and draw on the principles of CBT and GET (see recommendations 1.6.2.1–21)."
This is a travesty of evidenced based recommendation. You do not recommend drug therapies 'drawing on the principles of clinical pharmacology'. You test specific regimens and publish evidence for their validity. Nobody knows if 'principles' of CBT and GET have anything to do with any efficacy of those treatments - especially when we have no such evidence of efficacy and nobody can agree what the principles really are.

How on earth are we going to know that an email system that draws on principles is effective?
How come if a digital system is being advocated that a book out of the library is not just as good?
I have a suspicion the therapists may be marketing themselves out of business soon. After all, there is no evidence that the results of PACE cannot be obtained with robots.
 

user9876

Senior Member
Messages
4,556
This is a travesty of evidenced based recommendation. You do not recommend drug therapies 'drawing on the principles of clinical pharmacology'.

But if NICE accept this approach in one area then perhaps the drug companies will argue that is is sufficient in other areas. Hence the drug companies could start arguing that NICE should accept the drug therapies that are 'drawing on the principles of clinical pharmacology'.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
But if NICE accept this approach in one area then perhaps the drug companies will argue that is is sufficient in other areas. Hence the drug companies could start arguing that NICE should accept the drug therapies that are 'drawing on the principles of clinical pharmacology'.

But the drug companies are 'them' not 'us'. Simple human nature is capable of baulking such logical suggestions!