Full Description
Since 2008, the government's Improving Access to Psychological Therapies (IAPT) programme has been rolled out across England and Wales. In the 10 years of its existence it has transformed primary care mental health services and changed the landscape of counselling and psychotherapy across the UK. While IAPT services provide therapy to thousands of people experiencing depression and anxiety, they also absorb millions of pounds in government funding. This has resulted in wholesale cuts to numerous voluntary sector and GP-attached counselling services run by qualified and experienced counsellors and psychotherapists. Current plans to expand the reach of IAPT to 25% of need (NHS Five-Year Forward Plan) rely on an economic model of treatment that has more in common with the principles of Henry Ford than with those of either Rogers or Freud. This book, with chapters written by experienced therapists, psychiatrists and academics, unravels and exposes the neoliberal roots from which the IAPT programme sprang. It scrutinises the tightly regulated, manualised and medicalised therapies offered in IAPT, the constant surveillance under which its practitioners work and the dehumanising effects of this on clients and therapists alike. It also offers an in-depth cost-benefit analysis of IAPT's published outcomes, challenging the well-publicised claim that IAPT pays for itself by cutting the national welfare benefits bill and returning depressed and anxious people to work. Meanwhile, with therapists working on performance-rated, short-term and self-employed contracts, often in professional isolation with inadequate management and supervision support, the book exposes the difficulties, frustrations and hardships experienced by those on the front line of mental health services. Together, the contributors question whether and to what extent the IAPT `factory' system of care, driven by psychiatric diagnosis, fast through-put and quick-win `outcomes', can really provide a solution to Britain's growing mental health crisis.
Contents
Foreword - Nikolas Rose; Introduction, The modern myths of IAPT - Rosemary Rizq; Part 1: the State we're in; 1. Neoliberalism: what it is and why it matters - Philip Thomas; 2. The industrialisation and marketisation of healthcare - Penny Campling; 3. Health services without care: throwing good money after bad - Marianna Fotaki; 4. Positive affect as coercive strategy: the role of psychology in UK government workfare programmes - Lynne Friedli and Robert Stearn; 5. CBT's integration into societal networks of power - Michael Guilfoyle; Part 2: The state of the NHS; 6. IAPT and the flawed ideology of diagnosis - Sami Timimi; 7. IAPT, power and professional self-interest - Andy Rogers; 8. Why the economics of IAPT don't add up - Scott Steen; Part 3: The state of the workplace; 9. Perverting the course of therapy: IAPT and the fetishisation of governance - Rosemary Rizq; 10. The industrial relations of mental health - Elizabeth Cotton; 11. At what cost? The impact of IAPT on third sector psychological therapy provision - Jude Boyles and Norma McKinnon Fathi; 12. Industrialising relational therapy: ethical conflicts and threats for counsellors in IAPT - Gillian Proctor and Maeta Brown
