Wellbeing in IAPT

This section is for discussion relating to the Layard report, and subsequent schemes like Improving Access to Psychological Therapies where lower intensity inteventions are offered in primary care
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Wellbeing in IAPT

Post by enchanted » Sun Apr 28, 2019 10:24 am

Hi all,
I wondered if anyone could share their experience of wellbeing support in their IAPT services? We seem to have little to no focus whatsoever on ours, and I think that is shocking and quite appalling for an nhs mental health service that is responsible for providing therapy support to members of the public. Not to mention, I thought better from a team of mental health professionals, that, a bit more regard for it would exist.
The term “self-care” is largely thrown around, and seems nothing more than lip-service.

What has everyone else’s experience been? Does your service care more for your wellbeing as a worker? Do they do anything specific to address it?

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Re: Wellbeing in IAPT

Post by Sam1987 » Sun Apr 28, 2019 7:25 pm


I've worked in numerous IAPT services and it seems I have also experienced the same treatment as yourself. I have not felt entirely supported at any service I have worked for if I'm honest. When I worked as a PWP every so often I would get so burnt out that I would be signed off sick by my GP. The services I worked for at that time did do a phased return for a few weeks, but that's about it. I also do feel the term is "thrown around" but little is done to support staff. I have been diagnosed with ME since 2015, and my current service are not sure if they can put adjustments in place! I think its absolutely ridiculous and unfair if I'm completely honest. They're going to consider it with say so from HR. So I'll watch this space...
IAPT the tiger

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Re: Wellbeing in IAPT

Post by lakeland » Mon Apr 29, 2019 9:50 am

I'm not someone who works in IAPT but this worries me - I've heard so many people say that the workload in IAPT is too intense and that people struggle to do everything within the time they have. Is anyone looking into this on a more national level? I wonder if there's a downside to IAPT being made up of people from various professional backgrounds so that there's no collective voice advocating for IAPT workers.

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Re: Wellbeing in IAPT

Post by hawke » Mon Apr 29, 2019 10:18 am

I've had a good experience in IAPT in the past.

We were an IAPT+ NHS partnership service which gave us a bit more freedom. Rather than putting all of our efforts into screening people out of the service and fighting with secondary care, we instead introduced new pathways to meet the needs of the area. We were paid less (band 4 PWP, band 6 HI), but our caseloads were slightly lower. We worked to 6 clients a day (face-to-face treatment, phone assessments, some choice over the balance between the two), with a half day admin somewhere in the week, and with a morning off together midweek as a team for admin, meetings and supervision. That morning off midweek made the team, I think - I've never worked in a team that was so close and supportive. Our admin team were brilliant and well integrated into the team, so they worked to make our lives easier, rather than just working to processes. I remember having time in my day to work on extra projects that I felt were important. We had a management team that were responsive and democratic where they could be, so we felt we had control and autonomy in our roles. As PWPs, we had regular internal training as well as a HI in our supervision groups - so yes, we went beyond our official training, but usually in a way that felt supported. We had a monthly team-bonding session to use as we wanted to. I was given huge understanding and support when I was diagnosed with a long-term health problem that involved fatigue. Basically, we ticked off all the boxes of self-determination theory. I only left the team for career progression, but if clinical hadn't worked out, I would have been applying for HI training with them. Not that they came up very often, as their staff retention was so high - people who left, often came back!

There were of course problems, but compared to everywhere else I've worked, they were minimal. I also then worked for another IAPT service, who were also really supportive of me during a bereavement, although the service itself had many more problems. So there are good experiences to be had!

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Re: Wellbeing in IAPT

Post by LIWY » Sat May 04, 2019 2:38 pm

Good to read @hawke because my experiences in 10 yrs of IAPT were more similar to @Sam1987
It seemed to get ever worse because those that got promoted to management were those who were focussed on their own progression and/or had bought into the IAPT ideology and pushed staff hard to burnout whereas the caring, reflective, realistic higher level staff left, many to private practice, some to non-IAPT services, some just to retirement.
This article in this month's Therapy Today has much relevant to the discussion
https://www.bacp.co.uk/bacp-journals/th ... e-machine/
Have a look at Mike Scott's CBTWatch blog too.

I also went to some conferences and it seemed to me that the top levels of management lived in a world of dissonance. They said that the "IAPT manual" would sort everything out but it's done nothing from what I can see.

If IAPT was a private business it would long ago have failed. The training of PWPs in particular is so costly because so few stay in the role. The manipulation of statistics would have been uncovered. This strange mix of commerical tendering but no independent auditing has allowed a corrupted system to grow and grow it seems to me with many staff falling by the wayside and many patients being short changed.

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Re: Wellbeing in IAPT

Post by Bookend » Fri May 17, 2019 1:44 pm

The main people I have come across who say they enjoy working in IAPT are managers, I've met precious few front line clinical staff who feel the same. I've worked in two services, both nhs, one was hideous from day one the second initially supportive but went rapidly downhill after a new clinical lead was appointed. If I could I'd leave tomorrow I would but have a mortgage.

I'd second the recommendation for CBT watch - some interesting discussion on there.

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Re: Wellbeing in IAPT

Post by enchanted » Sat May 18, 2019 9:38 pm

Thanks for the replies everyone.
Fortunately, I’m in a position to leave IAPT, which I’ve chosen to do so. It was a tough decision to make, but I’ve decided to become a part-time locum whilst I consider other options. It’s really sad at its just not set up to support front-line staff. My wellbeing and health was beginning to suffer too much, and I just don’t want to sacrifice it anymore. I’ve lost a lot of faith in the system. PWPs don’t seem to be very protected.

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