Transcript CNWL Talking Therapies Service Westminster Improving Access to

CNWL Talking Therapies
Service Westminster
Improving Access to
Psychological Therapies
Overview of the National IAPT
Programme
•
Improving Access to Psychological Therapies (IAPT) is a Department of Health initiative to
implement NICE guidelines for psychological therapies for depression and anxiety
•
2005: Lord Layard made the economic argument for investment in evidence-based
psychological therapies
Core IAPT Staffing
• Two core types of psychological therapy practitioners:
• High Intensity therapists trained to offer evidence-based psychological
therapy for people with moderate and severe depression and anxiety
disorders . In Westminster these therapists are CBT Therapists and Clinical
/ Counselling Psychologists. Offer step 3 treatment.
• Low intensity therapy workers (Psychological Wellbeing Practitioners)
trained in cognitive behavioural approaches for people with mild to
moderate anxiety and depression. These approaches include guided self
help and delivering psycho-educational groups. Offer step 2 treatment.
Stepped Care
• Offer the least intrusive, most effective treatment to meet the patients
needs
• Steps 1-3: Primary Care
- Mild – Moderate presentations, less complexity, lower risk
• Steps 4-5: Secondary Care
- Moderate – Severe presentations, complex, high risk
The IAPT Stepped Care Model
Types of Intervention
Cognitive Behavioural Therapy
– Structured, short-term, problem-focussed
– Working on the “here and now”
– Development of a “tool-kit” of behavioural and cognitive coping
strategies
– Focus on specific symptoms of anxiety / depression
Counselling / Psychotherapy
– Exploratory space to think about experiences, less structure
– May be more focussed on early life experiences and attachments
– Emphasis placed on relationship between therapist and patient and
how this might reflect other important relationships
IAPT Service Delivery in Westminster
• Based in community locations: GP practices, health clinics, Job
centres, children’s centres
• Outreach groups at other sites by arrangement
• Partnerships with Jobs In Mind
• Professional and self-referrals are received by mail, email, fax,
phone or walk-in
• Interpreters and translated materials available
• Open 8am – 8pm Mon – Thurs, 8am – 5pm Fri
• Saturday morning assessments and workshops
• Group and individual treatments
How can people access the service
•
•
•
•
•
Referral from professional
Self referral by telephone: 030 3333 0000
Self referral by email: [email protected]
Through our website: www.westminsteriapt.org.uk
Visit one of our offices:
– 11 Praed Street W2 1NJ
– 192-198 Vauxhall Bridge Road SW1V 1DX
Referral Form
Treatment Provided: Low Intensity
Treatments for depression, generalised anxiety, panic and phobias:
• Guided self-help
– Face-to-face or telephone
• Workshops
– Improve your Sleep; Assertiveness; Managing panic; Confidence;
Procrastination
• 6 week CBT courses
- Mood Boost; Stress & Worry; Sleep
- rolling format
Treatment Provided: High Intensity
•
Individual CBT for
– depression, generalised anxiety, panic and phobias not fully resolved by Low
Intensity treatment
– Social anxiety
– Health anxiety
– Post-traumatic stress disorder
– Obsessive-compulsive disorder
•
Group CBT
– Self-esteem group for patients with depression
– Mindfulness-based Cognitive Therapy group for recurrent depression
– Post-natal depression group for mothers with a baby under 12 months
– Workshops: Introduction to CBT; Unhelpful Thinking; Introduction to Mindfulness;
Taking care of mental health in pregnancy and post-natally
•
Behavioural Couples Therapy for depression or anxiety
Outcome Measures
Case Example: Roy
• 45-year-old male with low mood and depression
(first episode)
• Married with 3 children, wife not working
• Recently made redundant, financial problems,
unable to support family, unable to focus on finding
work
• Feelings of guilt and shame.
Roy: Assessment and Treatment
• Assessment with PWP. Identified depression. Offered
individual GSH or mood boost course
• Attended unhelpful thinking and introduction to CBT
workshops
• Chose to attend 6-week Mood Boost course
• Follow up session with PWP
• Signposted to Jobs In Mind
Roy: Outcome
• Started to implement changes after workshops
• Fully recovered after 6-week group – learnt
behavioural strategies to manage mood and deal
with procrastination
• Follow up with PWP put together plans for the future
and cognitive strategies from courses
• Possible self-referral to self-esteem group in the
future to address underlying vulnerabilities
Feedback from Patients
“Therapy has helped me greatly to
regain my confidence.”
“I would wholeheartedly recommend this service - it is a way of treating
people which focuses on them individually, yet gives a very simple and
effective way of helping them find their own way out of their difficult
circumstances .”
“It’s now a year since I received treatment. I’m still
applying the lessons derived from guided self-help
and much more able to handle life’s stresses and
strains.”
CNWL Talking Therapies
Service Westminster
Improving Access to
Psychological Therapies
Any questions?