What Is The IAPT Initiative and Why Is It Important?

published:	18 Nov 2020
updated:	3 May 2022

As the mental healthcare landscape evolves, more government bodies have adapted to changing patient and practitioner needs. The wider public availability of e-mental health services is a significant sign of this, as peak bodies seek to overcome patients’ accessibility problems and achieve broader outreach.

The UK’s Improving Access to Psychological Therapies (IAPT) initiative is a prime example of one such program, and according to UK government statistics, over one million British mental health patients have accessed the IAPT’s online counseling services to seek help in managing or overcoming a condition.[1] Here, we explore the telepsychology services the program delivers, its benefits, and the promise the IAPT holds for e-health as a broader field.

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What is the IAPT?

The IAPT Initiative is a program established by the United Kingdom’s National Health Service (NHS) in 2008, with the main goal of Improving Access to Psychological Therapies (IAPT).[1]

In collaboration with other key healthcare bodies, the program strives to deliver evidence-based psychotherapeutic services to the general public, both online and through more conventional methods.

By making scientifically demonstrated mental healthcare services more publicly accessible, IAPT aims to promote better mental healthcare management and positive patient health outcomes.

The mental healthcare program is focused on the treatment of conditions such as:[2]

Anxiety Disorders, e.g. GAD, Social Anxiety Disorder, OCD, Panic disorders
Depression
Post-Traumatic Stress Disorder
Body Dysmorphic Disorders, e.g. anorexia, bulimia
Medically unexplained symptoms
Ante- and post-natal mental health conditions, and
Chronic Fatigue Syndrome.

By making scientifically demonstrated mental healthcare services more accessible to the British public, the IAPT initiative aims to promote better mental healthcare management and positive patient health outcomes such as recovery from depression, stress, or anxiety.

IAPT Services

Per the NHS, IAPT services have three characteristics:[1][3]

Psychotherapies are evidence-based and administered by licensed, trained professionals: E-mental healthcare treatments are assessed in accordance with pre-defined principles and standards at Improving Access to Psychological Therapies assessment briefings (IABs). Accreditation involves following a training pathway for an IAPT service.[4]
Evaluation and monitoring of outcomes are standard: The initiative aims for ongoing patient support through continued patient-practitioner collaboration.
Regular, outcome-focused practitioner supervision: To support IAPT mental health professionals.

IAPT Digital Therapies

Online therapy is a specific focus area of the IAPT initiative. In collaboration with the National Institute for Health and Care Excellence (NICE), the program offers several e-therapy solutions that can be accessed on a laptop or smartphone app.

There is substantial research to suggest that professional, therapist-guided e-therapy – which involves such applications – can be an effective way to treat common mental health disorders such as anxiety, depression, and stress.[5]

Quenza IAPT Initiative Mental Health App Example — For patients with sub-clinical mental health symptoms, lower-intensity IAPT interventions can involve the use of mental health apps. (Pictured: Quenza)

Mental health apps, such as Quenza above, are often most effective for managing sub-clinical symptoms. As such, they play a large role in the IAPT initiative at lower tiers.

Within the IAPT initiative specifically, examples of such solutions include the:[2]

Be Mindful for Adults with Depression program: An online mindfulness-based cognitive therapy (MBCT) treatment for mild to severely depressed patients, as well as those suffering from stress or anxiety
SHADE for adults with depression and drug or alcohol misuse: An iCBT teletherapy program for individuals with substance abuse challenges and mild to moderate depression
Velibra for adults with panic disorder: A digital therapy program combining CBT, exposure therapy, and other therapeutic techniques to manage panic and anxiety conditions
BDD-NET for adults with body dysmorphic disorder: Targeting moderate to severe body dysmorphia conditions through cognitive restructuring, psychoeducation, relapse prevention strategies, and more, and
OCD-NET for adults with Obsessive Compulsive Disorder: Which includes psychological assessments, treatment planning, and techniques such as goal-setting.

4 Benefits Of The Initiative

Globally, the IAPT initiative represents one among very few nationally available, government-funded mental healthcare initiatives. As such, its impact has been an interesting topic for practitioners and academics alike.

Some of its advantages, which include good patient recovery rates and wider access to evidence-based mental healthcare treatments, can be seen in the following table.[3]

Benefit	Details
Improved standards of patient care	Under the IAPT program, 7,000+ new psychotherapists have been trained, including ~60% High-Intensity psychotherapists and 40% PWPs[6]
Ongoing patient support	By design, IAPT programs include continued post-therapy follow-up IAPT employees include employment advisors liaisons who collaborate with therapists to facilitate post-recovery return to work
Wider access to mental healthcare	IAPT therapy services reach an estimated 960,000 people annually, ~16% of the English community with anxiety- and depression-related conditions[7]
Good recovery rates	51% of patients considered recovered on completing treatment[3] Of these, roughly 66.3% demonstrate reliable improvement

What Does It Mean For E-Health?

In its efforts to make evidence-based digital psychotherapy programs more widely available, the IAPT has seen industry peak bodies establish guidelines for e-therapy.

The development of e-health therapy programs, for example, involves:[8]

Identifying and screening teletherapy technologies
Preparing a technology summary that describes the technology and its potential applications in evidence-based blended care treatment plans
Summarizing and critically appraising the evidence
Conducting cost-benefit analyses, and
Submitting the findings for IAPT expert panel consideration, among other steps.

As well as making mental healthcare more widely accessible, the initiative is thus often seen as a significant forward step toward more accountability and availability in the field of digital mental health[9]

The IAPT initiative is often seen as a significant forward step toward more accountability and availability in the field of digital mental health.

3 Top IAPT Training Courses

IAPT services can be accessed directly from the National Health Service, or professionals with the requisite training can deliver the initiative’s services through third-party mental health providers. Examples include the British charity Mind, TurningPoint, TalkPlus, and more.

Accreditation typically involves applying to deliver an approved IAPT therapy as a trainee; during this traineeship, candidates pursue a combination of university courses and work experience.[10]

IAPT Career Opportunities

Practitioners operate within a stepped care model and can qualify as:[3]

High-intensity professionals: Delivering therapies THROUGH more frequent interactions, generally in-person and on a one-to-one basis. Can include group or couples therapy and formalized programs e.g. CBT, or
Low-intensity practitioners (Psychological Well-being Practitioners, or PWPs): Providing support, guidance, and encouragement to patients undergoing lower-intensity therapies such as self-help programs

Below are a few organizations for practitioners interested in IAPT Training.

Course	Details
	University College London offers postgraduate certificate pathways for individuals looking to become a Psychological Wellbeing Practitioner (PWP). Accredited by the British Psychological Society, the 9-month program can be undertaken part-time and forms part of the necessary training to become an IAPT PWP. Participants are required to provide evidence of previous formal or voluntary work with people suffering from mental health, social, or interpersonal challenges. The course content includes topics such as mental health issue recognition, recovery, and respect.
Certification	Low-Intensity Cognitive Behavioural Interventions Postgraduate Certificate
Price	Available on request
Organization	University College London (UCL)
Website	https://www.ucl.ac.uk/pals/study/masters/lowintensity-cognitive-behavioural-interventions-postgraduate-certificate

Course	Details
	High-Intensity CBT Psychotherapy courses are also available at The University of Sheffield and involves 2 days of study, plus 3 weekdays of IAPT traineeship work in the participant’s recognized organization. The course is designed to equip graduates with the skills required for managing and treating depression and anxiety disorders at Step 3 of the IAPT Stepped Care Model. On successful completion, graduates are qualified to work as IAPT High-Intensity CBT Therapists in their organizations and work in Stepped Care IAPT Services. The UoS also offers low-intensity PWP courses.
Certification	Postgraduate Diploma in High-Intensity Psychological Interventions (HIPI) – CBT Psychotherapist training
Price	Funded by employer
Organization	The University of Sheffield
Website	https://www.sheffield.ac.uk/clinicalpsychology/programmes/iapt/hipi

Course	Details
	For applicants in the South, the University of Southampton runs 1-year part-time courses at their Highfield campus that culminate in a postgraduate certificate. The BPS-accredited course covers talk therapy skills for delivering CBT within the stepped care model, including: Patient interviewing Using clinical information in decision-making Caseload management, and more
Certification	Low-Intensity Cognitive Behavioural Therapy with IAPT PWP Status (PGCert)
Price	£4,782 (UK students)
Organization	The University of Southampton
Website	https://www.southampton.ac.uk/courses/low-intensity-cognitive-behavioural-therapy-with-iapt-pwp-status-pgcert

Final Thoughts

The IAPT initiative is a fascinating example of the many ways that blended therapy and care more generally are advancing as broader fields. By leveraging digital clinical technologies to make science-based psychotreatments available nationwide, it’s a promising step toward a more innovative global mental healthcare model – one in which cost-effective, reliable therapy is more realistic for all.

As more IAPT studies are conducted, and more solutions designed, practitioners can be sure to learn more about its efficacy, evolution, and impact. In the meantime, do share your thoughts and experiences with the IAPT in a comment.

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