How well do IAPT services meet the needs of complex trauma clients
Research type
Research Study
Full title
How well do Improving Access to Psychological Therapies (IAPT) Services meet the needs of clients with a history of complex trauma?
IRAS ID
316692
Contact name
Batool Alalsayednasser
Contact email
Sponsor organisation
University of Exeter
Duration of Study in the UK
1 years, 6 months, 20 days
Research summary
Improving Access to Psychological Therapies (IAPT) are the major providers of psychological therapies in the UK NHS for depression and anxiety, seeing over a million people a year nationally, and over 600,000 go on to have a course of psychological therapy. IAPT services follow a stepped care approach, allocating milder cases to low-intensity interventions, and allocating more complex, severe, treatment resistant or recurrent presentations to high intensity interventions. Oure focus in the study will be the high intensity IAPT services.
Many individuals that present to IAPT services for treatment of symptoms of depression and anxiety have been exposed to complex trauma during development, which can lead to features of personality difficulty/disorder and/or complex post-traumatic stress disorder (PTSD) features alongside depression and anxiety. It is recognized that the needs of this group with these comorbidities have not been well served, in part leading to the community mental health transformation framework. More work is needed to understand the links between complex trauma and treatment engagement and clinical outcomes in IAPT to enhance the care that is provided.
This study will explore:
1) The prevalence of complex trauma exposure, current complex PTSD, and current personality difficulties/probable personality disorder in IAPT settings,
2) To what extent complex trauma history, current complex PTSD and current personality disorder are distinct constructs versus a related constellation of features,
3) To what extent complex trauma history, current complex Post Traumatic Stress Disorder (PTSD), and current Personality Disorder (PD) features (when considered individually and in combination with one another) are associated with treatment engagement and response in IAPT settings,
4) Whether associations between complex trauma history and engagement/outcomes are moderated by type of therapy clients are allocated to or characteristics of the care that they are offered,
5) To what extent positive childhood experience buffer against any detrimental effects of childhood complex trauma exposure.
Participants about to engage with high intensity treatment in IAPT services will be asked to complete a short online survey measuring exposure to complex trauma and positive childhood experiences during development, current symptoms of PTSD and complex PTSD, current levels of personality difficulties, and current levels of depression and anxiety and functioning. Answers to this survey will then subsequently be linked to routinely collected data in IAPT services to assess how these features predict treatment engagement and treatment outcome. This routine data includes measures of depression, anxiety and functioning taken during each treatment session and also clients pattern of engagement with treatments (sessions attended, cancelled and DNA’d; whether the client dropped out or had a planned discharge).REC name
London - Bromley Research Ethics Committee
REC reference
23/LO/0254
Date of REC Opinion
23 Mar 2023
REC opinion
Unfavourable Opinion