CBT emerged from Beck’s cognitive approach (1976) and the behaviourists (e.g.Pavlov, 1927 and Skinner, 1938). The origins of the methods are pure and noble; however in 2008 the NHS decided to use CBT to promote a sort of accessible model of therapy that became known as IAPT (Improving Access to Psychological Therapy). From that moment, IAPT CBT became extremely manualised and simplified. CBT lost its own essence in the NHS. Why did the NHS create such a model? They wanted to create something accessible and they used the so-called scientific method of seeing what type of therapy was more quantifiable. CBT seemed the most appropriate.
The common phrase used to describe CBT is ‘evidence-based’. The NHS created guidelines that legitimise and encourage the used of ‘evidence-based therapy’ (NICE guidelines). But what does it actually mean ‘evidence-based’?
2 - and most of all, the NHS wants symptom reduction.
The second point is a consequence of the previous one: the client might or might not experience less symptoms as a result of therapy. If, for example, a client is very avoidant and lives a very superficial existence, therapy will actually increase their existential anxiety. The IAPT model is nothing but a plaster on an existential wound.
What is now taught for IAPT therapists is nothing but a bastardised version of Beck’s vision. Beck talked about a relational approach, but IAPT is nothing but a sausage factory where people come and go thinking that they are going to be ‘fixed’ in 6 sessions. Therapy has nothing to do with IAPT. The term therapy is used inappropriately by the NHS. The IAPT model should be called psycho-education, or ‘guided self-help’.
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