Celebrating talking therapies at 10

Earlier this week NHS England marked 10 years of Improving Access to Psychological Therapies (IAPT) which, in 2018, supported more than one million people with their mental health. To mark 10 years of the programme, this joint blog gives the perspectives of a psychological therapist who joined IAPT in its early years, and a recovered former service user who has started a new career as an Employment Advisor in an IAPT service.

Rebecca Hughes, Service Lead

I joined the team as a Psychological Wellbeing Practitioner (PWP) trainee in 2010. I can still remember the day I was offered the job. I couldn’t believe the opportunity I had been given to learn new skills and make a difference to the lives of the people in my community. Looking back on my time as a PWP, a number of patients stand out: one I had seen in my previous role in a crisis mental health team. He could recognise where he needed to make changes, his risk levels significantly reduced and he no longer needed to access secondary care services. It was great to see him flourish with these extra skills. Another had Parkinson’s disease and struggled to accept his condition and its impact on his functioning. Giving him the tools to see things differently and adjust his lifestyle had a significant impact on his outlook and the management of his condition.

It was such a valuable experience working as a PWP that when I was given the opportunity to lead the team I jumped at the chance. I wanted the team to have access to the best resources, supportive and challenging supervision and engage regularly in good quality continuing professional development. As the service lead, I have been able to make changes so the whole team, including administration and leadership, have the same opportunities.

Over the last 10 years the workforce at my service increased from a handful of PWPs, cognitive behavioural therapy (CBT) and affiliate counsellors to three well-established teams with practitioners who provide core treatments as well as interpersonal therapy and other types. We have a focus on increasing access, building up the workforce and developing our Long Term Conditions pathway. It’s been a hectic and challenging few years building relationships with new partners in primary care. However, it’s been very rewarding and I couldn’t have done it without the skills and support of the whole team.

I believe the key to our success is to ensure every member of the team continues to get good quality supervision, good performance coaching and be aware of their contribution to the wider picture. It’s also important each member of staff gets the chance to expand their skills and pick up other roles within the service. I’ve learnt so much and continue to be passionate about IAPT. There is still so much we can do to support our community in its quest to achieve happier and mentally healthier lives.

Karla, recovered former service user

I have Ehlers-Danlos syndrome and Marfan syndrome – chronic illnesses that cause daily pain, heart issues and seep into every part of my life. My GP referred me to my local IAPT service as a result of mental health issues related to these long-term health conditions. I went through CBT. It challenges the way you think of yourself, your core beliefs and attitude towards yourself. In total, I used the IAPT service for six months. It helped me to take a step back. To look at the facts, not the thoughts. For me the key part was challenging my core belief that I was a weak person; I know now that’s false. We wrote a timeline of my life, my achievements big and small. It turns out there were a lot. Really seeing things was a big turning point and I’ve kept the timeline as a reminder.

Safe space and mindfulness exercises worked well for me, too. With safe space I recorded my therapist going through a script. It builds an image in your mind of a safe space, somewhere relaxing to decompress after the sessions. Mindfulness helped stop the overwhelming anxiety I could feel. I take a few minutes to be fully aware of what I’m doing, my feelings and thoughts. For me taking those few minutes to breathe and just be could help stop the circle of anxious thoughts. I can’t say my physical health improved – the difference is I have the tools to mentally deal with the negative thoughts about myself.

Following discharge, I was asked to take part in a webinar for IAPT clinicians. I wrote a small piece for the lead clinician explaining how IAPT had helped me deal with a long term condition. From this I was invited to speak to the clinicians about my experience of using the service as someone with a chronic condition.

I have started a new job, helping service users in the IAPT pathway as an Employment Advisor, ensuring they have support in the workplace, or helping them get back into work. As well as training, I have the lived experience of being in their shoes. If everything I’ve gone through means I can help one person, then it’s all been worth it. If you’re struggling, reach out.

Rebecca Hughes

After graduating in Psychology and Counselling, with post-graduate studies in Low Intensity Intervention, Rebecca Hughes began her career, in 2007, as an Employment Support Specialist for people with a learning disability in Boston, USA. At South West Yorkshire Partnership NHS Foundation Trust, she provided community support to individuals in crisis and experiencing common to severe mental health problems. In 2010 she joined Insight Healthcare talking therapies service in Calderdale, West Yorkshire, as a trainee Psychological Wellbeing Practitioner (PWP). Rebecca was appointed PWP Team Lead Insight Healthcare in 2014 and Service Lead two years later.

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