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IAPT: Improving Access to Psychiatric Training. CBT delivery by junior psychiatrists in primary care is good for the service, good for training and good for patients

Published online by Cambridge University Press:  07 May 2015

Steve Moorhead
Steve Moorhead*
Affiliation:
Newcastle Cognitive and Behavioural Therapies Centre, Northumberland, Tyne and Wear NHS Trust, Newcastle, Northumberland, UK
*
*Address for correspondence: Dr S. Moorhead, Newcastle Cognitive and Behavioural Therapies Centre, Northumberland, Tyne and Wear NHS Trust, Newcastle, Northumberland, UK. (email: steve.moorhead@ntw.nhs.uk)
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Abstract

The feasibility and effectiveness of trainee psychiatrists providing CBT in primary care was assessed by a triangulated procedure of service overview, trainee feedback and assessment of clinical measures. Hitherto trainees sought ‘suitable’ cases by individual request. In the primary-care setting: 82% of 11 trainees (50% previously) completed a ‘short case’ treatment within a 6-month attachment; 86% of trainees found the level of supervision ‘about right’; depression and anxiety scores for patients (n = 16) achieved statistically significant gains and showed moderate to large effect sizes. Although there was no comparator group, findings were just above the IAPT aim of a 50% recovery. Conclusions are that completion of their ‘short case’ experience within a 6-month attachment is feasible in a primary-care setting. Evidence that patients and the service also benefited demonstrates this to be good and ethical ‘business’ for the service provider. Integrating these skills into routine medical psychiatric practice may remain a later supervision need. Other training experiences including psychological treatments could initially be best met in less testing clinical encounters than those experienced in secondary care. Locally agreed formal arrangements would facilitate this and there is potential for the development of greater cross-service understanding in the longer term.

Keywords

CBT trainingclinical supervisioncognitive behavioural therapyprimary carepsychiatric trainingpsychotherapy training
Type
Education and supervision
Information
the Cognitive Behaviour Therapist , Volume 8 , 2015 , e9
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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