Access to psychological therapy via IAPT for adults presenting with depression and/or anxiety.

As the dementia progresses the person living with dementia may become angry or depressed, reducing their wellbeing and making it difficult for those that support for them. There are therapies available which can help improve the way they feel.

Your GP has more information about available psychological therapies and can help you decide if they are right for you and the person you care for. However, you can self-refer to these psychological services, known as Improving Access to Psychological Therapies (often shortened to IAPT).

For extra information, evidence and best practice please scroll down to the bottom of the page.

National offerings

Improving Access to Psychological Therapies

IAPT is widely-recognised as the most ambitious programme of talking therapies in the world and in the past year alone more than one million people accessed IAPT services for help to overcome their depression and anxiety, and better manage their mental health.
Weblinks:
NHS England » Adult Improving Access to Psychological Therapies programme
Find an NHS psychological therapies service (IAPT)

Healthwatch

Healthwatch is your health and social care champion. If you use GPs and hospitals, dentists, pharmacies, care homes or other support services, we want to hear about your experiences. As an independent statutory body, we have the power to make sure NHS leaders and other decision makers listen to your feedback and improve standards of care. Last year we helped nearly a million people like you to have your say and get the information and advice you need.
Telephone: Call: 03000 683 000 between the hours of 08:30 – 17:30 Monday to Friday
Email: enquiries@healthwatch.co.uk
Weblink: https://www.healthwatch.co.uk/your-local-healthwatch/list

Evidence

Cognitive behaviour therapy is a term used to describe a number of talking therapies which are used to overcome emotional and psychological problems. Cognitive behavioural therapy is commonly used to treat stress, anxiety and depression.

The word ‘cognitive’ refers to thinking, reasoning and memory. Cognitive behaviour therapy is also known as CBT.

There are alternatives to cognitive behaviour therapy. Other similar therapies include behavioural activation, acceptance and commitment therapy, cognitive analytic therapy, and mindfulness-based cognitive behaviour therapy.

There is evidence that psychological therapies including cognitive behaviour therapy reduce depression and anxiety for people living with dementia and mild cognitive impairment, as well as for family caregivers. See information from the British Psychological Society here

Improving Access to Psychological Therapies (IAPT) is a requirement for CCGs and providers

IAPT services are characterized by three things:

Evidenced-based psychological therapies: with the therapy delivered by fully trained and accredited practitioners, matched to the mental health problem and its intensity and duration designed to optimize outcomes. From April 2018 all clinical commissioning groups are required to offer IAPT services integrated with physical healthcare pathways. The IAPT Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms guidance is intended to help with implementation and sets out the ideal pathway for IAPT services.
Routine outcome monitoring: so that the person having therapy and the clinician offering it have up-to-date information on an individual’s progress. This supports the development of a positive and shared approach to the goals of therapy and as this data is anonymized and published this promotes transparency in service performance encouraging improvement.
Regular and outcomes focused supervision so practitioners are supported to continuously improve and deliver high quality care.

For the treatment of depression and anxiety disorders in the context of Long Term Conditions (LTCs), it has been concluded that:

psychological therapies are effective in people with and without LTCs
optimal results are obtained when psychological therapies are delivered to take account of the way in which LTCs interact with mental health problems and impact on daily functioning.

For this reason, it is recommended that the psychological therapies that are already used in IAPT services should be deployed in IAPT-LTC services.

You can find more information here and a guide to the IAPT-LTC pathway here

Best Practice Resources

Guidance from the NHS England Policy operational planning and contracting guidance 2019 - 2020 states that:

At least 75% of people referred to the IAPT programme should begin treatment within six weeks of referral.
At least 95% of people referred to the IAPT programme should begin treatment within 18 weeks of referral.