The Industrialisation of Care: counselling, psychotherapy and the impact of IAPT
The UK government’s Improving Access to Psychological Therapies (IAPT) programme has transformed the landscape of counselling and psychotherapy across England. Local IAPT services provide therapy to thousands of people experiencing depression and anxiety. But they also absorb millions of pounds in government funding and stand accused of relying on an economic model of treatment that has more in common with the principles of Henry Ford than of either Rogers or Freud.
This book, with chapters written by experienced therapists, psychiatrists and academics, reveals the neoliberal roots from which the IAPT programme sprang. It critiques the tightly regulated, highly manualised and medicalised therapies IAPT offers, the constant surveillance under which its practitioners work and the dehumanising effects of this on clients and therapists alike. Together, contributors question whether and to what extent the IAPT ‘factory’ system of care, driven by psychiatric diagnosis, fast through-put and quick-win outcomes, can really provide a solution to our growing mental health crisis.
Foreword – Nikolas Rose
Introduction: The modern myths of IAPT – Rosemary Rizq
Part 1: The State We’re In
1. Neoliberalism: what it is and why it matters – Philip Thomas
2. The industrialisation and marketisation of healthcare – Penelope Campling
3. Throwing good money after bad: health services without care under marketised welfare – Marianna Fotaki
4. Positive affect as coercive strategy: conditionality, activation and the role of psychology in UK government workfare programmes – Lynne Friedli and Robert Stearn
5. CBT’s integration into societal networks of power – Michael Guilfoyle
Part 2: The State of the NHS
6. IAPT and the flawed ideology of diagnosis – Sami Timimi
7. Staying afloat: hope and despair in an age of IAPT – Andy Rogers
8. A critical appraisal of the economic model underpinning the Improving Access to Psychological Therapies (IAPT) programme – Scott Steen
Part 3: The State of the Workplace
9. Perverting the course of therapy: IAPT and the fetishisation of governance – Rosemary Rizq
10. The industrial relations of mental health – Elizabeth Cotton
11. At what cost? The impact of IAPT on third sector psychological therapy provision – Jude Boyles and Norma McKinnon Fathi
12. Industrialising relational therapy: ethical conflicts and threats for counsellors in IAPT – Gillian Proctor and Maeta Brown
‘This excellent and incisive book exposes the many misleading myths on which our national IAPT programme is based. These writers are fearless in exposing the faults in the system and suggesting avenues for necessary and vital reform.’
Dr James Davies, University of Roehampton
'This book should be on every reading list for every training course in psychotherapy.'
David Murphy, Associate Professor and Course Director for the MA in Person-Centred Experiential Counselling and Psychotherapy, University of Nottingham
‘This book just has to be read by anyone concerned with “mental health” – from the generality of psychotherapists and counsellors to politicians to cultural commentators.’
Professor Andrew Samuels, former Chair, UK Council for Psychotherapy
'It is deeply sad that this book has had to be written but thank goodness that it has, as it holds truth to power. These chapters offer a searching account of where we are with regard to psychological therapies and the malign intent of the neoliberal agenda that is set on destroying the welfare state and imposing a taxonomy that is unrelated to human life. The implications for the education of counsellors and psychotherapists are dire. Double-speak is not a dystopian Orwellian fiction; it is thriving in the 21st century and driving IAPT.'
Catherine Hayes, Assistant Professor in Counselling at the University of Nottingham