Realizing the mass public benefit of evidence-based psychological therapies:
Science, economics, and politics
David M. Clark
Emeritus Professor of Experimental Psychology at Oxford University
David is well-known for his pioneering work on the understanding and psychological treatment of a wide range of anxiety disorders, including panic, social anxiety, health anxiety and PTSD. Since 2005 he has also focused on how to disseminate effective psychological treatments within the English and multiple international healthcare systems. He is an architect of the English Improving Access to Psychological Therapies (IAPT) programme, and continues to advise the UK government. He has received Distinguished Scientist / Lifetime Achievement Awards from the British, Canadian, Dutch and American Psychological Associations. The latter described his work as “pure genius with a real-world application”.
Keynote Address Summary: Effective psychological therapies have been developed for all common mental health problems, including eating disorders. The public shows a preference for psychotherapy over medication. However, in most countries most people cannot access effective psychological therapy. This talk outlines the history and development of the NHS Talking Therapies for Anxiety and Depression (formerly known as “IAPT”) program that has made psychological therapy for anxiety disorders and depression much more widely available in England and is being copied in some other countries. The talk covers the clinical model, the training program, outcome monitoring, and the combined economic & clinical arguments that were used to persuade the UK government to start the program. Currently, over 670,000 people receive a course of treatment each year. Outcome data is available for 99% of treated patients. Approximately 50% fully recover and around 7 in every 10-show significant improvement. The benefits of therapy are widespread. As well as improving patient’s mental health, the NHS Talking Therapies program reduces other physical healthcare costs and helps grow national economies in the countries where it has been implemented. The latter finding recently persuaded the UK government to release further substantial funding for the program. It is hoped that some of the key lessons from the NHS Talking Therapies programme will be of interest to conference attendees as they argue the case for expanded access to psychological therapies for eating disorders in their own countries.
Goals: To familiarize attendees with: 1) the way in which combined clinical and economic arguments can be marshalled to increase funding for psychological therapies; 2) how high levels of outcome monitoring can be achieved in routine practice; and 3) how such data can be used to further improve our offer to patients and secure sustained funding for psychotherapy services.