ABSTRACT
Improving Access to Psychological Therapies (IAPT) services are outcomes-based services that deliver interventions based on the stepped-care model, as described in NICE Guidance (NICE 2004a; 2004b) and provide step 2 and step 3 of the stepped-care pathway. This chapter explores whether one could identify the characteristics of those people who do less well in IAPT services, or who show reliable deterioration, and whether an intervention could be designed that would improve outcomes for this population. The italk service started to use the Standardised Assessment of Personality – Abbreviated Scale (SAPAS) and the four-question attachment questionnaire to see if one could more easily identify the patient population before engaging in a core IAPT therapy that may have little benefit to this group. Despite the fact that IAPT services collect a minimum data set of questionnaires at every session, which is accessible through an online database, evaluation of the CCC programme has proved surprisingly challenging.
