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CNWL Talking Therapies Service Westminster Improving Access to Psychological Therapies

CNWL Talking Therapies Service Westminster Improving Access to Psychological Therapies. Overview of the National IAPT Programme.

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CNWL Talking Therapies Service Westminster Improving Access to Psychological Therapies

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  1. CNWL Talking Therapies Service Westminster Improving Access to Psychological Therapies

  2. 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

  3. 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.

  4. 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

  5. The IAPT Stepped Care Model

  6. 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

  7. 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

  8. How can people access the service • Referral from professional • Self referral by telephone: 030 3333 0000 • Self referral by email: westminster.iapt@nhs.net • Through our website: www.westminsteriapt.org.uk • Visit one of our offices: • 11 Praed Street W2 1NJ • 192-198 Vauxhall Bridge Road SW1V 1DX

  9. Referral Form

  10. 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

  11. 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

  12. Outcome Measures

  13. 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.

  14. 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

  15. 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

  16. 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.”

  17. CNWL Talking Therapies Service Westminster Improving Access to Psychological Therapies Any questions?

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