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Title: Improving access to psychological therapies (IAPT) : linking training and patient outcome
Author: Branson, Amanda
Awarding Body: University of Reading
Current Institution: University of Reading
Date of Award: 2013
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The National Improving Access to Psychological Therapies (IAPT) programme aims to train 6000 Psychological Wellbeing Practitioners (PWPs) and High intensity therapists (HIs) to deliver evidence based Low and High intensity psychological treatments to patients suffering with depression and anxiety disorders. The studies reported within this thesis were conducted to ascertain whether training led to improved therapist competence, and to better understand relationships between training and patient outcomes. A secondary objective was to explore the influence of therapist characteristics on training and patient outcome. Competence was measured through a series of clinical and academic assessments. Clinical skill, measures by Observed Standardised Clinical Examination (OSCE) for PWPs and ratings of therapy sessions using the Cognitive Therapy Scale Revised (CTS-R) for HIs improved over the duration of the respective courses. No tests of clinical knowledge improved over training. Training outcome was best predicted by past performance, trainees achieving higher undergraduate degree grades were more likely to perform well clinically and academically. Demographic variables (age, gender and experience), personality and cognitive-ability were not consistently related to training outcome. Patient outcome was unrelated to performance on the PWP or HI training programmes, and did not differ according to whether patients were treated during, or after training. However, differences emerged in the outcomes of patients treated by the most and least competent therapists. More patients than expected treated by PWPs in the top quartile of OSCE performance reliably improved and recovered, the reverse was true of patients treated by the poorest performing PWPs. Similarly, more patients treated by the most competent HI therapists showed a reliable improvement in symptoms of anxiety, and reached recovery than expected. Therapist characteristics were unrelated to patient outcome. The implications of these findings are discussed, and directions for future research proposed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available