Epilogue: How Shall We Defeat the 6th Giant Now?

Clarke, Jeremy; Cundy, Paul; Yakeley, Jessica

doi:10.4324/9781003026020-9

Cited by 2 publications

(4 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…DIT is brief, goal‐oriented, in the here and now (8–16 sessions). It is proving to be a valuable addition to IAPT's offer (Clarke et al., 2020c). DIT is ideal also for psychiatry trainees to gain experience using psychoanalytic ideas.…”

Section: Imagine Turning Back the Clock: Dynamic Interpersonal Therap...mentioning

confidence: 99%

From here to I.A.P.T? (improving access to psychological therapies), preview for a new deal for dynamic psychotherapies: The psychoanalyst as street‐level bureaucrat

Clarke

2023

Appl Psychoanal Studies

View full text Add to dashboard Cite

This paper offers a preview of a forthcoming article on the world's first, universal free-to-access, evidence-based talking therapies programme to treat depression: Improving Access to Psychological Therapies. It was pioneered not in the USA, but the UK, in 2007. At one time it could have been led by psychoanalysts, but it wasn't. It was a New Deal, in fact, for CBT. But did this New Deal in 2007 also offer psychoanalysis an opportunity to renew its vitality as a discipline, after decades of being eroded by our long-term retreat into private practice? Illustrated in the film From Here to Eternity, through characters played by Burt Lancaster, Montgomery Clift and Frank Sinatra, this Preview shows how applied psychoanalysis can once again aspire to become a universal, genuinely popular, relevant professional discipline. How would we engage ethically with psychiatric casualties of war, for example, within an evidence-based practice framework today? A novel, brief psychoanalytic treatment for depression, Dynamic Interpersonal Therapy, was developed for use in the UK's Improving Access to Psychological Therapies (IAPT) programme. It is recommended by NICE (National Institute for Health and Care Excellence) as cost-effective for treating depression.

show abstract

Section: Imagine Turning Back the Clock: Dynamic Interpersonal Therap...mentioning

confidence: 99%

From here to I.A.P.T? (improving access to psychological therapies), preview for a new deal for dynamic psychotherapies: The psychoanalyst as street‐level bureaucrat

Clarke

2023

Appl Psychoanal Studies

View full text Add to dashboard Cite

show abstract

“…This was the genius invention of three psychoanalytic colleagues, whose combined talents came together at the right time, and in the right place, to produce the right outcome: Alessandra Lemma, Mary Hepworth (née Target), and Peter Fonagy (Fonagy et al, 2020). We are seeing a revival from the ground up-a new generation of practitioners in publicly funded services, using applied psychoanalysis to treat depression, and making a lasting difference to ordinary peoples' lives (Clarke et al, 2020). During IAPT's first phase (2008)(2009)(2010)(2011)(2012)(2013), I was the National Professional Adviser, which enabled me to oversee specification and commissioning of new therapy modalities that had been recommended by NICE for depression (NICE, 2009).…”

Section: Dream Team: the Invention Of Dit And The Revival Of Applied ...mentioning

confidence: 99%

“…The principle: iff the “least burdensome, most effective” treatments are offered first (stepped care), then moral hazard is reduced relies on decisions being made by trusted gatekeepers. Bower and Gilbody's (2005) review of evidence for stepped care was cautious: “Although psychological services might benefit from the adoption of the stepped care model, a substantial research agenda needs to be fulfilled before a judgment can be made as to whether stepped care might be an efficient method of delivering psychological services.” IAPT sought to test these relative benefits of efficiency, effectiveness and/or acceptability in its two “demonstration” pilots (Clark et al., 2009). But real‐world confounding factors got in the way of reaching a definitive answer.…”

Section: Reasons To Be Cheerful: One Two Threementioning

confidence: 99%

Section: Dream Team: the Invention Of Dit And The Revival Of Applied ...mentioning

confidence: 99%

See 1 more Smart Citation

A new deal for dynamic psychotherapies: The psychoanalyst as street‐level bureaucrat

Clarke

2023

Appl Psychoanal Studies

View full text Add to dashboard Cite

In the UK in 2007 a national experiment was initiated with the aim of tackling “Britain's Biggest Social Problem”—Depression. Improving Access to Psychological Therapies (IAPT) was devised as the solution. A universal free‐to‐access talking therapies program would make available evidence‐based treatment to all adults with depression. NICE (National Institute for Health and Care Excellence), the body that decides on what is cost‐effective, said CBT, not antidepressants, should be its first line offer. The starting gun was fired. The promise from IAPT was 3‐fold: to scale up access to CBT rapidly; to achieve recovery targets that would reduce the prevalence of depression over time; and—most ambitious of all—to ensure the Treasury would see a return on its investment by reducing the economic burden from depression. People who were on invalidity benefits due to depression would be supported back into employment. It was a New Deal for depression. As well as for CBT. But did it work? A decade and a half on with IAPT, are we in any position to give an answer? This paper will seek to draw lessons about “What Worked”, and what didn't, to ask ourselves a question: are we—those of us in the applied psychoanalytic community—willing to garner what can be learned from IAPT to advocate a new deal for evidence‐based psychoanalysis? Faced with challenges from unemployment and widening inequalities, against a backdrop where global economic recovery must heed the existential threats from climate change and ongoing warfare, to say nothing of the scale of loss and grief for those already impacted by bereavement due to the pandemic, the need for some such deal could not be more urgent.

show abstract

Epilogue: How Shall We Defeat the 6th Giant Now?

Cited by 2 publications

References 1 publication

From here to I.A.P.T? (improving access to psychological therapies), preview for a new deal for dynamic psychotherapies: The psychoanalyst as street‐level bureaucrat

From here to I.A.P.T? (improving access to psychological therapies), preview for a new deal for dynamic psychotherapies: The psychoanalyst as street‐level bureaucrat

A new deal for dynamic psychotherapies: The psychoanalyst as street‐level bureaucrat

Contact Info

Product

Resources

About